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Health insurers making cases for Pa. rate hikes

Saying their own costs have risen, health insurance companies made their cases to state regulators Wednesday for double-digit rate increases next year for individual policies in Pennsylvania.

Saying their own costs have risen, health insurance companies made their cases to state regulators Wednesday for double-digit rate increases next year for individual policies in Pennsylvania.

The requests before the Insurance Department include proposed average rate increases of 17.2 percent for Aetna Health Inc., 25.4 percent to 48.1 percent for Highmark companies, 0.9 percent to 16.2 percent for UPMC companies, and 19.9 percent to 22.5 percent for Independence Blue Cross companies, according to the department.

While Insurance Commissioner Teresa Miller described the proposed rate increases as significant, she said they are not unique to Pennsylvania.

Arthur Lucker, an actuary with INS Cos., said the consulting firm is seeing an average increase of about 22.5 percent in states where it is reviewing rates.

Five percent of Pennsylvania health insurance customers - more than 500,000 people - have coverage through individual plans, according to the Insurance Department.

Speaking at the informational hearing, insurance executives cited factors including the rising cost of health care.

"The underlying cost of providing services continues to go up, forcing health insurance companies to raise rates in order to cover the cost of services," said Jeffrey Scheib, vice president of actuarial services at Highmark Inc.

Rates represent the base prices for health insurance. In calculating premiums, the amount policyholders pay for coverage, companies can consider age, location, tobacco use, and family size."

Companies then calculate premiums, the amount policyholders pay for coverage, by considering age, location, tobacco use, and family size.

Regulators must approve rates for individual plans before policies can be sold to consumers, ensuring that they are priced neither unfairly high nor too low to maintain a stable and competitive market. The Insurance Department is scheduled to announce its determinations in October, ahead of the Nov. 1 start of the open-enrollment period. The rate requests were made public in May.

Antoinette Kraus, director of the Pennsylvania Health Access Network, urged the department in a statement to the media to ensure rates are fair. A group with the Put People First! PA campaign sat in the hearing room wearing red shirts, some of them labeled with the words "Health Care Is a Human Right."

Orlanda Smith, 60, of Philadelphia, traveled to Harrisburg to ask that the rate increase requests be denied. She said afterward that, after retiring from the city for medical reasons, she purchased an individual plan last year and has been dismayed by the costs. She said she has stopped taking a medication she had been taking for years because she cannot afford it.

"After working 37 years, hard, long years, I didn't expect that if I got sick, that I would have no coverage that I can afford to pay for," she said.

In a statement, Miller said that "cost is not the only measure of impact on consumers." She said her department is "also charged with ensuring this market is sustainable and that Pennsylvania's consumers continue to have choices when they seek health insurance coverage."

klangley@post-gazette.com 717-787-2141 @karen_langley