Insurance rates likely to change before approval
Insurance companies offering health care coverage on the Federal Health Insurance Marketplace were required for the first time this year to publicly release requested double-digit premium rate increases under the Affordable Care Act (ACA).
“That gets everyone a little more anxious than they should be,” said SC Department of Insurance Director Ray Farmer.
The actual rate increases could be much different after state or federal review and Marketplace competition, according to the federal Department of Health and Human Services. His department’s analysts and actuaries are in the process of reviewing the requests along with an outside actuary, said Farmer.
Farmer’s agency must also review rates for companies offering non-Marketplace coverage, he said, and all of the approved rates will be released after the Oct. 9 deadline to avoid unfair advantages.
Health insurance companies say rates are increasing due to a variety of factors: increased utilization of health care, rising health care costs, the failure of Medicaid and Medicare to reimburse the full cost of care (forcing hospitals to shift the difference onto private insurers), and utilization of new, more expensive technology. In addition, two federal programs that were helping to defray the cost to insurers are expiring or changing in 2016.
Double-digit rate increase requests are also the result of the insurers’ additional experience with the ACA, Farmer said. This is the third year of submitting rate requests; the first year, companies had no experience with the newly passed legislation and the second year only offered about three months before rate increases had to be submitted, he said.
If the Department of Insurance does not approve a rate increase request, insurers must adjust to one the department approves, Farmer said.
Rate increases are currently under review and the public can comment at doi.sc.gov/595/Insurance-Rates. To view rates, visit ratereview.healthcare.gov.
Enrollment in the federal Marketplace reopens on Nov. 15.
“We stress that consumers shop around and compare rates and metal levels [bronze, silver, gold or platinum],” Farmer said.
