Preliminary 2018 NY State of Health insurance rates announced

Aug. 17--Tweet

The state Department of Financial Services released preliminary health insurance rates for the 2018 individual and small group markets on Tuesday. The department had reduced insurers' requested rate increases by more than 3.8 percent overall. This would mean that rates will continue to increase, but increase by less.

Small group markets (for small businesses) will see rate increases of 9.3 percent.

The announcement stated that "the overall average 2018 cost of coverage for individuals who purchase the lowest-cost silver level plans ... will decrease by as much as 5 percent, compared to 2017 rates when federal tax credits are applied."

The State Department of Health reported the lowest number of uninsured New Yorkers on record, as of the open enrollment period on Jan. 31 of this year. Since 2013, the number of New Yorkers who go uncovered has halved, from 10 to 5 percent.

As of May, approximately 18 percent of the state's population participates in the health care marketplace. Thousands of north country residents -- including 119,987 people in Oswego County, 114,006 people in Jefferson County, 110,038 people in St. Lawrence County and 26,957 people in Lewis County -- are enrolled in insurance through the marketplace.

The reduced request 2018 rate increases are estimated to save small businesses $166 million, and individuals more than $59 million.

The Department of Financial Services Superintendent Maria T. Vullo called the marketplace "robust" even in the face of "ill-conceived Congressional attempts to repeal or replace the Affordable Care Act."

The department said it "is taking appropriate measures to counter the destabilizing actions of the federal government," which had caused some insurers to raise their rates in response to such uncertainty. A smaller group of people purchasing the more expensive coverage would further drive up premiums.

Individual enrollment in both the Essential Plan for low-income individuals and in Qualified Health Plans has also grown, increasing by 39 percent in the last year. Those who enroll in 2018 may face unique challenges after a new federal regulation by the Department of Health and Human Services shortened the open enrollment period by six weeks.

"The latest numbers offer further proof that the Marketplace is vital to the state's health care system, providing consumers with the health coverage they need," said DOH Commissioner Dr. Howard Zucker in a public statement, calling the state a national leader in quality, affordable health insurance enrollment.

"This past open enrollment period was our busiest yet, demonstrating that New Yorkers want and need affordable health insurance coverage," said Executive Director of NY State of Health Donna Frescatore in May. "Enrollment increased in every corner of the state, showing that we're successfully reaching consumers and meeting consumer demands."

The Department of Financial Services estimated that 350,000 New Yorkers are enrolled in an individual commercial health insurance plan, and the rates are more than 55 percent lower than prior to the marketplace's establishment in 2014.

The marketplace's 2018 premium rate increases are mainly driven by "underlying medical costs," with drug costs accounting for the largest share at 26 percent, followed by inpatient hospital costs at 19 percent, physician specialty services at 12 percent, and diagnostics at 10 percent.

State officials had taken strong action before to defend the Affordable Care Act and the health care marketplace before. In June, Gov. Andrew M. Cuomo mandated that health insurance providers do not discriminate against residents with pre-existing conditions, and maintained the categories of essential health benefits guaranteed by the ACA.

In a national first, the state also "took action to ensure that all medically necessary abortion services are covered by health insurance services without cost sharing, and that contraceptives are made available to women with no capos or deductible in amounts exceeding one month's supply at a time."

New York also redoubled its protection for transgender people by issuing a letter Wednesday stating that health insurance issuers "should not deny a claim for a health service provided to an individual because the individual is seemingly not of the gender to whom the service is typically or exclusively provided."

The state health care marketplace currently offers 15 individual coverage plans and 20 small group plans from 15 companies. As in previous years, assistors will be available online and in-person to help consumers navigate the marketplace.

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