The increases are across the board except for small-group coverage by UnitedHealthcare, which is reducing that rate by almost 4 percent.
New Mexico Health Connections is boosting individual rates 33 percent.
The biggest boost of 93 percent went to
"No final decisions have been made regarding our offerings in 2017," said
Insurance executives defended the rate increases as a necessity of doing business.
"I think the market needed a significant correction," said
Some of the hikes for companies that sell through the HealthCare.gov portal, also known as "Obamacare," have to be formalized by the
Taxpayer subsidies will temper some of the rate increases. A federal official says the advertised rates are before the federal subsidy and tax assistance is applied to applications.
And an analysis released this week by the
"Headline rate increases do not reflect what consumers actually pay," said
But the big increase for Health Connections is a result of a complicated formula imposed by the federal government that tries to spread the costs of sicker patients among many insurers.
"We all feel terrible here about the price increase," said Dr.
Health Connections has 28,000 individual members and 15,000 small-business employees in group plans. The nonprofit is challenging a mandate under the Affordable Care Act that it pay
Even though Hickey and others say the assessment is unfair to smaller carriers, this year's hikes are needed as a cushion. "We paid a whole lot of money to someone who isn't even on the exchange this year, and we have to cover that," Hickey said.
That means Presbyterian's customers will not be receiving government assistance to pay premiums.
Presbyterian is helping those who now have their exchange plans and want to keep their doctors, Fryar said. Those patients should call the insurer.
Presbyterian also sells a small-group preferred provider plan under an affiliate,
Vox Media reports that there is just one insurer signed up to sell in 687 U.S. counties in 2017 on the HealthCare.gov marketplace. That's nearly four times the number of counties that had just one offering in 2016.
"In 2016, 66.8 percent of Healthcare.gov counties had three or more insurers. In 2017, only 44.3 percent of counties are on track to have this level of competition," Vox reports.
Duhamel said carriers are getting more of an understanding of the population and who is obtaining individual insurance. The office has worked hard to make sure there is sufficient consumer choice and the state has a range of options from an insurance cooperative, to nonprofits as Christus Health Plan to multistate companies as Molina and
"For a smaller state, we have one of the more diverse markets in the country," she said.
The rate-review process began in April with companies submitting 2017 requests along with demographic and claims data. That was reviewed by Franchini's office and evaluated by outside actuaries. The final recommendations were released Wednesday.
The concept behind the universal health insurance mandate in the Affordable Care Act is to even out risk so not just sick people pay premiums.
In order for insurance companies to achieve that balance, some 40 percent of those insured need to be between the ages of 18 and 34, a population that is relatively healthy. Nationally, that number is closer to 28 percent.
So if higher premium rates drive more younger workers away from insurance, and they opt instead to pay a penalty with their federal taxes, that puts more stress on those who remain in the pool.
With higher prices, more might opt out, he said. "They might say, 'I'm going without it,' " Gallegos said. "We'll see, I think it's too early to tell."
"Not having everyone in the pool is leading to a lot of instability," added Fryer. "We see that in our numbers and it's having a tremendous effect."
Officials with the New Mexico Health Insurance Exchange, bewellnm.com, were not available to The New Mexican for comment on this story.
(c)2016 The Santa Fe New Mexican (Santa Fe, N.M.)
Visit The Santa Fe New Mexican (Santa Fe, N.M.) at www.santafenewmexican.com
Distributed by Tribune Content Agency, LLC.