Acting Insurance Commissioner Announces Approved 2018 Individual, Small Group Rates, Highlights Opportunities to Lessen Impact of Trump Administration Actions on Pennsylvania Consumers

HARRISBURG, Pa., Oct. 16 -- The Pennsylvania Insurance Department issued the following news release:

Acting Insurance Commissioner Jessica Altman today announced the approval of 2018 individual and small group health insurance rates. Because of President Trump's deliberate disruption of the individual market by discontinuing cost-sharing reduction payments to insurers and Congress's inaction to appropriate these funds, rates will increase by an average 30.6 percent in the individual market. Original projections indicated an increase of 7.6 percent.

"It is with great regret that I must announce approved rates that are substantially higher than what companies initially requested," said Acting Commissioner Altman. "This is not the situation I hoped we would be in, but due to President Trump's refusal to make cost-sharing reduction payments for 2018 and Congress's inaction to appropriate funds, it is the reality that state regulators must face and the reason rate increases will be higher than they should be across the country."

Governor Wolf, Acting Commissioner Altman, and Former Insurance Commissioner Miller have warned President Trump and administration officials about the potential impacts of failing to make a long-term commitment to paying cost-sharing reductions. If the Trump Administration had committed to making payments for cost-sharing reductions and alleviated uncertainty regarding the individual mandate, rates would have increased by an average of 7.6 percent rather than 30.6 percent. Small group market rates sold to employers with 50 or fewer employees will increase by an average of 7.6 percent for 2018.

"The president's deliberate action and Congress's failure to appropriate these funds despite repeated requests is forcing large rate increases on consumers in Pennsylvania and around the country, but my department is doing what we can to help our consumers understand their options and hopefully shield them from these rate increases," said Acting Commissioner Altman.

Under the Affordable Care Act, plans are available at four levels - platinum, gold, silver, and bronze. These levels represent different levels of cost-sharing based of monthly premiums and total out-of-pocket costs. A bronze plan will normally have the lowest premium but could have the largest out-of-pocket costs, whereas a platinum plan would have the highest monthly premium but lowest deductible. Because cost-sharing reductions are only available on silver plans, rate increases necessitated by the non-payment of these cost-reductions will be limited to silver plans. On-exchange bronze, gold, and platinum plans and off-exchange silver plans will not be impacted by these disproportionate increases.

Premium subsidies are calculated based on the cost of silver plans in each rating area, and subsidies increase in connection with rate increases. Because rates are rising on silver plans due to cost-sharing reduction non-payment, premium subsidies may be generous enough to allow an individual who qualifies to purchase a gold-level plan that has more favorable cost-sharing at a lower price than previous years.

Acting Commissioner Altman strongly encouraged individuals who do not qualify for premium subsidies to consider off-exchange options. The department worked with each of Pennsylvania's five marketplace health insurers to ensure they would offer an off-exchange only option that is not impacted by the disproportionate rate increases for on-exchange silver plans. Off-exchange plans must be purchased directly through one of Pennsylvania's five marketplace insurers or through an agent or broker licensed by the department to sell on behalf of these companies.

The Pennsylvania Insurance Department is partnering with Consumers' Checkbook again this year to create a shopping tool that allows consumers to compare both on-exchange and off-exchange plans available in Pennsylvania. Consumers can enter their income to see what subsidies may be available to them and estimate the monthly premium and total annual cost of plans in their area. If consumers find a plan they would like to buy, the plan comparison tool will take them to either Healthcare.gov or the company's website to make a purchase. Consumers can visit https://pa.checkbookhealth.org to use the plan comparison tool.

Open enrollment for 2018 health insurance runs from November 1 until December 15 - a change from previous years. Consumers must sign up by December 15 in order to have coverage effective January 1. The open enrollment period may be the only time consumers can enroll for 2018, and those who do not purchase a plan may be subject to a penalty as well as being uninsured for the year. On-exchange plans can be purchased at Healthcare.gov. Consumers who need assistance enrolling may visit localhelp.healthcare.gov to find free resources in their area.

"While there has been much conversation this year regarding the Affordable Care Act's future, it remains law. The benefits, consumer protections, and financial assistance that law provides are still available," said Acting Commissioner Altman. "I strongly encourage all Pennsylvanians who need coverage to use our plan comparison tool to find the best plan for them and protect their and their family's health by enrolling in coverage for 2018."

For more information on 2018 rates and resources for shopping for health insurance, visit www.insurance.pa.gov.