A nonprofit publication of the Kentucky Center for Public Service Journalism

Kentucky extends deadline for insurance companies to submit new rates a second time

By Melissa Patrick
Kentucky Health News

Uncertainty continues to surround the Patient Protection and Affordable Care Act’s market for individual heath-care policies. Kentucky has extended for a second time the deadline for insurance companies to file plans and rates for next year, Anthem has pulled out of Ohio’s marketplace, and states are making deals with insurers to keep them from leaving.

The Kentucky Department of Insurance initially extended its rate filing deadline for qualified health plans from May 17 to June 7, and has since moved it again to June 21, which is also the federal government’s deadline for filing healthcare.gov plans.

Qualified health plans are subsidized by tax credits and purchased on the federal or state marketplaces.

“This allows insurers more time to obtain relevant data, such as enrollment and claims data from the beginning of 2017, which is used by company actuaries to determine necessary plan pricing,” Ronda Sloan, spokeswoman for the department, said in an e-mail.

Meanwhile, Anthem announced it is dropping out of Ohio’s individual marketplace, citing concerns about whether or not the Trump administration will continue to pay cost-sharing subsidies that make coverage more affordable, Rachel Roubein reports for The Hill. Nationwide, these subsidies are estimated at $7 billion.

Insurance companies are also waiting to see what Senate Republicans’ health bill will look like and whether it will maintain core Obamacare provisions such as the individual mandate that requires everyone to purchase insurance or pay a fine or continue to require the same amount of coverage.

“The Individual market remains volatile, and the lack of certainty of funding for cost-sharing-reduction subsidies, the restoration of taxes on fully insured coverage and an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for Ohio consumers,” Anthem said in a statement.

Anthem’s concerns about the uncertainties of the marketplace aren’t specific to Ohio, Cynthia Cox, associate director for the Program for the Study of Health Reform and Private Insurance at the Kaiser Family Foundation, told The Hill in an e-mail.

“This could be the first of more exits,” she wrote. “If the company exits nationally, there could be more than 275,000 people with no insurer option.”

In Kentucky, Anthem Blue Cross Blue Shield is the only health insurance provider that offers marketplace coverage in every county, and is the sole source in 59 of the state’s 120 counties. Baptist Health Plans, United Healthcare and Aetna pulled out of Kentucky’s market in 2016, all citing financial reasons.

In some states, insurance commissioners “are pulling out all the stops” and offering “unheard of flexibilities” to keep insurers from leaving their states amid all of this uncertainty, Roubein and Nathaniel Weixel report for The Hill.

They write that California and other states are allowing insurers to file two sets of premiums for different circumstances: continuation or repeal of the Obamacare cost-sharing subsidies, and the enforcement of the individual mandate, which the Trump administration has stopped enforcing.

Insurers say premium increases will range from a 9 percent increase if the provisions remain in place to a 36 percent hike if they are dropped.

Anthem’s departure from Ohio will leave at least 18 of the state’s 88 counties without an insurer on the exchange for 2018. The news fueled the partisan divide on this issue.

“How many times does this have to happen before Democrats concede that Obamacare is an absolute and total failure? This is further evidence that government mandates, taxes, and penalties make it more difficult to provide Americans with reliable and affordable health insurance,” U.S. Rep. Bob Gibbs, R-Ohio, said in a statement.

House Democratic Leader Nancy Pelosi said in a statement, “Anthem’s decision to pull out of the Ohio marketplace is yet another example of the devastation wreaked on American families by the Trump administration’s efforts to sabotage the Affordable Care Act.”

Washington Insurance Commissioner Mike Kreidler told the Hill that his state was considering tax relief for insurance companies that agree to sell plans in rural counties, and requiring that they offer plans in both urban and rural areas. It is also considering creating a program to help subsidize insurance companies’ payments on high claims with a mix of state and federal money, like Alaska’s program.

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