Lower Delaware ACA rate hike approved

Delawareans who receive their health insurance through the Affordable Care Act will face premium hikes next year.



Delawareans who receive their health insurance through the Affordable Care Act will face premium hikes next year.

Insurance Commissioner Trinidad Navarro, D-Delaware, announced Thursday Highmark Blue Cross Blue Shield of Delaware will increase its “Obamacare” rates by 25 percent.

Highmark, which is the only insurance company participating in Delaware’s Marketplace since Aetna withdrew in May, originally requested a 33.6 percent rate increase for individual Marketplace policies.

Navarro said after several months of negotiating with Highmark executives to stay in the Marketplace, he was able to drop the rate increase slightly. He said it’s the first time in at least three years the state has been able to reduce the company’s rate request.

  • WHYY thanks our sponsors — become a WHYY sponsor

“I’m saddened by the fact there’s any increase whatsoever, but when Aetna left Delaware that left us with no advantage whatsoever with negotiating,” Navarro said.

“Highmark is the only company still offering plans on the exchange, and to their credit they could have said, ‘Give us what we want or we’re leaving,’ and they didn’t say that. They sat down at the negotiating table, and we sat for hours, multiple times, in-person, on the phone, with folks from Delaware, as well as from Pittsburgh.”

Costs are based on salary and other calculations, but if someone is paying $600 a month now, it will increase to $750 a month next year, for example.

Navarro said his office received calls from constituents who say they have to choose between paying for health insurance or for rent, food and prescriptions. Adding salt to the wound, Delaware is the 31st least healthy state in the country, and its population is aging, he said. Navarro said hospital costs also are significantly higher in Delaware than in neighboring states.

About 95 percent of the Delaware population has health insurance, and about 5 percent or 35,000 people, do not have coverage.

Last year, there were about 27,000 Delawareans insured under the ACA, which is 3 percent of the state’s population, according the commissioner’s office.

“These 27,000 people are among those who can least afford a rate increase. There were almost 200 public comments that my staff and I carefully reviewed and took into consideration. I anguished over this rate filing, particularly after reading the comments we received,” Navarro said.

“I thought about how this affects those with limited income, but I also had to consider the possibility of Delaware not having any Marketplace option should Highmark withdraw from the ACA market.”

This rate filing has no impact on Medicare, Medicaid or coverage by private and government employers, however.

Findings from an independent actuary determined Highmark’s request was slightly higher than warranted.

Navarro said attempts to repeal and replace the ACA and its uncertain future led to the increased rates. Part of that uncertainty includes assumptions the federal government would not make cost sharing reduction payments next year, something between 82 and 85 percent of Delawareans qualify for, and also would not enforce the individual mandate component of the ACA.

“It is unfortunate that all of the uncertainty in Washington regarding the ACA has such a devastating impact on Delawareans, as well as citizens of other states across the nation,” Navarro said. “Maryland just announced an increase of 47 percent for most ACA plans. There are some states seeing increases of 40 percent or more.”

Delaware Democratic Party Chairman Erik Raser-Schramm released a statement in response to the rate increase, blaming President Donald Trump for the burden.

“What Delawareans deserve to know—but likely never will—is the extent to which President Trump’s destructive brinksmanship has artificially driven up rates,” he said.

“From all but eliminating ACA outreach efforts to weakening enforcement of the individual mandate to threatening the withdrawal of federal cost sharing reductions on which insurance companies like Highmark rely, Trump is intentionally muddying the waters and unsettling the insurance marketplace, deceitfully playing politics with people’s lives. There are some Senate Republicans working with Democrats—including Sens. Carper and Coons—on crafting a serious proposal that will stabilize the insurance markets and repair the flaws in the ACA, but it is being undermined by our self-serving Saboteur-in-Chief, who is far more fixated on undoing President Obama’s legacy than he is helping Americans access affordable health care. If and when that interference ends, I’m optimistic real progress on health care is possible going forward.”

The state is in talks with two other health insurance companies interested in joining the Delaware Marketplace in 2019. Navarro said that would make the state more competitive and drive prices down. The likelihood of that happening depends on whether or not Congress can work together, he said.

“Not only have they not clarified whether they’re going to pay the cost share reductions or enforce the individual mandate, now commissioners across the country have to approve the rate increase. But they’ve also cut funding for advertising for the ACA by 90 percent, for some navigators they’ve cut the funding, we’re lucky in Delaware, but they’ve shortened the enrollment period by almost half, and they’ve announced they’re going to do maintenance on the healthcare.gov website on Sundays. Don’t forget, and many folks don’t know, about risk corridor payments, payments profitable insurance companies paid into a pool so less profitable companies could withdraw money from that and balance their losses. Sen. Marco Rubio eliminated that a few years ago, so that was no longer an option as well,” Navarro said.

“I think ultimately if you remove the lifeblood or oxygen of any organism it will die. There are so many things that have happened with the ACA this year that are leading to what’s going to be the end of it, unless cooler heads can prevail and both sides of the aisle can work together.”

The Healthcare.gov website should have updated ACA rates for all states after November 1st, according to the commissioner’s office.

WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.

Want a digest of WHYY’s programs, events & stories? Sign up for our weekly newsletter.

Together we can reach 100% of WHYY’s fiscal year goal