Yorkers could see 30 percent premium increases

Margarita Cambest
  • York’s federal marketplace shoppers might see silver plan premiums rise more than 30 percent.
  • Open enrollment for 2017 health insurance coverage runs from Nov. 1 through Jan. 31, but it must be purchased by Dec. 15 to be covered starting Jan. 1.

York County residents signing up for health insurance through federally facilitated marketplaces plans again this year could see their premiums increase as much as 39 percent.

If approved by the Pennsylvania Department of Insurance, rates filed earlier this year by four participating insurers in Region 7, which includes York, Lancaster, Adams and Berks counties, show silver plan premiums going up an average of 31 percent.

The law: Under the president’s signature health care law, the Affordable Care Act, also known as Obamacare, private insurance can be purchased for 2017 through federal or state-run marketplaces starting Nov. 1. Everyone in the U.S is now required to have medical insurance or face a tax penalty.

Health insurers participating in federal marketplaces file proposed rates for individual and small group plans with state insurance departments each year. From there, the departments review the filings to make sure that rates are not excessive or inadequate and to ensure that they are not discriminatory, according to Pennsylvania Department of Insurance spokeswoman Ali Fogarty.

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“The goal of this review is to protect consumers by ensuring rates are fair,” she said in an email. “However, our role is also to maintain market stability by ensuring that companies (see) the market’s attractiveness so consumers continue to have options.”

Participants: Highmark Health Insurance, Capital Advantage Assurance Co., Geisinger Health and Keystone Health are set to offer 2017 plans to Yorkers. An analysis of silver plan rate filings for 21- and 40-year old nonsmokers shows those re-enrolling in Highmark Health Insurance or Geisinger Health plans might pay as much as $144 more each month to maintain the same coverage. Keystone Health Plan and Capital Advantage plans could rise between $43 and $99.

Silver plans offer middle-of-the-road coverage and are often used as benchmarks when comparing rates.

Fogarty said last year the department was able to decrease proposed rates by nearly $81 million. However, for every dollar collected in premiums, Pennsylvania insurers paid $1.16 in claims.

“The Affordable Care Act is still new, and insurers are still learning this population and adjusting their rates to price these plans accordingly,” she said.

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Shop around: With four insurers offering plans in Region 7, York might see more options than other parts of the commonwealth. All but one insurer has pulled out of Philadelphia, and 33 other counties are projected to have just two insurers at the start of open enrollment, according to Pennsylvania Health Access Network. UnitedHealthcare and Aetna both announced they would pull out of Pennsylvania earlier this year, citing too many signups from sicker, costlier residents.

Pennsylvania is set to release final 2017 marketplace rates on Oct. 17, about two weeks before this year’s open enrollment period starts.

“We are stressing that these are proposed increases, and it will be important for individuals to shop around,” said Pennsylvania Health Access network director Antoinette Kraus. “In past years, individuals have been able to find comparable plans and in some cases save money.”

A plan chosen in 2016 might not be the most cost effective in 2017. Kraus also said many people eligible for tax credits would likely see much of the increase offset by the subsidies. To offset the cost of monthly premiums, the federal government offers income tax subsidies  to income-qualifying shoppers of the federal health exchanges.

The Department of Health and Human Services estimates more than 111,000 Pennsylvania residents who currently purchase health care outside of the federal insurance marketplace would be eligible for tax credits.

As officials get ready to tackle the fourth open enrollment of sweeping health care reforms, and with nearly 500,000 Pennsylvanians already covered through the federal marketplace, it’s that population that might be the focus of ads and outreach campaigns in upcoming months.

Obamacare graphic, Amanda J. Cain, acain@yorkdispatch.com