Montana’s health insurance companies are asking for rate increases for 2018 ranging from 2 percent to 23 percent. Those numbers released today are much lower than the rate increases for last year, some of which topped 50 percent.
The proposed increases are only for the individual and small group markets. Most Montanans get their health coverage elsewhere, either through their jobs or government programs like Medicaid, Medicare and the Veterans Administration.
The biggest average increase being proposed is by Blue Cross and Blue Shield of Montana: A 23 percent average increase on individual policies. Blue Cross spokesman John Doran says a big factor in that is not knowing whether Congress and the White House will repeal parts of the Affordable Care Act.
"Yeah, that’s exactly it. There is just so much uncertainty with what’s happening in Congress, but also with what the administration will do. They’ve said so far that there’s potential they may not fund the cost sharing reductions, or that they may not enforce the individual mandate, and that provides a lot of risk to the insurance companies in this market," Doran says.
Larry Turney is the president of Montana Health Co-op, which is proposing a four percent increase in premiums for individual health policies next year. He says his company based their rates on the assumption that the Affordable Care Act will remain in place. He says he thinks Blue Cross’s rate increase would probably be about the same as his company’s if they had done the same.
"I think all three insurers are pretty close," Turney says. "I think it tells you the market is stabilizing already, before we even do anything with Trumpcare."
The third insurance company that sells health policies in Montana is PacificSource. It is proposing an average rate increase in its health plans in that market of 7.4 percent. A statement from PacificSource says, "What we see is the marketplace starting to turn around and stabilizing a little bit."
All three insurance companies say it’s not clear whether the plans they’re making for next year, and the rates they plan to charge, will remain in place because of what President Trump and Republicans in Congress are trying to do. Both the Montana Health Co-op’s Larry Turney and Blue Cross and Blue Shield’s John Doran say the biggest thing de-stabilizing the health insurance market in Montana right now is not knowing what Congress and the White House might do.
Blue Cross’s John Doran:
"We need to stabilize the marketplace. And until we get to a stable marketplace, where we have a better projection on the actual healthcare costs of the membership, as well as clarity on the regulations, we’ll continue to see some instability and some uncertainty, and that’s driving rates up. So we need that stability in the marketplace to stabilize rates for Montanans."
Montana’s Insurance Commissioner Matt Rosendale:
"The market will stabilize the more concrete information that we can get out of Washington. Everybody wants to have reliable information. Everyone wants to have a dependable process that they can count on, and I think that what we are seeing come out of Washington is some additional information that gives the insurers some comfort level as to what they can rely on," Rosendale says.
Rosendale is a fierce critic of the Affordable Care Act. His election in November switched control of the insurance commissioner’s office away from Democrats. Rosendale blames the current healthcare law for increased health insurance prices in Montana.
"The rate increases are affected by a number of factors, including the increasing costs of healthcare services, the government policies that mandate insurance companies to provide certain benefits and ban other options, and the amount of healthcare services that are consumed by the insured individuals," he says. "So it’s a number of factors, many of which the insurers themselves can’t control. It’s because of the mandates that have been established through the Obamacare system."
The proposed rate increases would affect about 114,000 Montanans who buy coverage in the small group and individual marketplaces. Most of those buying individual coverage qualify for subsidies that reduce their actual out of pocket costs.
The majority of Montanans get health coverage through their jobs or from government programs including Medicare, Medicaid and the Veterans Administration.
Commissioner Rosendale’s office has the power to review the proposed rate increases, but cannot legally deny them. Rosendale’s office is taking public comment on the rates through August 1, and will hold public meetings about them in Billings and Helena on July 24 and 26.