Health insurance rates even out

Study finds law’s marketplaces stabilizing, insurers returning

The healthcare.gov website is pictured in 2017. An analysis projects only modest premium increases next year in the government health program.
The healthcare.gov website is pictured in 2017. An analysis projects only modest premium increases next year in the government health program.

WASHINGTON -- Millions of people covered under the Patient Protection and Affordable Care Act will see only modest premium increases next year, and some will get price cuts. That's the conclusion from an exclusive analysis of the program, which still sparks deep divisions heading into this year's midterm elections.

The Associated Press and the consulting firm Avalere Health crunched available state data and found that health insurance marketplaces seem to be stabilizing after two years of sharp premium increases. And the exodus of insurers from the program has halted, even reversed somewhat, with more consumer choices for 2019.

The analysis found a 3.3 percent average increase in proposed or approved premiums across 47 states and Washington, D.C., for next year. In Arkansas, rates will rise an average of 4.1 percent.

This year the average increase nationally was about 30 percent. In Arkansas, the increases ranged from 14.2 percent for Arkansas Blue Cross and Blue Shield plans to more than 24 percent for those offered by Little Rock-based QualChoice Health Insurance.

The average total premium for an individual covered under the health law is now close to $600 a month before subsidies nationally and $509 in Arkansas.

For next year, premiums are expected either to drop or increase by less than 10 percent in 41 states with about 9 million customers. Eleven of those states are expected to see a drop in average premiums. In six other states, plus Washington, D.C., premiums are projected to rise between 10 percent and 18 percent.

Insurers also are starting to come back. Nineteen states will either see new insurers enter or current ones expand into more areas. There are no bare counties lacking a willing insurer.

Even so, Chris Sloan, an Avalere director, said, "This is still a market that's unaffordable for many people who aren't eligible for subsidies."

Nearly 9 in 10 Affordable Care Act customers get government subsidies based on income, shielding most from premium increases. But people with higher incomes, who don't qualify for financial aid, have dropped out in droves.

It's too early to say if the Affordable Care Act's turnabout will be fleeting or a more permanent shift. Either way, next year's numbers are at odds with the political rhetoric around the health care law, still heated even after President Donald Trump and congressional Republicans failed to repeal the law last year.

Trump regularly calls the health care law a disaster, and time and again has declared it dead. The GOP tax-cut bill repealed the Affordable Care Act requirement that Americans have health insurance or risk fines, effective next year. But other key elements remain, including subsidies and protection for people with pre-existing conditions. Democrats, meanwhile, accuse Trump of sabotage, driving up premiums and threatening coverage.

The Trump administration has said it won't defend the law's protections for pre-existing conditions in a federal case in Texas that could go to the Supreme Court.

In solidly Republican Arkansas, Democratic state legislator and cancer survivor Clarke Tucker is using the Affordable Care Act in his campaign to try to flip a U.S. House seat from red to blue. Tucker, 37, says part of what made him want to run is the House vote to repeal the law last year and images of Trump and GOP lawmakers celebrating at the White House.

Business analysts say the relatively good news for 2019 is partly the result of previous premium increases, which allowed insurers to return to profitability after losing hundreds of millions of dollars.

"They can price better, and they can manage this population better, which is why they can actually make some money," said Deep Banerjee of Standard & Poor's.

Repeal of the the health law's requirement to carry insurance doesn't seem to have had a major impact yet, but Banerjee said there's "a cloud of uncertainty" around the Trump administration's potential policy shifts. Yet some administration actions have also helped settle the markets, such as continuing a premium stabilization program.

To calculate premium changes, Avalere and The Associated Press used proposed overall individual marketplace rate filings for 33 states and D.C., and final rates for 14 states that have already approved them. Data was not available for Massachusetts, Maryland and Alabama.

Information for this article was contributed by Andy Davis of the Arkansas Democrat-Gazette.

A Section on 09/08/2018

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