Premiums for Californians’ Obamacare health coverage will rise by an average of 13.2% next year — more than three times the increase of the last two years and a jump that is bound to raise debate in an election year.
The big hikes come after two years in which California officials had boasted that the program helped insure thousands of people in the state while keeping costs moderately in check.
On Tuesday, officials blamed next year’s premium hikes in the program that insures 1.4 million Californians on rising costs of medical care, including expensive specialty drugs and the end of a mechanism that held down rates for the first three years of Obamacare.
Two of the state’s biggest insurers — Blue Shield of California and Anthem Inc. — asked for the biggest hikes. Blue Shield’s premiums jumped by an average of more than 19%, according to officials, and Anthem’s rates rose by more than 16%.
- The rates vary significantly by region and insurer. Los Angeles and the rest of southwest Los Angeles County will see an average increase of almost 14%.
Blue Shield’s preferred provider organization rate in Los Angeles, chosen by 21% of those using the exchange, is increasing by an average of 19.5%.
Blue Shield, in an email to brokers, stated three reasons for the increase:
- Underpricing of 2016 Rates: 2016 pricing was completed in the first quarter of 2015 and relied heavily on the favorable 2014 healthcare expense experience to set rates.
- Higher than Anticipated Member Utilization of Healthcare Benefits: According to data, the higher trend was driven by prescription drugs and by members who joined during the special enrollment period. The SEP population had up to 30% higher utilization than members who joined during the standard open enrollment period.
- Removal of ACA Reinsurance: The reinsurance program had provided funds to plans with higher-cost enrollees to offset those medical costs and guarantee coverage regardless of health status. The end of this program alone added 4.6% to our 2017 rates.
An Anthem spokesman stated “Factors such as increased use of medical services and added costs of drugs and medical therapies put upward pressure on rates and underscore the additional work that needs to be done to moderate the growth in healthcare costs.”
Covered California officials defended the system Tuesday, saying that the competition between insurers offering coverage on the exchange was working to keep rates lower than they otherwise would be.
Around the country, several insurers, including giant UnitedHealth, have stopped selling health plans on the exchanges, and a number of new nonprofit health insurance coops have gone out of business.
Americans who make too much to qualify for subsidies are likely to feel the brunt of the premium hikes. That may increase pressure to review the exchanges in 2017, for ways to make health plans more affordable.
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*Modified from LATimes.com and Hotair.com online articles; Blue Shield notification to brokers.