Those buying health insurance next year should be prepared for sticker shock — at least if insurance companies have their way.
Insurers have submitted rate requests to the government that, in some cases, call for increases as high as 81 percent, according to newly released data from the Centers for Medicare & Medicaid Services.
As shocking as those hikes might be, a Pennsylvania Insurance Department spokesman says consumers don’t need to panic yet.
“There’s a process to go through,” he said, referring to the ability of the state to reject outlandish proposals. “Whatever numbers they’re looking at now, they should not interpret those as necessarily being what is going to be in place in November.”
The figures also don’t reflect the entire market — just increases of 10 percent or more, which by law must be made public for review and are available on a new website.
“It’s impossible to gauge what will be happening in the market as a whole by just looking at the big premium increases,” said Larry Levitt of the Kaiser Family Foundation. “It’s like trying to estimate the average height of the population by just looking at NBA basketball players.”
Nevertheless, some of the numbers are startlingly high — 24 percent more for a Highcross plan in Delaware, for instance, or 61 percent more for a Time Insurance Company plan in Pennsylvania.
One reason for increased premiums is a slight tick upward in heath care costs, particularly due to rising prescription drug expenses, said Levitt.
But the largest rate bumps are more likely the result of companies making poor initial estimates and ending up with sicker and older enrollees than they envisioned.
“The really big swings in premiums we’re seeing are because insurers either guessed very wrong on the high side or the low side about how much health care people were actually going to use,” said Levitt.
Delaware Insurance Commissioner Karen Weldin Stewart said that while state actuaries will be looking for places to cut costs for consumers, many of the rate increases are reasonable.
“When they’re paying more out per dollar than they’re receiving, it’s definitely something that is non-negotiable,” she said. “You’re going to have to yield, because you can’t expect them to go under.”
The Delaware Insurance Department is holding three information sessions in June to hear from the public on the planned rise in premiums, along with a 30-day comment period that will close July 15.
Americans receiving subsidies through the health care law won’t necessarily have to pay more if plan prices are jacked up. Levitt said those individuals would still only be expected to shell out a certain percentage of their income, although they might have to change plans to qualify.
“If premiums rise substantially,” he said, “it’s really the government that takes the hit, not consumers.”
More than 80 percent of Americans with a marketplace plan in 2015 received a tax credit, averaging $263 per month.
Rates will be finalized by Nov. 1, in time for the next open enrollment period.