Affordable Care Act (ACA) premiums are still rising.
According to statistics gathered by the Urban Institute and the Robert Wood Johnson Foundation, premiums in the state exchanges jumped 32% nationally for silver-tiered plans, with gold-tier plans rising 19.1%.
Increases in the lowest silver plan premiums tended to be larger than the increases in the lowest gold premiums, but there were several exceptions.
There was tremendous variation across states in rates of increase. Some of the smallest increases (including some decreases) were in states with high 2017 premiums.
The average lowest silver premiums remained below the average lowest gold premiums in each state we studied, but the difference between the two ranged from 3.0 percent (District of Columbia suburbs in Maryland) to 77.4 percent (Augusta, Georgia), in the selected large markets analyzed.
More insurers exited markets than entered new markets in 2018 in our study areas.
States with Medicaid managed care organizations and/or many competing insurers offering marketplace coverage tended to have the lowest premiums.
Why Did Obamacare Premiums Rise So Much in 2018?
According to the researchers:
“The premium increases reflect significant policy changes and policy debates specifically affecting insurer decisions for the 2018 plan year as well as more typical annual considerations such as trend and healthcare costs,”
The loss of the “Cost Sharing Reduction (CSR)” payments meant that insurers no longer were helped in offsetting the cost of covering lower-income enrollees in the ACA.
States were given the choice of spreading out the lost CSR payments across all the plan levels, or loading all the increases into just the silver tier.
26 states had insurers allocate the CSR costs to silver marketplace premiums alone, eight states had the costs allocated to silver plans on and off the marketplaces, three states had insurers spread the costs across all metal tiers in the marketplace, three had insurers spread the costs across all metal tiers on and off the marketplace, and in three states’ approaches varied across insurers,” the study found.