Insurance rates on Affordable Care Act exchange for Illinois stabilizing

Oct. 07--Illinoisans shopping this fall on the state's online health-insurance marketplace for 2019 coverage will pay the smallest average annual rate increases in at least three years.

"In fact, many consumers may see a decrease in rates," Jennifer Hammer, director of the Illinois Department of Insurance, told The State Journal-Register on Friday.

Consumers will see average 4 percent increases in monthly premiums for "silver" plans and 6 percent increases for "bronze" and "gold" plans on HealthCare.gov, Hammer said.

Those increases are based on rates submitted to the state by insurance companies that plan to participate in Illinois' health-insurance exchange.

The rate changes don't reflect federal subsidies for monthly premiums that are provided through the Affordable Care Act for people with incomes up to 400 percent of the federal poverty level, Hammer said.

More information will be released by the state this week on rates for health plans that consumers can choose during this year's open-enrollment period for the Illinois marketplace, she said. Open enrollment will run from Nov. 1 through Dec. 15 for plans that take effect Jan. 1.

The more-modest increases indicate that Illinois' health-insurance market is stabilizing as part of a trend being seen across the country as insurers get better at predicting what it will cost to insure people seeking coverage through state-level insurance exchanges, Hammer said.

"When insuring the subsidized population, they're starting to understand how sick those people are," she said. "We're excited that consumers will finally have some relief after facing years of average double-digit rate increases."

More choice for consumers will come with the addition of a fifth insurance company that will sell health plans on the exchange, Hammer said.

Gundersen Health Plan will join Celtic Insurance Co, also known as Ambetter; Health Alliance Medical Plans; Cigna; and Blue Cross and Blue Shield of Illinois as options on the state's online marketplace this fall, she said.

The Springfield area will be served by two companies on the exchange, Health Alliance and Blue Cross and Blue Shield, she said.

The rate situation will offer a welcome respite for consumers, but it's unclear how much of a difference the new rates will make overall, Hammer said.

That's because many people who don't qualify for subsidies still find plans on the exchange unaffordable, a result of "structural flaws" in the Affordable Care Act, she said.

Republican Gov. Bruce Rauner, who controls the Department of Insurance, has said he likes the ACA's protections for people with pre-existing conditions and the law's requirement that allows children to remain on their parents' employer-sponsored insurance until age 26.

But the governor said the ACA has shown "dramatic weaknesses and flaws."

In the 2017 open-enrollment period for plans that began in January 2018, 334,979 people in Illinois -- and 3,931 people in Sangamon County -- selected a marketplace plan, according to the U.S. Centers for Medicare and Medicaid Services.

The average unsubsidized premium for Illinoisans on the exchange was $644, though eight out of 10 enrollees received federally mandated assistance that reduced their cost of premiums or other out-of-pocket costs, such as deductibles, co-payments or co-insurance.

For enrollees benefiting from that assistance, their average premium was $135.

Hammer said she doesn't know whether rates proposed for 2019 would be even more favorable for consumers if President Donald Trump and Congress hadn't made certain decisions in 2017.

The Republican president used his executive authority last year to stop federal payments to insurance companies. Those payments, set in motion by the 2010 health-care law passed while Democrat Barack Obama was president, had been used to subsidize insurance companies' costs for offering cost-sharing assistance.

Federal subsidies continue to flow to insurance companies for premium assistance.

And the GOP-controlled Congress last year rescinded federal tax penalties associated with the ACA's individual insurance mandate.

The changes, along with constant Republican threats to repeal the ACA, were part of actions to "sabotage" the law by politicians who then said the law was flawed and imploding, according to Stephanie Altman, director of health-care justice for the Sergeant Shriver National Center on Poverty Law.

Altman said she was happy to hear about premium rates stabilizing on the Illinois exchange for 2019.

The stabilization could have happened two years earlier if not for the efforts of Trump and Republicans in Congress, she said.

The actions in Washington, D.C., prompted nervous insurers to institute rate increases most keenly felt by people who don't qualify for premium subsidies or cost-sharing assistance, Altman said.

Hammer said the Department of Insurance operates GetCoveredIllinois.gov to help state residents be wise consumers as they shop on the exchange and learn about the ACA-subsidized expansion of Medicaid eligibility and other insurance options.

Those options, she said, include what are known as "short-term limited duration" health plans, the terms of which have been expanded by Trump.

ACA supporters have criticized the president for expanding the potential time period those plans can cover because the plans are allowed to exclude certain health conditions from coverage. A bill in the Illinois General Assembly that would have limited the terms of those plans was vetoed by Rauner this year.

Hammer said insurance department officials will conduct a statewide tour in village halls and public libraries to educate consumers during the open-enrollment period.

"We know that purchasing health insurance is extremely confusing, and we are there to help," she said.

Hammer said she will encourage consumers to "shop around and utilize the tools available to them to be educated about the product that they're purchasing."

Contact Dean Olsen: [email protected], 788-1543, twitter.com/DeanOlsenSJR.

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Illinois health-insurance marketplace in 2018

Counties; Number of enrollees; Enrollees with income-based subsidies; Average monthly premium; Avg. premium paid by enrollees qualifying for subsidies

Sangamon; 3,931; 3,319; $709; $124

Cass; 317; 288; $739; $111

Christian; 721; 650; $768; $128

Logan; 757; 647; $709; $120

Macoupin; 1,231; 1,137; $833; $67

Menard; 235; 209; $771; $137

Montgomery; 712; 639; $821; $53

Morgan; 852; 763; $745; $137

Source: U.S. Centers for Medicare and Medicaid Services

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