Uncertainty remains over Illinois Obamacare premiums as other states reveal rate proposals

June 25--Illinois residents who buy health insurance on the state's Obamacare exchange are unlikely to find out until later this summer how much more they might pay in 2019, but consumers in some other states are facing double-digit increases.

Premiums are set to increase by an average of 15 percent for silver-level plans in 10 states and the District of Columbia where proposed rates have been publicly released, according to consulting firm Avalere.

Costs will likely go up in all but one of those states, Minnesota, where rates are set to decline by 5 percent for an average silver plan. In Maryland, rates are projected to climb by 53 percent for an average silver plan.

In Illinois, it's unknown whether rates will increase again next year, and, if so, by how much because the state has not released proposed rate changes. Those proposals for plans in Illinois will likely be publicly released on ratereview.healthcare.gov on Aug. 1. The Department of Insurance will release more detailed information about plans and costs in October, once they're finalized.

Open enrollment to buy coverage through the exchange will begin Nov. 1.

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Consumer advocacy groups have long requested the state release information sooner.

"A lot of other states make this information available much earlier," said Kathy Waligora, director of health reform initiative at EverThrive Illinois. "We think information is power and it should be available to folks as early as possible."

But the state has stuck by its guns each year, waiting to release the data.

"Rates have not yet been finalized and releasing premature information could create confusion among Illinois consumers and prompt insurers to revise rates based on initial competitors' rates rather than actuarial analysis," said Department of Insurance Director Jennifer Hammer, in a statement.

Illinois residents buying insurance on the exchange, like consumers in much of the country, have been squeezed in recent years. On average, Illinois insurers increased rates by 16 to 37 percent for the lowest-priced plans on the exchange this year, and in 13 Illinois counties, only one insurer offers plans on the exchange.

The state's largest insurer, Blue Cross and Blue Shield of Illinois, will again offer plans in every county next year, said spokeswoman Colleen Miller. Rates will not be finalized until later this year, she said.

Rate changes will depend partly on how insurers plan to respond to continued uncertainty about Obamacare, experts say.

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The tax bill signed by President Donald Trump eliminated Obamacare's requirement that everyone buy insurance or pay a penalty, starting in 2019. Also, the Trump administration has ceased paying federal subsidies, called cost-sharing reduction payments, to insurers.

But a number of insurers, including Blue Cross and Blue Shield of Illinois and Cigna, built uncertainty around those issues into their rates for this year in Illinois. That means it's possible prices may not soar because of those issues.

Other uncertainties, however, have since emerged, including whether the expansion of cheaper association plans and proposed changes to short-term plans will draw healthy people away from the exchanges, compelling insurers to raise prices on those who remain.

"On balance, we're seeing rates going up, and that is because the individuals who are covered under these programs are increasingly challenging populations that are not getting coverage elsewhere, and because there is no compulsion to purchase insurance at this point, the plans are bracing themselves to care for a sicker population," said Dan Mendelson, founder of Avalere.

It's also unclear how many insurers will offer plans on the exchange in Illinois. This year, four insurers sell individual plans, down from 10 in 2016. Some states, however, are seeing more competition on their exchanges next year. Michigan and Virginia's exchanges will likely gain another insurer, and seven states will, on average, have more silver plan options next year, according to Avalere.

lschencker@chicagotribune.com

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