Win McNamee Donald Trump and Barack Obama.
- Virginia and Maryland posted proposed rates for 2019 Obamacare plans, the first states to do so.
- The proposals showed significant proposed increases in premiums for many of the plans.
- Insurance industry professionals and health policy experts say the market is partly to blame, but President Donald Trump also made the problem worse.
Affordable Care Act premiums look like they will continue to soar in 2019, according to early indications from a handful of states. And President Donald Trump may bear some of the blame.
Virginia and Maryland were the first states to post initial proposals for plans through the Obamacare marketplace, which can be purchased by people who do not receive insurance through work or a government program like Medicaid.
In those rate requests, most insurers asked for double-digit increases from 2018 to 2019 following the upward trend in health insurance costs for the marketplaces:
- CareFirst, a member of the Blue Cross Blue Shield Association that focuses on Maryland, requested a 91% increase for its PPO plan in the state and a 19% increase for its HMO plan, according to the Maryland Insurance Administration.
- The other provider in Maryland, the Kaiser Foundation, requested a 37% jump.
The average increase requested in Maryland was 30%, according to the insurance administration.
In Virginia:
- CareFirst requested 64% and 27% increases for its PPO and HMO plans, respectively.
- Kaiser asked for a 32% bump.
- Virginia-based Piedmont requested a 18% increase.
- Cigna asked for a 15% increase.
- And Anthem asked for a 6% jump.
- The only request for a decrease came from Optima, which wants to lower premiums by 2% in the state, though the company's rates are among the priciest in the country.
Charles Gaba, who writes for the health policy blog ACASignups, said that based on the number of people signed up for each plan, the average rate hike works out to 13.4% in Virginia.
The reasons for the increases, according to insurance commissioners and experts, is twofold.
On one hand are the long-term problems of the marketplaces. Fewer than expected young people have signed up for Obamacare plans, making the pool of people in the marketplace older and more expensive to cover for insurers.
But CareFirst CEO Chet Burrell told The Washington Post that the Trump administration's actions have made the Obamacare marketplaces "materially worse." He said the company could consider leaving the space altogether.
"Continuing actions on the part of the administration to systematically undermine the market and make it almost impossible to carry out the mission," Burrell said. "If continued efforts at the federal level undermine the marketplaces, I would think the board would have to examine what they would want - that's very much on their mind."
The Trump administration eliminated the individual mandate - the requirement to buy coverage or face a financial penalty - as part of the GOP tax law.
The Congressional Budget Office has projected that eliminating the mandate will hike premiums by 10% and leave 13 million more people without insurance by 2027.
Larry Levitt, senior vice president at the Kaiser Family Foundation, a nonpartisan health policy think tank, said Trump's repeal of the mandate would force premium hikes much higher in 2019.
"With insurers now mostly profitable in the ACA individual insurance market, I would have expected single-digit premium increases for 2019 reflecting health cost growth," Levitt tweeted Monday. "With repeal of the individual mandate and expansion of short-term plans, double-digit hikes are now likely."