Majority of insurers cite federal uncertainty as reason for double-digit premium hikes

A large portion of payers selling coverage on the ACA exchanges next year are blaming proposed premium rate increases in part on policy uncertainty, according to a Kaiser Family Foundation report.

In recent 2018 rate filings, some insurers are overtly assuming enforcement of the ACA's individual mandate will weaken or cost-sharing reduction payments, which help insurers subsidize the cost of coverage for low income Americans, will cease.

For its report, KFF examined publicly available preliminary premiums and ACA exchange participation for insurers in 20 states and the District of Columbia. Researchers focus on the second-lowest cost silver plan — which represents the benchmark for premium tax credits — offered in major cities across the states. Proposed premiums and exchange participation are subject to change, as rates and participation aren't confirmed until late summer or early fall, the report states.

Based on preliminary 2018 rate filings, KFF researchers found a 40-year-old nonsmoker with a silver plan will pay premiums ranging from $244 in Detroit to $631 in Wilmington, Del. KFF notes 84 percent of ACA exchange enrollees are eligible for tax credits to lower premiums.

Payers assuming the ACA's individual mandate won't be enforced factored in a between 1.2 percent and 20 percent increase in their 2018 rate proposals. Insurers assuming cost-sharing reductions payments will be eliminated assumed an additional 2 percent to 23 percent rate increase for 2018 premiums.

"A number of insurers have requested double-digit premium increases for 2018. Based on initial filings, the change in benchmark silver premiums will likely range from -5 percent to 49 percent across these 21 major cities," the report states. 

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