With individual mandate nixed, Obamacare rates going up
Oregonians who buy their own health coverage will see significant premium hikes, as carriers react to Trump administration changes and rising health care costs.
Federal subsidies hold down premiums for about half of Oregonians. But for others, the state's three largest carriers, Providence, Kaiser and Moda, have proposed average rate hikes ranging from 6.4 percent to 14.3 percent in the individual market.
That's bigger than Jesse O'Brien, consumer advocate for the Oregon State Public Interest Research Group, had hoped.
"It's sort of a mixed bag," he said, adding that OSPIRG had hoped the market was stabilizing. "They're still far too big for comfort."
Only one carrier, PacificSource, is asking to reduce rates.
About 200,000 people in this state buy their own policies, representing a small portion of the insured in Oregon. But the individual market is important because people like restaurant servers, independent professionals and contractors have no other options.
Individual rates went up under Obamacare largely because it guaranteed coverage for chronically ill people, adding to carriers' costs. Changes by the Trump administration are driving further rate hikes by eliminating the mandate that most people have coverage, among other things.
Obamacare subsidies cover costs for people who earn less than 400 percent of the federal poverty level, on a sliding scale, limiting the impact of hikes.
But the new requests suggest a tightening market, making it harder for consumers to find deals in the individual market:
• Providence Health Plan, which has about 91,000 individual-market members in Oregon, requested average rate hikes of 13.6 percent. For example, it wants to offer a middle-of-the-road silver plan to 40-year-old Portlanders for $453 a month, up from $407 this year.
• Kaiser Foundation Health Plan, which has about 47,000 members in the individual market, requested average rate hikes of 14.3 percent. It wants to offer a silver plan to 40-year-old Portlanders for $433 a month, up from $381 this year.
• Moda Health, which has about 40,000 such members, requested average rate hikes of 6.4 percent. It wants to offer a silver plan to 40-year-old Portlanders for $450 a month, up from $432 this year.
• PacificSource, which has about 13,000 members, requested to reduce its rates by an average of 9.6 percent. It wants to offer a silver plan to 40-year-old Portlanders for $425 a month, down from $484 this year.
• Regence, which has about 4,300 members, requested average rate hikes of 5 percent. It wants to offer a silver plan to 40-year-old Portlanders for $456 a month, up from $433 this year.
• Bridgespan, which has about 1,100 members, requested a 9.4 percent average hike. It wants to offer a silver plan to 40-year-old Portlanders for $467 a month, up from $424 this year.
• Health Net, which has about 600 members, asked for a 16.3 percent hike. It wants to offer a silver plan to 40-year-old Portlanders for $513 a month, up from $442 this year.
Kaiser, the Portland-area price leader, said it had no choice but to raise rates, though it hopes to work with the state to stabilize the market.
"Our rate increase reflects the expected costs of providing coverage for our members, including the impact of eliminating the individual mandate," said Keith Forrester, a Kaiser vice president.
The federal changes are being cited by insurers to justify a portion of their increases, ranging from 1.2 percentage points to 11.5 percent points, state officials said.
O'Brien said that the state may want to explore further policy changes to help stabilize the individual market, observing that small group rates that are available to small businesses continue to be generally more stable.
He also noted that the state will hold hearings and accept comment on oregonhealthrates.org before setting final rates.
"We would encourage people affected by these rate increases to follow along and submit comments," O'Brien said.
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