Cost for Marylanders buying exchange health insurance may drop again

Those who buy their own health insurance through the state's health exchange are likely to see lower premiums for the third year in a row - a major turnaround from price spikes so large that customers and insurers had fled the market.

Carriers have proposed rates for 2021 that are an average of 4.8% less expensive than this year, according to the Maryland Insurance Administration, which oversees plans sold under the Affordable Care Act.

The state agency will hold hearings and tweak the prices by mid-September, ahead of a fall enrollment period.

"We are pleased with the continued downward trend that we see in the proposed rates," said Kathleen A. Birrane, Maryland insurance commissioner. "It is important to remember that these are the rates requested by insurers and not necessarily the rates that will be approved."

The proposed rates come from two current exchange providers, CareFirst BlueCross BlueShield and Kaiser Permanente, and one returning carrier, UnitedHealthcare. UHC had a small market share and left the market in 2017.

Officials largely credit the drop in prices and UHC's return to a state program that helps carriers pay for their most expensive customers. The Maryland General Assembly created a program to make up for payments to insurers that were stopped by the Trump administration. The administration continues to challenge the constitutionality of the overall health care law, and a decision is expected in the fall.

"Although these are just proposed rates, it's exciting that Maryland Health Connection will offer lower rates for the third year in a row," said Michele Eberle, executive director of the Maryland Health Benefit Exchange, which oversees the online marketplace. "Also, UnitedHealthcare's return to the marketplace will give Marylanders more choices for a health plan that fits their needs."

The average proposed drop is 4.8%, and affects just over 150,000 people now in the individual market.

CareFirst HMO customers, typically a popular plan, will see a decrease of 1.1%. CareFirst PPO customers would get a 12% decrease. Kaiser customers would get an 11% reduction.

Most people enjoy public subsidies to pay premiums. But without those subsidies, a 40-year-old person in metropolitan Baltimore who buys the lowest-cost Silver plan (a mid-priced plan) would pay $294 monthly with a $3,200 deductible.

Those buying the CareFirst HMO would pay $351 with a $2,250 deductible. Those on the UHC HMO would pay $380 with a $4,500 deductible. Those with the CareFirst PPO would pay $543 with a $3,000 deductible. Deductibles are the amount consumers have to pay before insurance kicks in.

"As the exchanges have matured and stabilized, we intend to offer exchange plans in those states where we can provide an efficient network and competitive product capable of driving sustainable value for consumers and our state and federal partners," Sara Belfry, a spokeswoman for UHC, said in a statement.

UHC will provide plans in several Maryland counties where only CareFirst plans have been available in recent years. The number of counties with only one carrier will drop to eight from 13, according to the insurance administration.

Brian D. Pieninck, CareFirst president and CEO, said the coronavirus pandemic could yet influence rates.

"As part of our initial rate filing, CareFirst has not included any adjustments, upward or downward, to reflect COVID-19 impacts on expected healthcare costs," he said in a statement. "As more data and information becomes available, we will remain committed to market stability and to working with the Maryland Insurance Administration to finalize appropriate rates for 2021."

Kaiser also said it was working to keep rates affordable in uncertain times.

"Our proposed 2021 individual and family plan rates represent our efforts to ensure we can sustain and deliver high-quality health care for all our members over the long term," said Marisa Lavine, regional spokesperson for Kaiser.

A special enrollment period for insurance due to the coronavirus, which ends June 15, has led about 40,000 more people to sign up for coverage.

Proposed rates for small business plans also were released and show an average increase of 5.3%, though three of nine plans offered by four carriers proposed a drop in premiums. The plans would affect about 266,000 workers. The insurance administration will hold a hearing July 15.