ACA Price Increase In Virginia Less Than Projected

Virginians who buy their health insurance on the individual market will see an average rate increase of about 9 percent in 2019, slightly less than the 13 percent increase that was anticipated earlier this year, according to the State Bureau of Insurance.

The average monthly premium is anticipated to be $796.29, less than the $830.18 from the insurance providers' initial proposed rates, but up from an average rate of $732.45 in 2018.

The lower rates are a result of new guidelines and pushback on the insurance providers' assumptions from the State Corporation Commission's Bureau of Insurance, David Shea, health actuary for the bureau, told the Health Insurance Reform Commission at a meeting of the legislative body Tuesday.

Shea estimated that the reduction from regulators saved about $81.6 million for Virginia residents insured through the Affordable Care Act individual marketplace.

The small group market, which has 16 insurance companies signed up, saw a negligible decrease in the average rate, from a proposed $530.48 to $529.30 approved.

Eight insurance carriers will offer plans for individuals on the exchange marketplace, and one carrier will offer individual plans that can be purchased directly. Virginia Premier Health Plan Inc., which is owned by VCU Health System, is new to the exchange. Six of those carriers offer individual plans in central Virginia and will have average premiums ranging from $584 from Cigna Health and Life Insurance Co. to $761 from Optima Health Plan, which is lowering its premiums by 7.2 percent compared with last year.

"These numbers look pretty high, admittedly," Shea said, explaining that rates could be much lower for younger people.

Most people who use the exchange receive at least some level of government subsidy that lowers their out-of-pocket costs.

Cigna insures the largest percentage of the more than 300,000 Virginians on the individual market, covering about 29 percent, followed by Kaiser at 22 percent, Anthem HealthKeepers at 21 percent and Optima Health Plan at 19 percent, according to data released by the State Corporation Commission Bureau of Insurance in July.

Rising rates and lack of competition in the insurance market have proved a challenge for Virginians, especially this year, when rates went up an average of 69 percent and about 70 percent of the state's cities and counties had only one insurance provider on the individual market. Charlottesville had some of the highest premiums in the country after Anthem HealthKeepers, the state's largest insurance provider, pulled out of the individual marketplace for 2018.

Anthem's return to the individual market brought the percentage of localities with only one provider down to 45 percent from 70 percent.

It was also a contributing factor to the comparatively low rate increases, Shea said.

"This year, fortunately, it is a competitive market," ha said.

Open enrollment for 2019 runs from Nov. 1 through Dec. 15.

bbalch@timesdispatch.com

(804) 649-6601Twitter: @bridgetbalch