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Maine ACA Insurers Seek Far Lower Rate Hikes Than Expected
06/04/2014   Reported By: Patty B. Wight

What goes up, as they say, must come down. But the law of gravity doesn't necessarily apply to insurance premiums. Next year, Maine insurance premiums for the Affordable Care Act's online Marketplace will generally go up, but far less than expected. Patty Wight reports on the outlook for individual insurance on the 2015 Marketplace.

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 Duration:
3:32

Forty-one percent. One-hundred percent. Four-hundred percent. These were some of the projections on how much insurance premiums would rise on the individual insurance marketplace under the Affordable Care Act.

But in Maine, Insurance Superintendent Eric Cioppa says the actual numbers for 2015 are much smaller: "The range of requested increases is from .1 percent to 3.1 percent," Cioppa said.

That's for all three insurance companies who will sell plans on the Marketplace next year - Anthem, Maine Community Health Options, and newcomer Harvard Pilgrim.

Cioppa shared the proposed increases with Maine's Health Exchange Advisory Committee on Tuesday, and the news prompted a double take from some members of the committee, including Mitchell Stein, an independent health care policy consultant.

'I'm sorry, I just have to make sure that we heard correctly: The highest rate increase from any carrier is 3.1 percent?" Stein asked.

"Average. These are average numbers," Cioppa replied.

"Average - OK. That's why I needed to clarify," Stein responded.

Anthem's premiums will fluctuate between about an 8 percent drop to a maximum 10 percent increase. Maine Community Health Options' premiums will vary from a 3 percent reduction to about a 1 percent increase.

The rates are still subject to review, and the director of communications at the U.S. Department of Health and Human Services, Erin Shields Britt, says the final rates could be even lower. "Actually in Maine, last year the state reduced premium requests by as much as 35 percent," she says.

Historically, insurance rates on the individual market have seen annual double-digit rate increases. But Mitchell Stein, who spoke on the phone after the advisory committee meeting, says he thinks next year's low premium hikes aren't just a blip.
"I would also expect to see even more moderated rate increases going forward after 2015," he says.

That's because Stein expects the number of people covered by insurance to grow. That means less uncompensated care, which is typically paid for through higher premiums for everyone else.

Though Stein sees sunnier skies ahead, not everyone shares that outlook. A health economist from the University of Minnesota predicts that over the next decade insurance enrollments will decrease and premiums will go up. Stephen Parente based his projections partly on the end of premium-stabilizing programs in 2016.

But Erin Shields Britt of the U.S. DHHS says it's important to remember the so-called 80/20 rule, "that requires insurers to spend at least 80 percent of premium dollars on health care needs," versus administrative and overhead costs.

This rule, which is designed to ensure that consumers receive value, doesn't expire. And Britt says some Maine consumers have already received rebates because their insurance companies didn't adhere to the 80/20 rule - a total of $3 million in 2011.
"And in 2012 we saw the state receive nearly $500,000 back in rebates," she says.

Both Anthem and Maine Community Health Options declined to go on tape about their proposed rates, but released written statements that said the filings reflect current information on health care costs, as well as commitments to accessing high quality care.

While Mitchell Stein is thrilled with the numbers as they stand, he says there's still more work to do."We know that any rate increase is still problematic for some people," he says, "so while we think, historically, this is very good news, we're not done."

Stein says he hopes in the future, premium rates will hold steady or match overall inflation.



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