Kaiser Releases Tracker for 2019 Marketplace Insurance Premiums

Using data from 8 states, the Kaiser Family Foundation is tracking preliminary 2019 insurance premiums in the Affordable Care Act (ACA)’s marketplaces as rate information is filed with state regulators. The 8 states are Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington, plus the District of Columbia.

The tracker, which will be updated as additional states release insurers’ preliminary rate filings, shows preliminary premium information in 9 major cities for the lowest-cost bronze plan and “benchmark” silver plan. Silver-level plans are used to determine the size of the premium tax credits available to low- and moderate-income enrollees.

Based on insurers’ requested premium increases in the states available, benchmark premium increases before tax credits range from 7% to 36% in these 9 cities, compared to 2018.

The tracker presents premiums for a hypothetical 40-year-old nonsmoking enrollee making $30,000 annually, before and after available tax credits. In that example, the average increase in the benchmark silver premiums is 2% after tax credits. The tracker also includes the number of insurers that plan to participate and the range for insurers’ average rate increases in each state.

Kaiser said that insurers are factoring in changes made by the Trump administration, including the repeal of the individual mandate and the encouragement of short-term, limited-duration (STDL) health plans.

Kaiser noted that without the individual mandate penalty, some people who currently have marketplace insurance may stop purchasing or switch to the non—ACA compliant STDL plans. It is likely that those who leave the regulated individual insurance market will be healthier than those left in the marketplace, Kaiser said. That change will increase premiums in 2019 more than would otherwise be the case, Kaiser said.

Short-term plans will compete with plans regulated by the ACA, which currently offer more robust health coverage by prohibiting annual and lifetime benefit limits, requiring coverage of all essential health benefits, and otherwise prohibiting insurers from setting premiums or choosing whether to sell coverage to consumers based on pre-existing conditions.

However, that could change. Last week, in a surprise move, the administration said it would not defend the defend the constitutionality of the ACA, mostly siding with 20 Republican-led states that brought a suit against the ACA, saying it is unconstitutional.

The brief was filed in Texas v. Azar, a case brought in February by Texas and 19 other Republican-led states. The states said that since President Trump’s tax reform package in December 2017 removed the individual mandate requirement as a tax penalty, the law should go away altogether, because a 2012 Supreme Court decision said that it was Congressional power to tax that kept the law from being held unconstitutional.

The brief filed by the Department of Justice said consumer protections for people with pre-existing conditions should also be declared unconstitutional, because they cannot be separated from the mandate.

That would mean 52 million Americans with pre-existing conditions are at risk of denial of coverage or higher premiums, wrote Timothy S. Jost, JD, an emeritus professor at the Washington and Lee University School of Law. Insurers would be able to charge higher premiums for patients with chronic conditions, those in certain occupations, women, or older people, he said.