More options for Lehigh Valley Obamacare buyers

July 24--Lehigh Valley residents seeking insurance through the Affordable Care Act's individual marketplace will have more options in 2019, according to filings released Monday by the Pennsylvania Insurance Department.

Buyers across the state will have more options as well with premiums rising less than 1 percent despite the Trump administration's moves to chip away at the federal health insurance program.

UPMC, a Pittsburgh-based insurance company, will offer plans in Lehigh County for the first time next year. Its offerings add to the growing number of plans available in the county.

Next year, residents will be able to choose from 30 individual plans of varying coverage and price. This year, they were offered 15.

Northampton County residents also will have more choices -- 26 plans are available for individual buyers next year compared to 15 this year.

The trend is statewide. Four out of the five companies that offered individual insurance plans will expand through more of Pennsylvania in 2019,Insurance Department Commissioner Jessica Altman said. One new company, Pennsylvania Health & Wellness Inc., entered the state market.

The expansion speaks to a healthy individual insurance market in Pennsylvania, Altman said.

"I do often think carriers, or insurers, have a sense that their market is getting more competitive and that does have a positive influence in bringing rates down," she said.

Altman said she did not know whether companies knew of their competitors' requested rates before Monday, though expectations of increased competition may have tempered any price increases.

The average statewide requested increase is 0.7 percent. In previous years, premium increases had averaged more than 30 percent in Pennsylvania, according to The Associated Press.

The big rate hikes in years past may be the reason the 2019 rate increases are so small, with some companies even decreasing premiums, said Gary Claxton, vice president of the Kaiser Family Foundation, a nonprofit, nonpartisan organization focusing on national health issues.

Companies have to pay out a certain percentage of what they take in to pass regulatory muster, and raising rates could mean they have to rebate customers.

"Not only is there the fact that they have competitors keeping their premiums low, there's also this regulatory constraint," Claxton said. "If they have to raise premiums beyond what they need, eventually they have to give the money back."

A modest increase is good for consumers, he said.

The state Insurance Department previously expected the price increase to be almost 5 percent. The department said it lowered projected increases after it reviewed 2018 costs, including federal cost-sharing payments covering deductibles, co-payments and co-insurance for lower-income buyers, AP reported.

The expected prices of monthly premiums on plans to be offered in the Lehigh Valley ranged from about $486 to $727, according to the filings released Monday. Three insurance companies, Capital Blue Cross, Geisinger Health and Highmark, will offer plans in Northampton County in 2019. Those three, plus UPMC, will offer plans in Lehigh.

------

Northampton County expected monthly premiums

Silver plans for 40-year-old nonsmokers, not including subsidies

Capital Blue Cross: $496 -- $590

Geisinger Health Plan: $575 -- 690

Geisinger Quality Options: $607 -- $727

Highmark: $538 -- $692

------

------

Lehigh County expected monthly premiums

Silver plans for 40-year-old nonsmokers, not including subsidies

Capital Blue Cross: $496 -- $590

Geisinger Health Plan: $575 -- $690

Geisinger Quality Options: $607 -- $727

Highmark: $538 -- $692

UPMC: $486 -- $590

------

About 390,000 Pennsylvanians are covered under Obamacare, according to the U.S. Department of Health and Human Services. Of those, about 20,000 live in the Lehigh Valley.

Most people won't see a significant difference in their premium prices because federal financial assistance typically increases to match price hikes. Those who don't qualify for subsidies will have to pay more.

Claxton recommended customers shop around for 2019 plans instead of automatically renewing previous insurance plans, especially since some companies offering plans in the Lehigh Valley decreased their premiums. Capital Blue Cross requested a 20 percent rate decrease for one of its plans, for example.

The state's announcement of 2019 projected premium prices followed another year of Obamacare news.

President Donald Trump repealed the requirement for individuals to buy health insurance and has encouraged legislators to repeal and replace Obamacare.

A repeal of the individual mandate likely will reduce the federal deficit by about $338 billion in the next decade but increase the number of uninsured people by 13 million, a 2017 Congressional Budget Office estimate shows.

Enrollment for 2018 fell about 9 percent short of the 2017 numbers after federal officials cut the enrollment period in half and reduced funds for advertising and enrollment assistance.

The people who have chosen not to purchase insurance in Pennsylvania are not disproportionately healthy compared to those who did, Altman said. That's a good thing -- Altman said it means the "risk pool" is fairly stable.

The administration has also cut funding programs that help people enroll.

In Pennsylvania, national funding that pays navigators who help people sign up for Obamacare decreased 87 percent since 2016, according to a Kaiser Family Foundation report. Those new to the federal marketplace may have a harder time finding navigators to explain the process.

These cuts to enrollment programs affect vulnerable populations, such as those who do not speak English or don't have the documents to sign up for health insurance, said Karen Pollitz, a senior fellow at Kaiser Family Foundation.

The Centers for Medicare and Medicaid Services said enrollment program funding decreased because people are gaining familiarity with Obamacare and no longer need the same level of face-to-face assistance.

But Obamacare enrollees are not long-term insurance buyers, Pollitz said. They may have aged out of their parents' plan or lost their jobs.

"There's no learning curve," Pollitz said. "This is a market that by definition churns. There's always new people buying coverage."

___

(c)2018 The Morning Call (Allentown, Pa.)

Visit The Morning Call (Allentown, Pa.) at www.mcall.com

Distributed by Tribune Content Agency, LLC.