Premium increases of 2 percent to almost 15 percent would seem like bad news for Georgians needing health care coverage.
But the rate hikes proposed by insurers for Georgia’s 2019 insurance exchange appear almost as a relief, compared with huge rate hikes a year ago — more than 50 percent.
The proposed premiums for next year, released Friday by the state insurance department, still can be changed by the four insurers before final approval. The initial filings, though, show “a pretty stable market,’’ said Bill Custer, a health insurance expert at Georgia State University.
The rate hikes are 2.2 percent for Blue Cross and Blue Shield of Georgia; 5.7 percent for Alliant; 8.8 percent for Ambetter; and 14.7 percent for Kaiser Permanente, state insurance officials said. The same four companies offered coverage in the exchange this year.
And Blue Cross, which pulled out of 74 of Georgia’s 159 counties for this year’s exchange, is seeking to provide coverage in 2019 in 135 counties. Those include most of the metro Atlanta area, where Blue Cross does not currently offer exchange plans.
The insurance exchanges were created by the Affordable Care Act, the 2010 health law also known as Obamacare. They offer health insurance plans for individuals and families who don’t have job-based or government coverage. About 480,000 people bought coverage this year through Georgia’s exchange, which like most state exchanges is run by the federal government.
The state insurance department has until Aug. 22 to approve or reject the insurers’ proposed rates.
Custer said Friday that he was surprised a year ago when Blue Cross decided to pull out of the metro Atlanta exchange market.
Kaiser’s increase for 2019, he added, may reflect its expansion in coverage areas this year, and the insurance risk that the health plan shouldered during that growth.
The 50 percent increases in premiums that took effect this year, Custer added, may have been an overreaction by Georgia insurers to the uncertainty last year over the ACA’s future, or because the plans were anticipating changes in the health law.
Congressional efforts to repeal the ACA failed last year, but lawmakers did vote to abolish the individual mandate, the ACA requirement that people have health coverage or face a penalty.
Insurers may now feel the shocks to the market “have been baked in,’’ Custer said. The proposed hikes now seem more like the annual rate of medical inflation, increasing by 5 percent to 7 percent, he said.
Nationally, premiums are set to increase by an average of 15 percent for silver-level plans in 10 states and the District of Columbia where proposed rates have been publicly released, according to consulting firm Avalere, the Chicago Tribune recently reported.
Meanwhile, experts say that many insurers’ ACA business nationally has become profitable, after years of rate increases that have helped premiums catch up to costs.
“We have finally reached the point where insurers are making money in the marketplaces [the ACA exchanges],” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, according to a report in The Hill. “The market is stable economically, but it’s stabilized where premiums are very expensive.”
Current uncertainty over the ACA is based on such factors as the official end of the individual mandate next year (which means some people could try to save money by skipping health coverage), and the White House opening the door to alternative types of coverage that insurers say could pull healthy enrollees out of ACA plans.
In addition, Georgia and 19 other states are challenging the ACA in court. The administration has asked the courts to strike down key elements of the law, including the current protections for consumers with pre-existing medical conditions.
Laura Harker of the Georgia Budget and Policy Institute, which supports the ACA, said Friday that ‘’although the individual mandate will not be in effect next year, I think the failure of repeal efforts last year has reduced some of the uncertainty around the ACA.
“The law proved to be more resilient, and some insurers may have more confidence that it will be around for longer than the federal administration expected. This year, I think the rates are also lower because there is still strong enrollment in the state’s marketplaces.’’