Obamacare premiums set to rise next year, filings show

Premiums for Affordable Care Act coverage are on track for sharp increases next year, according to the current rate increase requests health insurers are seeking from the State Corporation Commission's Bureau of Insurance.

Most insurers offering plans in the Richmond area are proposing double-digit percentage increases, a bureau summary of average premium rates shows.

HealthKeepers, the largest Obamacare insurer in the state, covering 115,000 Virginians, is seeking an average increase of 12.6%, for an average monthly bill of $687.18.

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Sentara Health plans, covering more than 100,000 Virginians, are seeking an average increase of 22.7%, to $666.14.

Kaiser Foundation Health Plan, which covers more than 31,000 people, is seeking an average 11.3% increase, to $635.03.

Optimum Choice, which covers 6,200 people, is seeking an average 3.9% increase to $691.90.

Oscar Insurance Co., which covers 2,200 people, is seeking a 13.4% increase to $516.07.

The Bureau must still review the insurers' filings. In past years, it has rolled back many of the increases insurers request.

It looks at whether the insurers have been paying out at least 80% of premium revenue in claims and at projections for where healthcare costs are headed.

The amounts Virginians actually pay, and the increases they see, will depend on what kind of Affordable Care Act coverage they buy — plans that require high out-of-pocket spending, for instance, cost less. Other factors affecting Affordable Care Act bills include how many people are covered, their ages and their eligibility for tax credits.

The General Assembly, earlier this year, approved a $150 million fund to offset the impact of President Donald Trump's so-called "One Big Beautiful Bill," which ended an enhanced tax credit that had been holding down Affordable Care Act bills.

But the number of people keeping Obamacare coverage shrank dramatically with the end of the enhanced tax credits, said Doug Gray, executive director of the Virginia Association of Health Plans.

"The pool (of people with Affordable Care Act coverage) is getting sicker because many health participants left ... the pool that is left is much sicker, leaving much higher claims" with fewer people paying premiums to cover those rising costs, he said.

"There is no other choice than to raise premiums," he said.

The increases HealthKeepers and Sentara are seeking would also apply to people in Roanoke, Lynchburg and Danville, where they are the only two insurers offering Affordable Care Act coverage. In addition to HealthKeepers and Sentara Optimum, Oscar offers coverage in Martinsville.

One insurer, Aetna CVS left the Virginia Affordable Care Act market this year while Cigna will not be participating next year.

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