Wisconsin insurers that participate in Healthcare.gov are requesting double-digit premium increases for individuals for next year, citing a population that’s less healthy than expected and a marketplace that isn’t profitable.
The filings reflect increasing uncertainty over the health care marketplace from last year, with some insurers citing concerns about cost-sharing reduction payments being cut off. President Trump has weighed eliminating those subsidies.
The increased premiums will be accompanied by higher tax credits for Healthcare.gov consumers to pay for them, though those above 400 percent of the federal poverty level don’t qualify for credits.
At this point last year, most insurers also requested double-digit premium increases, though a handful of insurers had requested more modest increases and one, MercyCare, had actually proposed cutting its rates. Two insurers — Anthem and Health Tradition Health Plan — already said they won’t participate in 2018.
The requests are preliminary and pending approval from the state Office of the Commissioner of Insurance. OCI spokeswoman Elizabeth Hizmi said the agency expects to send its initial review of the filings to the feds this month, though she noted the rate requests can change in the coming months.
The final rates, she said, will be posted on Nov. 1 when the feds begin open enrollment for Healthcare.gov plans next year.
Molina Healthcare of Wisconsin, Inc. is proposing some of the highest premium increases for its members, though the rates would vary depending on what plans people select and where they live. The company says it’s requesting a 41.3 percent increase for its premiums, with the increases ranging from 30.9 percent to 46.7 percent.
Most Healthcare.gov consumers are eligible for tax credits, which would also increase, to pay for their premiums.
Molina said the premiums it had laid out for 2017 weren’t high enough to cover the medical expenses it’s paying. In its filing, the company also pointed to uncertainty over whether the Trump administration would enforce the Affordable Care Act’s individual mandate and the rising costs of medical claims and prescription drugs.
Unity Health Plans, which is requesting premium increases around 30 percent, also said the ACA population it covers has had higher medical costs than expected. Unity spokeswoman Jennifer Dinehart said the company doesn’t “anticipate any further changes to our rates at this time.”
Network Health is asking for a 43 percent increase in one of its exchange plans and a 25 percent increase in another. The company said in its filing that it expects to see higher medical costs due to a population that will need to use their services more. It also said it’s trying to “minimize future losses” on the exchanges with its rate increase.
Jessica Fischer, a Network Health spokeswoman, said the company developed its rates to “reflect the risk we are assuming in the marketplace and the uncertainty in the industry.”
See the rate filings: