Insurers appear to be leaning toward cost increases in the proposed new ACA proposed bill. Based on regulatory filings in two states – Virginia and Maryland – saw several insurers seeking major premium increases for their 2018 Affordable Care Act exchange plans.

Some insurers are wavering between larger increases or lowered fees based on the uncertainty about the level of federal payment guarantees – which help reduce costs for low-income enrollees. This decision is under review but plays a big role in how the insurance companies will calculate their fees.

Several Insurance Exchanges Have Begun Filing Their Increases For 2018 plans:

  • Anthem Inc. said in a filing that it was seeking an average boost of 37.7% in Virginia
  • CareFirst BlueCross BlueShield is proposing a 52% average increase in Maryland
  • They are also proposing a 35% average rise in Virginia

They claim these increases are based on the government’s continued enforcement of the ACA’s coverage mandate. In addition, they claim a rise in costs will compensate for previous under-pricing along with an “increasingly sick and high-cost pool”.

Other insurers warn about exchange pullbacks – but have not yet settled on a decision. Non-profit insurer Medica, is considering withdrawing from Iowa’s exchange next year. The firm must file 2018 rates next month, and are watching the government’s moves carefully.

  • Based on its concerns about “financial risk, and growing uncertainty in the marketplace”, Aetna Inc. plans to pull out of Virginia’s exchange in 2018; this move will substantially scale back its already-limited marketplace offerings in the state.
  • Humana Inc.’s announcement in February plans to withdraw from all marketplaces, leaving an area of Tennessee at risk of having no exchange insurers.
  • Anthem and Molina Healthcare Inc. have said they are weighing pullbacks.
  • Several insurers that disclosed exchange-plan moves Wednesday nodded to the uncertainty around the future of the ACA and key federal payments that help reduce costs for low-income enrollees.

Insurers Perspective: Rising Rates, Market Conditions, Economy, Pharmacy Costs

  • Aetna’s and UnitedHealth Group Inc. plan to continue providing insurance in Virginia; so far has a number of insurers remaining in for next year. UnitedHealth Group Inc. will stop selling exchange plans in Virginia in 2018.
  • Cigna Corp. sought an increase 44.7% on average in rates on its individual Virginia plans. In Maryland the increase will be 37%.
  • Kaiser Permanente’s proposed average increase would be 15% in Virginia and 18% in Maryland.

All insurer’s state that reflect our efforts to sustain and deliver high-quality health care for all our members over the long term” and it plans to continue offering exchange plans in every region where it operates.