Premiums for ACA health plans to decline 15 percent in PA

Oct. 11--After years of double-digit premium rate increases, people who buy health plans through the Obamacare marketplaces in Pennsylvania and New Jersey for 2019 will see some of the largest rate decreases in the country among states that use the federally run healthcare.gov marketplace.

Individual rates for the benchmark second-lowest cost silver plan in 2019 will decline an average of 16 percent in Pennsylvania and an average of 15 percent in New Jersey, according to data released Thursday by the U.S. Centers for Medicare & Medicaid Services.

The open enrollment period for plans that take effect at the beginning of the year is Nov. 1 through Dec. 15.

Pennsylvania and New Jersey are among the 39 states that use the federally run insurance marketplace, rather than setting up their own. Among those 39 states, premiums will decline an average of 1.5 percent for 2019.

The Trump administration long has advocated for eliminating the Affordable Care Act, insisting that premiums are too high. President Trump has frequently described the program as "failing," and stopped paying subsidies to insurers that cover many low-income Americans, a move observers thought might sink the ACA. Yet in a call with reporters Thursday morning, CMS Administrator Seema Verma said Trump administration policies are the reason for the rate decreases.

She spoke about eliminating the penalty for people who don't buy insurance and expanding access to short-term health plans, which are less expensive because they often do not cover certain benefits, such as maternity and mental health care. Both measures were expected to reduce the number of people buying insurance through the exchanges, which analysts predicted could actually drive up prices.

Analysts have said the skimpier plans and penalty elimination could also lead to more people purchasing coverage that doesn't meet all their needs or skipping insurance entirely.

"While we are encouraged by this progress, we aren't satisfied. Even with this reduction, average rates are still too high. If we are going to truly offer affordable, high quality healthcare, ultimately the law needs to change," Verma said in a statement.

New Jersey, which released its rates in September, attributed the decrease to the fact that it is requiring most people to buy insurance or pay a penalty. A new reinsurance fund to help insurers cover the cost of their most expensive members also has helped push rates down, officials said. Short-term plans are banned in New Jersey.

Health plans sold through the online marketplace are labeled bronze, silver, gold or platinum. Bronze plans offer the lowest premiums with higher deductibles and cost-sharing, and platinum plans offer higher premiums and greater coverage.

The second-lowest silver plan -- a benchmark regulators have used to compare marketplace plans -- will cost an average of $289 a month for an individual in New Jersey, according to estimates released Thursday by CMS.

In Pennsylvania, the second-lowest silver plan for an individual will cost $397 a month.

The estimates are for a 27-year-old nonsmoker. Rates are higher for older people and smokers because of their greater care needs.

Philadelphia-area residents who turn to the health exchange for insurance this fall will also find more options than last year, when Independence Health Group was the only insurer to offer plans through the exchange in the five-county area.

Pennsylvania Health & Wellness Inc., operated by Centene Corp. in St. Louis, will offer plans in Bucks, Montgomery and Philadelphia counties. Geisinger Health Plan, which is owned by Geisinger Health System of Danville, Pa., will also sell health plans in those counties, as well as Chester and Delaware counties.

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