Pennsylvania Obamacare insurers ask for a 5 percent increase next year

June 06--Insurers want to raise premiums on Obamacare plans by about 4.9 percent for 2019, the Pennsylvania Insurance Department said Tuesday.

The good news is that consumers in about half of Pennsylvania's counties will have more options, as insurers will offer more plans in the Affordable Care Act marketplace. The department declined to share which counties will have more competition, so as not to influence insurers as they set final prices, Insurance Commissioner Jessica Altman said. The number of counties with just one insurance company offering marketplace plans will decrease from 20 to eight.

Nearly 20,000 Lehigh Valley residents are covered under Obamacare, and three insurance companies -- Highmark, Capital BlueCross and Geisinger -- offer more than a dozen Obamacare insurance plans in the region.

The Insurance Department compiled an aggregate price increase percentage based on requests by insurers offering plans in the marketplace. More county-specific estimates and offerings will be released in July, with final rates set in the fall.

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

Nearly 390,000 Pennsylvanians signed up for insurance through the Affordable Care Act for this year, according to the U.S. Department of Health and Human Services.

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.

President Donald Trump and Republican lawmakers have made several significant changes to the health law in the past year, including eliminating the requirement that people have health insurance and reducing subsidies.

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

The mandate repeal likely prompted insurers to rise prices in numerous states, said Cynthia Cox, a program director at Kaiser Family Foundation, a nonprofit focused on health care policy.

Pennsylvania's marketplace fared better than other states, some of which are expecting premiums to rise by double digit percentages.

Pennsylvania may have a lower rate increase because of higher increases in the previous year, said Robert Laszewski, president of Health Policy and Strategy Associates in Alexandria, Va.

"PA got clobbered by the huge rate increases early and now that the prices are sky high it is not necessary for the carriers to increase the rates by big margins," he said.

Despite the relative stability of the marketplace, people who don't qualify for financial assistance for premium prices are suffering, Laszewski said. In Pennsylvania, 1 in 5 people who buy plans from the marketplace do not receive subsidies.

"Before Obamacare the poorest and those with pre-existing conditions in the individual market had poor health insurance options," he said. "Today, the poor and the sick have much better options, but the healthy in the middle class [not subsidy-eligible] are the ones who are the big losers."

Last year, insurance companies in the Lehigh Valley raised Obamacare rates up to 49 percent. Statewide, the increase was 31 percent, a response to federal cuts, state officials said.

In Pennsylvania, the average premium for a middle-of-the-road insurance plan this year is $312, according to the Insurance Department.

Insurance Commissioner Altman and U.S. Sen. Bob Casey, a Pennsylvania Democrat, blamed Republican policy changes for the recent prices increases.

Democrats and Republicans were quick to blame each other for rising prices in past years.

The initial price increases, when Democrats first rolled out Obamacare, were largely due to the cost of covering pre-existing conditions; essential benefits such as maternity care and mental health; and chronically ill people, Cox said. Later prices hikes were due to insurers underestimating the cost of offering benefits to previously uninsured people.

Because of multiple years of significant price hikes, insurance companies across the country are making money off the marketplace and thus making the marketplace stable, health experts said. Insurers are no longer leaving the marketplace, Cox said.

And the program has gained popularity.

A Kaiser poll last month found that 49 percent of people favor Obamacare, compared to 43 who do not. That's a flip from two years ago, when only 38 percent of people found Obamacare favorable, and 49 percent did not.

Bhuang@mcall.com

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