Health insurers seek big premium increases in RI, citing costs and rising demand

Health insurers are asking the state for large increase in health insurance premiums in 2023, citing increased visits and higher health care costs.

The proposed premium increases have to go through the Office of the Health Insurance Commissioner, which makes the final decision on how big an increase, if any, it will allow insurers to levy on their plans.

Cory King, chief of staff at the health commissioner's office, said the proposed increases are the biggest he's seen in eight years working for the commission.

Insurance premiums for plans bought on the state's individual market, HealthSource RI, are proposed to go up 9.6% for Blue Cross Blue Shield of Rhode Island and 6.8% for Neighborhood Health Plan of Rhode Island.

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For small businesses' plans, proposed increases are 11.7% for Blue Cross, 9.3% for Neighborhood Health Plan, between 10.8% and 12.3% for UnitedHealthcare and 10% to 9.2% for Tufts.

For the biggest group, larger employers, Blue Cross has proposed a 7% increase, UnitedHealthcare an 11.3% increase, Tufts a 10.4% increase, Aetna a 13.4% increase and Cigna a 8.5% increase.

What is driving insurers' requests to increase premiums?

This year, requests for premium increases are being driven by pent-up and "catch-up" demand for health care, as procedures and surgeries were postponed or canceled during the pandemic.

Add in inflation, affecting the cost of supplies and prescription drugs, and health insurers say premiums need to go up to cover their costs.

King said the commissioner's office always finds reasonable ways to reduce insurers' proposed premium increases.

"We can't just make things up, because the insurers can appeal the decision we've made, whether we've complied with the laws," King said.

Who is affected by the proposed rate increases?

Whatever final increases, if any, the commissioner approves will affect 172,746 people, or 16% of Rhode Island's population, although some likely live in other states and work for Rhode Island companies.

The proposed increases would affect the 42,658 people on the individual market, 47,433 people on small-employer plans, and 82,655 people on large-employer plans.

According to census data from 2019, 4% of Rhode Island residents reported they don't have health insurance.

In all, 52% of residents have employer-sponsored health coverage and another 38% have insurance through Medicare, Medicaid or the military, according to data from the Kaiser Family Foundation.

Many companies that provide health insurance either bear the cost of insurance themselves or pay for plans in other states, King said.

Last year, Attorney General Peter Neronha objected to proposed rate increases, between 2.9% and 17.5%, on the grounds that some plans would become unaffordable. State Health Insurance Commissioner Patrick M. Tigue approved insurance rates that reduced those increases significantly.

2022's increases: RI health insurance premiums rose in 2022 less than companies wanted

King said insurance companies didn't have to pay out as much last year because people weren't going to the doctor or accessing health care as frequently.

Public comment is open until July 12

Public comments will be accepted through July 12 via email to [email protected]. The commissioner's office will take comments during a virtual town hall, 4:30 to 5:30 p.m. on July 7.

"We appreciate when the public comments, because it helps us build our case of why premiums should be lower and what the impact of these increases is," King said. "It's useful evidence to incorporate into our process."

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Reach reporter Wheeler Cowperthwaite at [email protected] or follow him on Twitter @WheelerReporter.