Rate Cuts Planned By Some Health Insurers Next Year

Sep. 1--For the second year in a row, three health insurers offering individual health plans under the Affordable Care Act in Tennessee are planning to cut their premiums next year as the competition among insurers grows with the return of the nation's biggest health insurer into the Tennessee health exchange market.

Cigna, Oscar Health and Celtic /Ambetter are all proposing to lower premiums on their individual plans in 2021 and UnitedHealthcare, which is America's biggest health insurer by revenue, is returning to the Tennessee market in Chattanooga, Nashville, Memphis and other west Tennessee cities.

But the state's biggest health insurer, BlueCross BlueShield of Tennessee, plans to boost its increase in premiums next year by nearly 10% after making only a modest 1.4% boost in its premium rates in 2020.

BlueCross, which is the only health insurer that plans to participate in the health exchange market for individuals in all 95 of Tennessee's counties, is planning to boost its premiums next year by 9.8%. In its hometown of Chattanooga, three other health insurers -- Cigna, United Healthcare and Celtic/Ambetter -- also plan to offer plans under the Affordable Care Act (ACA) for local residents.

The Tennessee Department of Commerce and Insurance announced Tuesday it has approved rates for six health insurance carriers offering individual plans through the so-called Obamacare program, in 2021, pending final approval by federal regulators. Last year, 221,553 Tennesseans bought individual health plans through Tennessee's exchange market under the Affordable Care Act and enrollment stood at 200,445 at the end of the open enrollment period.

"Heading into 2021, Tennessee's hard-working and resilient families in 81 of the state's 95 counties will have more than one choice of health insurance carriers on the Federally Facilitated Marketplace," said Hodgen Mainda, commissioner for the Tennessee Department of Commerce and Insurance. "Additionally, the Department has approved premium rate decreases from market participants for just the third time in the ACA marketplace era. Increased competition and lower prices perfectly align with Gov. (Bill) Lee's vision to help support Tennessee consumers."

Backers of the Affordable Care Act, often called "ObamaCare," said the increased number of insurers offering plans next year and rate reductions by some in competitive markets proves that the program is working six years after Americans first began enrolling for individual coverage under the health exchange marketplace. Despite President Trump's efforts to end Obamacare and an ongoing legal challenge to the law's constitutionality, more than 3% of all Tennesseans are insured through the individual exchange market and the law sets standards for nearly all other persons insured through other private and government plans.

"The fact that we got another major new entrant into our market (UnitedHealthcare) despite continued efforts to destabilize the program over the past four years proves that the Affordable Care Act has been remarkably resilient," said Gordon Bonnyman, an attorney for the Tennessee Justice Center. "But the big threat now is that no matter how the market is performing or the demand of both consumers or the willingness of insurers to participate, we have this huge looming threat over the program which is the states' challenge to its constitutionality of the law."

Tennessee, Georgia and Alabama have joined in an 18-state legal challenge to the constitutionality of Obamacare after Congress removed the tax penalty for not buying health insurance. Critics of the Affordable Care Act note that in the 38 states where the federal government administers health exchanges, including Tennessee, premiums more than doubled from 2013 to 2017. Last year, nearly 82% of U.S. counties, primarily in rural areas, had only one or two insurers selling coverage under the Obamacare exchanges.

"Congress meant for the individual mandate to be the centerpiece of Obamacare," Texas Attorney General Paxton said in his argument for the court to strike down the law now that the mandate has been removed. "Without the constitutional justification for the centerpiece, the law must go down."

"Obamacare is a failed social experiment," Paxton said. "The sooner it is invalidated, the better, so each state can decide what type of health care system it wants and how best to provide for those with preexisting conditions, which is federalism that the Founders intended."

The U.S. Supreme Court has scheduled oral arguments on the challenge to Obamacare on Nov. 10, just a week after the presidential election day.

In the meantime barring any court ruling overturning the law, persons may sign up for the individual coverage plans for 2021 through the health care exchanges from Nov. 1 through Dec. 15 at www.healthcare.gov.

Six health insurers are planning individual coverage through the health exchange marketplace in Tennesse in 2021. The carriers, areas of coverage, and rate changes sought for next year include:

BlueCross BlueShield of Tennessee. Statewide coverage. Proposed 2021 rate request seeking an average increase of 9.8%.

Bright Health. Continuing coverage in Knoxville, Memphis and Nashville areas. Proposed 2021 rate request seeking an average increase of 3.01%.

Celtic/Ambetter Insurance. Proposed coverage expansion into Jackson and Tri-Cities areas with continuing coverage in Nashville, Knoxville, Chattanooga and Memphis areas as well as cities in West Middle Tennessee such as Columbia, Dickson and Lawrenceburg. Proposed 2021 rate request seeks an average decrease of 2.5%.

Cigna. Continuing coverage in Chattanooga, Jackson, Knoxville, Nashville, Memphis and Tri-Cities. Proposed 2021 rate request seeking a premium decrease of 6.1%.

Oscar Health. Continuing coverage in Nashville and Memphis. Proposed 2020 request seeking an average increase of 9.9%.

UnitedHealthcare. After dropping its individual coverage plans in 2017 after hefty early losses in the program, UnitedHealthcare will resume coverage in 2021 in the Chattanooga, Jackson, Memphis and Nashville areas as well as cities in West Middle Tennessee such as Columbia, Dickson and Lawrenceburg.

Insurers have until Sept 23 to sign final agreements with Centers for Medicare and Medicaid Services (CMS) to participate in the 2021 marketplace.

Though decreases bring down premium prices in rating areas with more competition, an individual's maximum out-of-pocket premium costs depend on several factors, including the amount of federal subsidies available in the state. Mainda said consumers should contact licensed insurance agents or company representatives in considering 2021 plan coverage.

"We urge consumers to carefully review plans when shopping on the exchange during Open Enrollment," said Rachel Jrade-Rice, an assistant commissioner for the state insurance department. "While it may be tempting to enroll in a plan with the lowest premium, consumers should also take into account other potential costs such as co-pays and deductibles. Ask questions and contact the carriers about their plans.

Additionally, consumers should conduct research on premiums, deductibles, co-pays and cost-sharing along with reviewing each insurance carrier's networks for their most accessible and/or preferred providers and hospitals. To avoid unexpected or 'balance' bills, always visit in-network providers."

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