Health Insurer Considers Leaving N.J. Market as Obamacare Premiums Set To Rise

New Jersey’s largest health insurer has proposed raising premiums by an average of 22 percent next year for people who buy their own coverage, while another insurer wants rates for its Obamacare plans to climb as much as 59 percent — and may consider leaving the market.
Citing uncertainty about the changes in health policy in Washington, Horizon Blue Cross Blue Shield of New Jersey said it needs the price hikes — the largest it has requested since the law took effect in 2014 and roughly three times what it requested last year.
AmeriHealth of New Jersey, the other insurer in New Jersey’s Obamacare marketplace, said “We may have to revisit our filings or reassess our participation in the marketplace,” because of uncertainty about health-care reform.
Rates have been rising nationwide while Congress has fought over plans to repeal and replace the Affordable Care Act. President Donald Trump has long criticized the health plan, tweeting last month: “As I said from the beginning, let ObamaCare implode, then deal. Watch!”
In New Jersey, the individual health market had been stabilizing, with modest premium increases in recent years compared with the rest of the country. But mixed signals from Washington have made insurers wary about their ability to continue to offer coverage and consumers worried about whether they will be able to afford it.
“Like any business, health plans want to know with certainty what the rules of the market are,” Ward Sanders, president of the New Jersey Association of Health Plans, said Monday. “They don’t. It makes it a very difficult environment in which to set prices. Leaders in Washington should “make up your mind, and tell everybody what the rules are.”
Nearly 370,000 people buy their own health coverage in New Jersey, and about 220,000 would be insulated from rate hikes by the subsidies they receive through the ACA. But more than 100,000 people buy their coverage directly from insurers, and they will face sticker shock on Jan. 1.
The premium a 40-year-old would pay for one of Horizon’s most popular plans, the Omnia Silver plan, for example, would go from $353 monthly to $416 – a difference of $762 over the year.
AmeriHealth’s “Silver EPO H.S.A. Tier 1 Advantage” plan, the benchmark plan used to set subsidies in New Jersey, would rise by 10.3 percent. For a 40-year-old, that would mean an increase of $34.86 monthly, from $338.52 to $373.39.
The rates still must be approved by the state Department of Banking and Insurance. The federal government recently extended its deadline to Sept. 5 for final rate requests. It’s possible changes will still be made.
Open enrollment begins on Nov. 1 for six weeks, so a decision will have to be made soon. Last year, two insurers withdrew from the marketplace in May and late August, and a third faced a state takeover in September.

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