- Insurer's rate hike of 16.3 percent exceeds first request
- Blue Cross & Blue Shield of Florida also sees added premiums
No. Take more. Really.
While most states have been pushing health insurers to curb proposed price increases, Florida is telling some of them they can charge more.
The state on Wednesday approved an average premium increase of 9.5 percent for Affordable Care Act plans sold to individuals for next year. Insurers had asked to boost rates 8.6 percent on average.
Humana Inc. and Blue Cross & Blue Shield of Florida were among those whose final rates were higher than they’d first sought. Alex Kepnes, a Humana spokesman, said the approved increase incorporated updated information from the U.S. government on ACA programs designed to spread cost, known as reinsurance and risk adjustments.
Kepnes said it’s routine for rates to be adjusted between initial submission and final approval. Calls to a BCBS media line weren’t answered.
Blue Cross Doubled
Regulators can push insurers to raise rates if they think companies aren’t charging enough to cover costs, which could raise the prospect of a company failing. They also have the power in some states to force insurers to lower rates.
“In most cases, when a state changes a rate in the rate review process, it’s to lower it, not to increase it,” said Cynthia Cox, who studies private health plans at the Kaiser Family Foundation.
Humana had asked to raise rates 7.4 percent in one set of plans it’s selling in Florida. Instead, the Florida Office of Insurance Regulation told it to boost rates 16.3 percent. For the Blue Cross & Blue Shield plan, the final rate increase was 8.9 percent, more than double the 4.3 percent request.
The rate increases were determined by a review that included risk adjustment amounts and other factors, Amy Bogner, a spokeswoman for the Florida regulator, said by e-mail.
Florida also held down rate requests for some insurers. Aetna’s premium increase was limited to 13.9 percent, down from a requested 21 percent.
Humana, which is being acquired by Aetna Inc., has faced higher-than-expected costs in some policies it sold under Obamacare. In Georgia, for instance, the company said its customers were sicker than expected, and it had to cover more out-of-network doctor visits than it planned for.
The insurer ran into that problem in Florida as well, and told regulators it expects more customers to stay in network next year.
The rates are averages, weighted by 2015 enrollment, and don’t take into account subsidies that individuals with low incomes get to buy coverage. More than 93 percent of enrollees in Florida are getting those subsidies this year, receiving $294 a month on average. Rates can vary by age and geographic area.
Florida isn’t the only state that made insurers raise their charges. In Oregon, Kaiser Foundation Health Plan asked to cut rates by 2 percent and ended up increasing premiums by 8.3 percent on average.