New Jersey regulators approve Affordable Care Act rate increases

Horizon Blue Cross Blue Shield of New Jersey, the state’s largest health insurer, said Tuesday that state regulators had approved average rate increases of 24.3 percent on individual Affordable Care Act plans for next year.

The New Jersey Department of Banking and Insurance also approved an average overall increase of 17.1 percent for competitor AmeriHealth New Jersey, a unit of Philadelphia’s Independence Health Group, AmeriHealth said.

Were it not for uncertainty over federal policy, such as the elimination of payments to insurers to cover out-of-pocket costs for consumers and weakened enforcement of the requirement that individuals buy health insurance, the increases would have been significantly lower, Horizon said.

Horizon had 72.43 percent of New Jersey’s individual market, including plans sold on and off the federal marketplace in this year’s second quarter, with 246,632 customers. AmeriHealth had 27.01 percent, or 91,989 customers, according to state data. Aetna, Cigna, and Oxford had small numbers of customers in plans sold off the exchange.

Since the launch of the individual health insurance market under the ACA in 2014, New Jersey has generally seen lower increases than many other states because New Jersey already prohibited insurers from turning consumers away based on preexisting conditions. Adjusting to that ACA rule was a factor that made it hard for insurers in many states to accurately price their plans.

The steep increases approved by regulators this week in New Jersey and Pennsylvania could change if a deal is reached in Washington to restore the cost-sharing payments to insurers. In any case, most consumers will not feel the full impact of the increases because advance refundable tax credits will make up much of the difference.