Federal Uncertainty Could Impact Pennsylvania Individual Market, Miller Says

July 28, 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 that rate filings for 2018 individual market and small group plans and additional materials that help explain county-level impacts of the filings are available.

“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. For months, I have asked Congress and the Trump Administration to help stabilize the individual market rather than trying to undermine the entire law, which will only hurt the real Pennsylvanians who benefit from the law.”

A recent 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 that 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.

“The 506,000 Pennsylvanians in the individual market deserve single-digit average rate increases,” Commissioner Miller said in the release. “If Congress and the Trump Administration do not make a long-term commitment to insurers to preserve the rules that are currently in place, they alone will be responsible for raising prices for consumers and risking insurers exiting the market.”

Companies have until the end of September to commit to participating in the market for 2018.

Final approved rates for 2018 plans will be made public in mid-October. Public comment on rate requests and filings will be accepted for 30 days. Additionally, the Pennsylvania Insurance Department will hold in-person town hall meetings to discuss the rate review process and provide an opportunity for feedback on requested rates.

Source: Pennsylvania Insurance Department

Latest Comments

  • July 28, 2017 at 2:55 pm
    Agent says:
    Translation: Send us more money to "stabilize" the market so it won't go completely belly up in the near future.
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