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Individual Health Is Stabilizing in Pennsylvania, Unless GOP Disrupts It

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(Bloomberg) — Prices for individual major medical plans are stabilizing in Pennsylvania and will continue to unless the Trump administration and Republicans in Congress take action that would hurt the program, the state’s insurance regulator said.

After a jump of more than 30% this year, insurers are raising their rates 8.8% on average in the Affordable Care Act’s individual public exchange market for 2018, the Pennsylvania Insurance Department said. All five insurers that sold plans this year will again offer health insurance next year in the market, which covers about 500,000 people in the state, according a department statement.

(Related: California Lets Insurers Put ACA Changes in 2018 Rate Filings)

“These low percentages show that Pennsylvania’s market is stabilizing and insurers are better understanding the markets and the population they serve,” Insurance Commissioner Teresa Miller, a former federal health official in the Obama administration, said in the statement.

Increases in the cost of health insurance under the Affordable Care Act have become a political flash point, with Democrats and Republicans trading blame for the causes. Insurers across the U.S. have been raising rates as they struggle to profit from the public exchange programs that were created by the ACA for individuals to buy health insurance. Health and Human Services Secretary Tom Price has been touting a study put out by his department that shows premiums have doubled since key ACA health insurance rules took effect, in January 2014. The study doesn’t account for the subsidies that help individuals afford insurance purchased through the public exchange system.

In Pennsylvania, insurers told the regulator what would happen if key pieces of the ACA are eliminated or altered by Washington lawmakers. If the ACA requirement that all people buy insurance, known as the individual mandate, is repealed, companies would boost premiums 23.3%. President Donald Trump has threatened the health law’s cost-sharing reduction payments that help patients pay out-of-pocket health expenses. If those were to end, premiums in Pennsylvania would climb an estimated 20.3%.

The story was similar in North Carolina. BlueCross BlueShield of North Carolina, the state’s dominant insurer, said it assumed the cost-sharing reduction payments wouldn’t be made, when it asked regulators to boost its premiums about 23%. The company said that if the federal payments were guaranteed to continue, it would have asked for an 8.8% rate increase.

— Read Actuary Sizes Up 2018 Individual Health Picture on ThinkAdvisor. 


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