IBC seeks smaller hikes on Philly area's 2018 Affordable Care Act plans

Independence Blue Cross requested rate increases ranging from 2.8 percent for an HMO to 15 percent for a Personal Choice plan, the Pennsylvania Insurance Department announced Friday.

If granted, the company-average 8.5 percent increase would be far less than the 28 percent average increase that regulators approved for Affordable Care Act plans in effect this year. The rates could still increase dramatically if Washington makes big changes to the health law or repeals it, or Independence could leave the exchange entirely, as many insurers across the country have already done.

Republican congressional leaders, urged on by President Trump, continue to wrestle with ways to radically alter the system established by the 2010 law or to simply repeal it and replace it with something else later.

The turmoil has been frustrating for insurers, said Daniel J. Hilferty, president and chief executive of Independence, which is the only company selling individual ACA plans on the federal exchange for Philadelphia and Bucks, Chester, Delaware, and Montgomery Counties.

Not knowing whether subsidies, known as cost-sharing reductions, will be paid or if the individual requirement to buy insurance will be enforced or dropped is making it hard for Independence to commit to selling plans on the exchange for next year because without those pillars of the ACA, its average rate increase would soar into the high 20 percent range.

"We have made no decision at this point. Things are so fluid. We are looking for any sign of commitment to pay the CSRs, of commitment not to repeal the mandate, at least during a transition period to whatever comes next in 2020," Hilferty said Friday.

Insurers have until Sept. 27 to decide whether they will be on the exchanges next year, according to consulting firm Mark Farrah Associates, which also said this week that nationally, 141 health plans filed applications to offer ACA coverage next year, down 38 percent from 227 last year.

Open enrollment will start Nov. 1 and run through Dec. 15, a shorter period than in recent years, designed to make it harder for individuals to opportunistically sign up for insurance when they get sick.

Independence's Keystone Health Plan East, which sells HMOs, requested an average rate increase of 4.6 percent, with a range of 2.8 percent to 12.3 percent. The company has 151,360 people in plans affected by these changes.

For a 40-year-old nonsmoker, the monthly cost before subsidies of Keystone's cheapest Silver plan would climb 3 percent, to $385.71 from $373.94, if Independence's request is granted, the state said. From 2016 to 2017, the cost of the corresponding plan soared 35 percent.

The Independence unit that sells Personal Choice plans asked for a bigger average increase of 13.9 percent, with plan hikes ranging from 11.7 to 15 percent, the state said. These plans have 53,205 members.

The monthly cost before subsidies of the cheapest Silver Personal Choice plan for a 40-year-old nonsmoker would jump 13 percent to $515.10 from $453.95, if the insurance department approves the company's request. Last year, the corresponding plan was up 17 percent.

Statewide, insurers asked for an average 8.8 percent increase.

"Pennsylvania's individual market is stabilizing, and the current rate requests we see, which are in line with the annual trend in medical costs, are proof of this," Insurance Commissioner Karen Miller said.

Miller cited a study by consulting firm Oliver Wyman that predicted nationwide average increases of 5 percent to 8 percent to account for the cost of care. Insurers had a break in 2017 from the federal health insurer tax. Its return next year accounts for a 3 percent increase from that tax.

Other states, like Maine, Georgia, Florida, Colorado, and Washington, are still struggling with volatility and have seen requests for across-the-board double-digit rate increases, according to local news accounts.

Miller warned that Pennsylvania's relative stability this year is not guaranteed to last. "I have asked Congress and the Trump administration to help stabilize the individual market rather than trying to undermine the entire law, which will only hurt the real Pennsylvanians who benefit from the law," she said.

The department has scheduled meetings to gather feedback on the rate requests. In the Philadelphia area, consumers will be able to comment on 7 p.m. Aug. 30 at the Free Library of Northampton Township, 25 Upper Holland Rd,, Richboro. For 30 days, public comments will also be accepted by email at ra-in-comment@pa.gov.