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Tracking 2019 Premium Changes on ACA Exchanges

In a recently updated article from the Kaiser Family Foundation, the authors continue to monitor insurer’s Affordable Care Act (ACA/ObamaCare) marketplace filings by State.  These filings detail premiums the marketplace insurers will be charging in the areas where they plan to participate in 2019.  The State or the Federal Government reviews each of these premium rates to ensure that they are both accurate and justifiable before they go into effect.  There are different criteria used by State and each State varies on how much information they release.

The KFF analysis compares and contrasts various levels (bronze, silver and gold) of  the ACA across the 50 States and the District of Columbia.  The authors will continue to update this report as additional States release or update their reviews.  It is likely that the information will change over the remainder of 2018.

The authors note:

“The second lowest-cost silver plan serves as the benchmark for premium tax credits (which subsidize premiums for low and modest income exchange enrollees) and is the only plan that offers reduced cost sharing for lower-income enrollees. About 63% of marketplace enrollees are in silver plans this year, and 29% are enrolled in bronze plans.”

 The insurers that participate in the various States are mostly taking into account the repeal of the individual mandate (associated with the tax cut in December 2017) that goes into effect this coming year.  It is also anticipated that there will be an increase in non-compliant, short-term, limited duration health plan (STDL).  Without the penalty, it is expected that relatively healthy individuals will leave the regulated insurance marketplace and thereby cause an increase in the 2019 premiums.  It is unsure if all the providers have fully included this information in their 2019 estimates.

The authors also include:

“Additionally, the Trump administration decision to stop making cost-sharing reduction payments to insurers had an upward effect on 2018 premiums, but some insurers may adjust premiums in 2019 up or down if their 2018 adjustments proved to be inaccurate. Some insurers may be changing which plans are subject to increased premiums to compensate for the loss of cost-sharing reduction payments. In 2018 many insurers increased premiums just on silver marketplace plans – which are the only plans in which consumers can receive cost-sharing reductions — but a small number of states directed insurers to increase individual market premiums across the board.”

How was the data collected?

The authors collected data from health insure filings to the various States released by the State’s Insurance Departments.  The submissions were public and available for the States they investigated.  The data focuses on major cities and larger communities where insurance providers participate.  Some of the plans may not be available in all cities or counties within the individual rating areas.  Rating areas are defined as groups of adjacent counties and the analysis chose a represented sample within each area.

As always, if you have any questions or comments with what this means for your business, please contact us.


Source: Kaiser Family Foundation

Additional Resource:


Modern Healthcare

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