Health care sabotage hits home: Blue Cross seeks 22.9 percent average premium increases amid federal uncertainty on subsidy payments

If not for uncertainty from Trump administration about payments for cost-sharing reductions, increase would be only 8.8 percent

RALEIGH (May 25, 2017) — Today, Blue Cross Blue Shield of North Carolina announced it is requesting an average premium rate increase of 22.9 percent for individual market plans in 2018. Before the Trump administration took power, Blue Cross had been making progress in managing costs of new members who gained coverage as a result of the Affordable Care Act. In 2016, the company reduced their losses on the individual market by 86 percent and returned to overall profitability. The company notes today that they were seeing the market begin to stabilize with a healthier risk pool.

However, since January, the Trump administration has deliberately undermined the health insurance markets in an attempt to cause the Affordable Care Act to fail. Despite continued requests from the health insurance industry, health care providers, and consumer advocates alike, the administration has threatened to hold hostage payments it owes to insurers for cost-sharing reductions. Blue Cross notes that this uncertainty is direectly responsible for three-fifths of their requested increase (14.1 percentage points alone). Without the Trump administration destabilizing the market in such a way, Blue Cross would only seek an increase of 8.8 percent for 2018.

The administration has also undermined enrollment, threatening to not enforce the individual mandate, scaling back marketing and outreach efforts, and instituting new rules that make it harder for consumers to enroll.

The aggregate impact of these policy decisions is a climate of uncertainty and instability for the health insurance market, leaving insurers little choice other than to raise premiums higher than otherwise necessary in order to brace against potential losses. Like Blue Cross Blue Shield of North Carolina, insurers in other states have clearly attributed significant portions of their rate hikes directly to uncertainty from the federal level.

What’s more, Congress’ ongoing and misplaced attempt to repeal and replace the Affordable Care Act has further destabilized the health insurance markets, as insurers face an unclear legislative and regulatory environment moving forward.

While we’re glad to hear that Blue Cross Blue Shield remains committed to serving all 100 counties of our state, we fear that further destabilization by Congress and the Trump administration could put these decisions in jeopardy or lead them to request even higher rate increases.

For the more than half a million North Carolinians who get their coverage through the Health Insurance Marketplace, they should not yet fret about today’s news. The good news is that 90.5 percent of North Carolinians who enrolled this year are insulated from rate hikes, as they qualify for premium tax credits that will increase to increase along with any gross premium rates.

What’s more, the announced figures today represent average rate increases for 2018; they do not necessarily mean that an individual’s premium will rise by this figure for 2018 coverage. On top of that, North Carolinians in every county will still have plan options to choose from.

Every consumer should take the following steps:

  • If you’re enrolled in a plan for 2017, keep paying your premiums and keep using your coverage to get the care you need. Your current plan is not affected by today’s announcement.
  • Make plans to meet in person with an enrollment assister to learn more about how this announcement might affect your coverage options moving forward. You can make a free appointment with a local expert enrollment assister by calling 1-855-733-3711, a toll-free hotline operated here in North Carolina.
  • Make note of a shorter Open Enrollment period for 2018 coverage: consumers will have between November 1 and December 15, 2017 to enroll in coverage for 2018.

FOR MORE INFORMATION, CONTACT Brendan Riley, brendan@ncjustice.org, 919.861.2074; Julia Hawes, julia@ncjustice.org, 919.863.2406.