2019 ACA rates to decrease for first time in Pennsylvania

In this Aug. 22, 2018 photo, April Box poses for a photo at her home in Spokane, Wash. Box is a healthcare advocate and runs a website to help guide people through major surgeries and other aspects of the healthcare system.  (Ted S. Warren/AP Photo)

In this Aug. 22, 2018 photo, April Box poses for a photo at her home in Spokane, Wash. Box is a healthcare advocate and runs a website to help guide people through major surgeries and other aspects of the healthcare system. (Ted S. Warren/AP Photo)

Pennsylvanians on Affordable Care Act insurance will see an overall rate cut of 2.3 percent for 2019.

This will mark the first year since the individual marketplace opened in 2014 that rates will go down, not up. Premiums increased 114 percent over the previous three years ending in 2018.

What people will end up paying, as in previous years, varies by age and county. Some counties will see significant premium decreases. The lowest-cost silver plan in Dauphin or Cumberland counties for a 21-year-old nonsmoker will be $410 in 2019. That’s down from $491 in 2018. In York or Lancaster counties, a 40-year-old nonsmoker would pay $598 a month for a silver plan in 2019. That’s $108 less than what they’d have spent on a silver plan this year.

Elsewhere the changes are less substantial.

In Chester County, a 30-year-old nonsmoker will pay $412 in 2019 for the lowest-cost silver plan, a $1 decrease from 2018. In Allegheny County, that same person would pay $291 for the cheapest silver plan, odwn $19 from this year.

Four out of five people will qualify for a subsidy to lower their premium, Insurance Commissioner Jessica Altman said.

Altman said last year’s big increases were due to Trump administration efforts to dismantle the ACA. Trump ended a key subsidy known as the cost-sharing reduction.

Trump’s 2018 tax package also reversed the individual mandate rule, which required people to get insurance or pay a tax.

“We accounted for many of the things that have happened to this market because of the federal government last year, and so the increases from last year’s rates are minimal.”

Altman also points to more insurer options, as well as a 5.5 percent uninsured rate, as evidence of a healthy marketplace.

The moment of stability comes as the future of the ACA is uncertain. A federal lawsuit filed this year by 20 Republican state attorneys general aims to declare the ACA unconstitutional.

In addition to providing the insurance marketplace, the ACA expands Medicaid and prevents insurers from denying coverage to those with pre-existing conditions.

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