Health care exchange rates stabilizing

Sunday, July 22, 2018 8:40 PM
Anita Gates, health coverage guide with the Piñon Project, speaks with Geof Byerly. The Piñon Project helps residents in Montezuma County buy insurance through Connect for Health Colorado. Anticipated 2019 rate changes for medical insurance offered through Connect for Health Colorado are on par with inflation for medical services, said Joe Hanel, a spokesman for the Colorado Health Institute.

Customers who purchase insurance through the state health care exchange could see smaller rate increases than in previous years, and some rates could decline.

Across the state, insurance rates through Connect for Health Colorado are set to rise 5.95 percent on average, according to a news release from the Colorado Division of Insurance.

The average rate increase is fairly low compared with last year, when rates increased on average more than 20 percent across the state. In Montezuma and La Plata counties, rates increased by more than 30 percent.

The anticipated rate changes for 2019 are on par with regular inflation for medical services, said Joe Hanel, a spokesman for the Colorado Health Institute.

In La Plata County, about 2,900 residents bought insurance through the health care exchange from either Anthem or Friday Health Plans in 2018, according to a state report. In Montezuma County, about 740 residents purchased policies from Connect for Health Colorado.

The market may be seeing some relative stability because companies increased rates last year in anticipation of federal policy changes, Hanel said.

“What you might call the political-instability risk was probably baked into the rates last year,” he said.

For example, rates last year may have taken into account the elimination of the tax penalty on those who don’t have insurance. The tax penalty will no longer apply in 2019. It was aimed at encouraging young and healthy people to purchase insurance.

The recent estimate of rate increases is based on the preliminary rates submitted by the seven companies that offer insurance to individuals through the exchange. But only two companies, Anthem and Friday Health Plans, sell insurance in La Plata County through the exchange. It is unknown if both will continue to operate in the county next year, said Vincent Plymell, a spokesman with the Division of Insurance.

If Anthem continues to operate in the county, customers could see their rates decline for the first time in years.

There are two branches of Anthem, HMO Colorado and Rocky Mountain Hospital and Medical Service.

HMO Colorado customers could see rates decline 0.44 percent on average and Rocky Mountain Hospital and Medical Service could see rates drop 2.64 percent on average.

Customers of Friday Health Plans could see rates increase about 7.5 percent.

The rate increases vary regionally in Colorado, and the state does not have estimates yet for how rates may change in La Plata and Montezuma counties.

Rate increases also could change based on new federal policy – as they did last year when President Donald Trump ended cost-sharing payments.

The federal government was paying subsidies to insurance companies that covered low-income customers and customers with higher health risks.

However, insurance companies are still required by the Affordable Care Act to pay more of the medical costs for those customers who purchase silver plans through the exchange and make 2.5 times the federal poverty level. As a result, the cost of the silver plan is going up 12.3 percent on average.

Last year, after the cost-sharing payments were eliminated, Colorado required companies to spread the rate increases across all types of plans, according to the news release.

As rates go up for the silver plans, so do the tax credits residents qualify for, so those with lower incomes are insulated from the increases, Hanel said.