MTPR

Insurer Cites D.C. Uncertainty For Higher Health Premiums

Sep 28, 2017

It's about one month until open enrollment starts for health insurance plans sold on Healthcare.gov. Yesterday Montana's biggest health insurance company said it won't attempt to adjust its premiums downward for next year.

Montana's health insurance companies submitted their proposed prices for next year to the state Office of Securities and Insurance in June. At the time, Blue Cross and Blue Shield of Montana said that they could charge substantially less if there were no substantial changes in how the Affordable Care Act, or ACA, is administered.

On Tuesday Republican Senate leaders in Washington said they're withdrawing their latest attempt to repeal and replace that law, also known as Obamacare. But John Doran, a spokesman for Blue Cross Blue Shield in Helena said Wednesday that doesn't mean the health care law will be enforced as the Obama administration intended.

"There's been a lot of discussion in Congress of course about the different types of plans, the repeal and replace, none of those have come to fruition," Doran said, "but there still hasn't been that certainty on the provisions that exist today in the ACA, and that's what we need for 2018."

Specifically, Doran says, there's uncertainty that the Trump administration will enforce the individual mandate that requires most Americans to have health insurance or pay a penalty. Nor has the administration said it will continue funding so-called “cost-sharing reductions” that help lower income people with insurance co-pays and deductibles. If either or both of those provisions go away, Doran says, insurance companies could see big hits to their bottom lines, making it harder for them to pay claims.

"There's still no guarantee that the rules of the road won't change for 2018," Doran said, "and again, the components of the ACA might still be in place, but whether or not those are enforced is really the uncertainty that we've put into play in our 2018 rates."

In July Blue Cross and Blue Shield's CEO said that if all the components of the ACA remain in place, they would only have to raise their prices by a little over two percent. But with continuing uncertainty, the company will be raising prices by more than 17 percent. The two other insurance companies that sell policies in Montana on Healthcare.gov, PacificSource and Montana Health Co-op, have said they'll raise prices next year by seven and four percent respectively.