Rate proposals for insurers that plan to participate in the Obamacare exchanges next year range from a 5 percent reduction in cost in Providence, R.I., to an increase of 49 percent in Wilmington, Del., an analysis from the Kaiser Family Foundation shows.
Those increases in insurance premiums for the most part will be subsidized by the federal government, but individuals who make more than $48,000 a year are vulnerable to premium hikes that may take a significant toll on their finances or make them leery of buying coverage.
The Kaiser study examined rates for silver plans, which are mid-level plans, filed in 21 major cities, including the District of Columbia.
The second-lowest silver premium for an unsubsidized, 40-year-old non-smoker would range from a monthly rate of $244 in Detroit to $631 in Wilmington, Del., based on the initial filings.
The rates aren’t finalized, and insurers in each state submitted rates that aren’t easily comparable from one state to the next, but they offer an initial view of what to expect.
For instance, in some states insurers assumed that the federal government would enforce Obamacare’s individual mandate requiring people to buy insurance or pay a fine. Other states asked insurers to file rates that assume they would be receiving federal payments that they use to reduce out-of-pocket medical expenses for customers. The funds are mired in a legal battle, and President Trump has threatened to cut them off.
Without the payments, called cost-sharing reduction subsidies, and without the individual mandate, rates were higher.
Lawmakers have vowed to work together to help stabilize the exchanges for next year, and that could involve Congress appropriating the funds or suspending taxes that make coverage more expensive. Some insurers have left the exchanges amid the uncertainty about the law, but also because they have lost money doing business on the exchanges as too many sick, costly enrollees participated and created an unbalanced risk pool. The exits can cause disruptions for customers who must switch plans and often doctors and hospitals as well.
If cost-sharing subsidies are cut off, other insurers are likely to look to exit particular states or counties. Final contracts with states that sell plans on the federal exchange, called healthcare.gov and used in 39 states, are due Sept. 27.
The Kaiser Family Foundation data show that so far an average of 4.6 insurers plan to participate in the exchanges in the cities next year, compared with 5.1 in 2017.
Alleigh Marré, spokeswoman for the Department of Health and Human Services, pointed out that last year, premiums for plans sold on healthcare.gov increased by an average of 25 percent.
Analysts have blamed insurers for the increase, saying that they priced their plans too low to begin with, but have noted that a disproportionately sicker population enrolled in the exchanges than anticipated.
“Since Obamacare went into effect under the previous administration, skyrocketing healthcare costs and fewer choices have become the norm,” Marré said. “This analysis confirms what we already knew — Obamacare is flawed, failing and harming the American people. Inaction is not an option. The Trump administration is committed to repealing and replacing Obamacare and will always be focused on putting patients, families and doctors, not Washington, in charge of healthcare.”
• This article has been updated.
