Health insurers in Oregon continue to request smaller annual increases in health insurance rates from year to year and are expanding into new service areas — both signs the market is stabilizing. But efforts to undermine the Affordable Care Act on the federal level are keeping premiums from dropping.
“There’s a likelihood we could have seen rate decreases across the board if not for the federal uncertainty,” Oregon Insurance Commissioner Andrew Stolfi said.
On Tuesday, Stolfi released the rates Oregon insurance companies requested for plans sold to individuals and businesses with 50 or fewer employees. The rates do not apply to most Oregonians who are covered by large employer sponsored plans or public plans such as Medicare or Medicaid.
Seven insurers requested 2020 premium changes ranging from a 3.2% decrease to a 13.5% increase from 2019 rates.
“After net losses in 2015 and 2016, health insurers’ financial statements have revealed over the past two years a return to profitability in 2017 and 2018,” Stolfi said. “Those get reflected in the rates we’ve seen.”
Premiums increased by 23% in 2016 and 27% in 2017, followed by smaller increases of 13% in 2018 and 7% in 2019. The requested rates for 2020, which are likely to be adjusted by the state, represent an average increase of 3.3%.
No insurer pulled out of any of the counties in which they offered plans in 2019, and four plans are entering new services areas in 2020. BridgeSpan Health and Regence are both expanding into Deschutes County, bringing the total number of plans serving Central Oregon to six.
Under the proposed 2020 rates, a 40-year-old Portland resident would have a choice of seven plans with monthly premiums ranging from $436 to $552 per month for a silver level plan, designed to cover about 80% of health care costs. Premiums for the Central Oregon market were not yet available.
Officials noted, however, that 74 percent of Oregonians who purchase individual plans on the health insurance exchange receive a federal subsidy that lowers their costs.
In the small group market, nine insurers requested premiums ranging from a 0.3% decrease to a 13.1% increase, or an average 8.7% increase.
The state will now accept public comment on the proposed rates, issuing its preliminary rate decision in late June, with final rates expected by the end of July.
“Our main role is to make sure the rates charged to consumers adequately cover health care costs, without being too high or too low,” Stolfi said.
State officials said rates for 2018 and 2019 would have been 6% higher if not for a reinsurance program passed by the state Legislature in 2017. That program set aside $90 million in 2018 and $94 million in 2019 to reimburse plans for high-cost patients. In 2018, for example, the state will cover half the claims for patients requiring between $95,000 and $1 million in medical services.
The Legislature has renewed that program for another six years.
But changes at the federal level have largely offset those savings. The Trump administration has eliminated the penalty for not having insurance, allowed for association health plans and short-term health plans that siphon off healthier, lower-cost enrollees, cut funding for marketing and shortened the annual enrollment period. Oregon has factored in these changes in calculating premium increases starting in 2018.
“All of these things have contributed to increase rates about 7% more than they would be otherwise,” Stolfi said.
Mark Griffith, a health care advocate with the consumer-focused Ospirg Group in Portland, said the rate requests are generally modest, although they build on fairly sizable increases in previous years.
“I think this shows that under the status quo, the market is in a fairly stable place in spite of federal disruptions,” he said.
— Reporter: 541-633-2162, firstname.lastname@example.org