March 19, 2014, 06:00 am - The Hill
O-Care premiums to skyrocket
By Elise Viebeck
Health industry officials say ObamaCare-related premiums will double in some
parts of the country, countering claims recently made by the administration.
The expected rate hikes will be announced in the coming months amid an
intense election year, when control of the Senate is up for grabs. The sticker
shock would likely bolster the GOPfs prospects in November and hamper ObamaCare
insurance enrollment efforts in 2015.
The industry complaints come less than a week after Health and Human
Services (HHS) Secretary Kathleen Sebelius sought to downplay concerns about
rising premiums in the healthcare sector. She told lawmakers rates would
increase in 2015 but grow more slowly than in the past.
gThe increases are far less significant than what they were prior to the
Affordable Care Act,h the secretary said in testimony before the House Ways and
Means Committee.
Her comment baffled insurance officials, who said it runs counter to the
industryfs consensus about next year.
gItfs pretty shortsighted because I think everybody knows that the way the
exchange has rolled out c is going to lead to higher costs,h said one senior
insurance executive who requested anonymity.
The insurance official, who hails from a populous swing state, said his
company expects to triple its rates next year on the ObamaCare
exchange.
The hikes are expected to vary substantially by region, state and
carrier.
Areas of the country with older, sicker or smaller populations are likely to
be hit hardest, while others might not see substantial increases at all.
Several major companies have been bullish on the healthcare law as a growth
opportunity. With investors, especially, the firms downplay the consequences of
more older, sicker enrollees in the risk pool.
Much will depend on how firms are coping with the healthcare lawfs raft of
new fees and regulatory restrictions, according to another industry
official.
Some insurers initially underpriced their policies to begin with, expecting
to raise rates in the second year.
Others, especially in larger states, will continue to hold rates low in order
to remain competitive.
After this story was published, the administration
pointed to some independent analyses that have cast doubt on whether the current
mix of enrollees will lead to premium hikes.
ObamaCare also includes several programs designed to ease the transition and
stave off premium increases. Reinsurance, for example, will send payments to
insurers to help shoulder the cost of covering sick patients.
But insurance officials are quick to emphasize that any spikes would be a
consequence of delays and changes in ObamaCarefs rollout.
They point out that the administration, after a massive public outcry, eased
their policies to allow people to keep their old health plans. That kept some
healthy people in place, instead of making them jump into the new exchanges.
Federal health officials have also limited the amount of money the government
can spend to help insurers cover the cost of new, sick patients.
Perhaps most important, insurers have been disappointed that young people
only make up about one-quarter of the enrollees in plans through the insurance
exchanges, according to public figures that were released earlier this year.
That ratio might change in the weeks ahead because the administration
anticipates many more people in their 20s and 30s will sign up close to the
March 31 enrollment deadline. Many insurers, however, donft share that
optimism.
These factors will have the unintended consequence of raising rates, sources
said.
gWefre exasperated,h said the senior insurance official. gAll of these major
delays on very significant portions of the law are going to change what itfs
going to cost.h
gMy gut tells me that, for some people, these increases will be significant,h
said Bill Hoagland, a former executive at Cigna and current senior vice
president at the Bipartisan Policy Center.
Hoagland said Sebelius was seeking to gsoften up the American publich to the
likelihood that premiums will rise, despite promises to the contrary.
Republicans frequently highlight President Obamafs promise on the campaign
trail to enact a healthcare law that would gcut the cost of a typical familyfs
premium by up to $2,500 a year.h
gTheyfre going to have to backpedal on that,h said Hoagland, who called
Sebeliusfs comment a gpre-emptive strike.h
gThis was her way of getting out in front of it,h he added.
HHS didnft comment for this article.
Insurers will begin the process this spring by filing their rate proposals
with state officials.
Insurance commissioners will then release the rates sometime this summer,
usually when theyfre approved. Insurers could also leak their rates earlier as a
political statement.
In some states, commissioners have the authority to deny certain rate
increases, which could help prevent the most drastic hikes.
Either way, there will be a slew of bad headlines for the Obama
administration just months before the election.
gItfs pretty bad timing,h said one insurance official.
Other health experts say predictions about premiums are premature.
David Cutler, who has been called an architect of Obama-Care, said, gHealth
premiums increase every year, so the odds are very good that they will increase
next year as well. None of that is news. The question is whether it
will be a lot or a little. That depends in part on how big the insurers
think the exchanges will be.h
Jon Gruber, who also helped design the Affordable Care Act, said, gThe bottom
line is that we just donft know. Premiums were rising 7 to 10 percent a year
before the law. So the question is whether we will see a continuation of that
sort of single digit increase, as Sebelius said, or whether it will be
larger.h
The White House and its allies have launched a full-court press to encourage
healthy millennials to purchase coverage on the marketplaces.
HHS announced this week that sign-ups have exceeded 5 million, a marked
increase since March 1.
White House press secretary Jay Carney on Tuesday claimed the administration
has picked up the pace considerably, saying months ago reporters would have
laughed if he ghad said there would be 5 million enrollees by March 18.h
It remains unclear how many of those enrollees lost their insurance last year
because of the lawfs mandates. Critics have also raised questions about how the
administration is counting people who signed up for insurance plans.
Political operatives will be watching premium increases this summer, most
notably in states where there are contested Senate races.
In Iowa, which hosts the first presidential caucus in the nation and has a
competitive Senate race this year, rates are expected to rise 100 percent on the
exchange and by double digits on the larger, employer-based market, according to
a recent article in the Business Record.
Sheila Timmons contributed.