Feds say marketplace plans will remain affordable as insurers propose hikes

The feds are countering criticisms that Healthcare.gov plans will be too expensive for consumers next year.

The feds’ contention that affordable plans will be available comes as insurers in Wisconsin are proposing significant rate hikes for next year’s plans, with most looking for double-digit increases.

Only one health plan proposes a cut. MercyCare, is proposing a rate decrease of 13 percent.

Some proposed rate boosts are modest. Group Health Cooperative of South Central Wisconsin and Managed Health Services Insurance Corporation are proposing increases below 10 percent.

The rates vary across geography and coverage levels, and some consumers in other health plans will see lower increases or might even see decreases. The state’s Office of Commissioner of Insurance could also lower the proposed increases during the rate review process, which is expected to wrap up this fall.

Unity Health Plan, for example, is proposing an average increase of nearly 38 percent, though its range is somewhere between a nearly 4 percent decrease and a 60 percent increase.

“Our price reflects the underlying risk in the pool, changes in the population, health status and claims,” Unity spokeswoman Jennifer Dinehart said.

The proposed increases are posted on a rate review website from the feds. But the U.S. Department of Health and Human Services noted yesterday the Affordable Care Act tax credits will increase along with premiums, and consumers can “shop around to find the best plan.”

Even if rates go up 25 percent next year, HHS says 70 percent of Wisconsin’s Healthcare.gov consumers will be able to pick plans with premiums under $100.

“Headline rate increases do not reflect what consumers actually pay,” said Kathryn Martin, the agency’s acting assistant secretary for planning and evaluation. “Our study shows that, even in a scenario where all plans saw double-digit rate increases, the vast majority of consumers would continue to have affordable options.”

The insurers largely attribute the increases to higher-than- expected claims in recent years and the loss next year of the federal reinsurance program that gave insurers money to help stabilize premiums. Children’s Community Health Plan is looking to enter the marketplace next year, though other insurers are leaving the marketplace in some parts of the state.

Common Ground Health Cooperative in Milwaukee — one of the few remaining health care co-ops established under the Affordable Care Act — is requesting an increase of 12.18 percent.

The lone insurer seeking a rate decrease, MercyCare, decided to lower its prices so more people could get care at Mercy Health System, which owns MercyCare.

Patrick Cranley, senior vice president and COO of MercyCare, said officials were hearing from some customers who “couldn’t afford to make up the difference” between what MercyCare was charging and the ACA premium subsidies.

“We are gambling a little bit, but we feel that our mission to the community would be compromised if we cannot give them an affordable way to access our services,” Cranley said.

See the rate increases
— By Polo Rocha,