Federal Uncertainty Could Impact Pennsylvania Individual Market, Miller Says

August 7, 2017

Pennsylvania insurers are seeking a statewide average rate increase of 8.8 percent for individual plans and 6.7 percent for small group plans, but this could be adversely affected by actions taken by the Trump Administration or Congress against the Affordable Care Act, according to a Pennsylvania Insurance Department press release.

This comes after Insurance Commissioner Teresa Miller announced rate filings for 2018 individual market and small group plans.

“Pennsylvania’s individual market is stabilizing, and the current rate requests we see, which are in line with the annual trend in medical costs, are proof of this,” Commissioner Miller said in the release. “But that stability is not absolute.”

A study on 2018 rate increases across the country by Oliver Wyman management consultants predicted the annual trend in the cost of care would result in a 5 to 8 percent increase in rates, and the return of a federal health insurer tax would account for another 3 percent, the press release stated. This would put Pennsylvania’s 8.8 percent request near the minimum expected increase. If changes are made to the individual mandate or the law’s cost-sharing reduction payments, Pennsylvanians would see significant premium increases, the release said. Pennsylvania’s five individual market health insurers estimate if cost-sharing reduction payments were not made, they would need to request a statewide average 20.3 percent rate increase. If the individual mandate is not enforced, they say they would seek a 23.3 percent rate increase. If both changes occur, insurers estimate they would seek an increase of 36.3 percent.

Companies have until the end of September to commit to participating in the market for 2018. Approved rates for 2018 plans will be public in mid-October.

Topics Pennsylvania

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