Calling the increases "significantly higher than (she) would have liked," Insurance Commissioner
"We were trying to make a one-time correction ... we hopefully got these products to a place now where they are more accurately priced," Miller said.
Increases averaged 32.5 percent for individual plans and 7.1 percent for small group plans, according to a department news release. The annual open enrollment period during which people can buy and switch plans on the marketplace runs from
The insurer says new members were sicker than expected. Miller said Monday that insurers in
Many of the approved rates were higher than what the insurers requested in regulatory filings in May. Highmark's original requests ranged from 25 percent to 48 percent for its approximately 117,000 ACA members in the state.
Miller said the final rates followed a back-and-forth in which insurers threatened to abandon the market, which could have left some counties with no insurers selling the plans.
Aetna abandoned the market in
Highmark has sued the federal government in the
The Affordable Care Act required insurers to sell insurance to everyone no matter how sick, ending a longstanding practice of denying coverage or charging higher rates for the sickest. "Despite the progress we have made in getting more Pennsylvanians insured, we could not expect the Affordable Care Act to fix everything at once,"
"The rates announced by the
"It's what we needed to do for 2017, but for long-term sustainability things have to change with the actual ACA law and regulations," Miller said.
The law allows insurers to charge older people more per month for insurance but restricts how much more they can charge. People who are 64 can only be charged up to three times what the youngest members pay each month. Miller, of Highmark, said the oldest members' medical bills are closer to seven times what the youngest members pay, and the insurer supports changes to allow for a larger difference between premiums for the oldest and youngest.
The insurer also supports changes to prevent people from buying insurance, paying premiums for a few months while they get treatment and then abandoning the plans.
Both Highmark and
Highmark has reduced by 4.5 percent what it pays doctors to treat ACA patients.
People with individual and small-group plans -- for businesses with fewer than 50 employees -- make up about 10 percent of insured Pennsylvanians, according to the
The uninsured rate in
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