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Capital Beat: N.H. Insurance Department officials denounce provider-mailed letters


Saturday, November 04, 2017

The language is startling: a nearly $400 monthly premium increase for a New Hampshire 2018 health insurance plan over last year’s rates.

A letter sent recently by an insurance provider to a New Hampshire resident states that in contrast to the $237 monthly premium the consumer paid in 2017, the cost of that plan next year would shoot to $630 a month if they chose to stay on – despite their federal subsidies.

It’s the kind of mailer that doesn’t get ignored. And according to the New Hampshire Insurance Department, which provided a redacted excerpt of the letter to the Monitor, it’s one of many letters Granite Staters have received in recent weeks, prompting a volley of anxious emails and calls.

There’s just one problem, officials say: The letters are often wrong. For those receiving federal subsidies, the gargantuan estimated premium increases are usually far from accurate. In fact, officials say, most subsidized consumers will likely keep paying the same rates as they did before, even as the premium price tags rise.

Now, with the health insurance open enrollment just getting underway, outreach officials at the department and at community health services are working to tell residents not to panic.

“We’re concerned that (the letters) might lead people to not actually go on Healthcare.gov and see what their premium contribution requirement is going to be,” said Alex Feldvebel, deputy commissioner of the Insurance Department.

So what’s actually going on? According to Feldvebel, the misinformation comes out of a simple scheduling inefficiency.

Due to contractual obligations with the state, each insurance company offering plans on the individual market is required to send letters ahead of the open enrollment period. This year – with premiums skyrocketing an average of 52 percent – the baseline price for nearly all plans is set to spike.

But that price does not account for subsidies – which are tied to benchmark rates and designed by law to increase proportionally. According to Feldvebel, while 2018 premiums may be skyrocketing, 2018 subsidies are projected to rise 78 percent to meet the demand.

It’s good news for the roughly 72,000 Granite Staters who receive federal assistance on the individual market. The problem: The exact subsidy increases were not released by the federal Centers for Medicare and Medicaid Services (CMS) until Wednesday – too late for insurance carriers to incorporate into their rate increase letters.

So when updating customers by mail the past few weeks, the companies fell back to last year’s subsidy levels instead. In the example letter provided by the department, the consumer was told that the sticker price for their 2017 premium was $728, but would come down to $237 after a $491 subsidy.

In 2018, the sticker price for that plan shot up to $1,121. Using the 2017 subsidy level, that monthly rate came down to $630 – an apparent $393 increase.

According to Feldvebel, had the company used the correct 2018 subsidy level, that estimated price for the consumer would likely have dropped back down to the $200 range.

It’s a frustrating problem for a department already dealing with a smaller enrollment period and general confusion among consumers about the status of their tax credits or cost sharing reduction subsidies. And because this year is the first year the rates have spiked so dramatically, it’s also not an issue that’s come up before.

Richard Silverberg, CEO of Health First Family Care Center in Franklin, said the center is well aware of the letters.

“That’s been the number one question that all of our people that try to help clients have been trying to answer for people over the past couple of days,” he said. “They call in thinking they’re not going to be able to get insurance that’s affordable because they won’t have as much of a subsidy.”

He said that staff members in the organization’s billing department have been working to provide accurate information.

And Feldvebel said that despite confusion, the Insurance Department appears to be getting through to those who do call. Their main advice? Go to Healthcare.gov, and look up the subsidies yourself.

The kids are heading right

By now the assumption is practically universal: young voters lean Democratic; older generations vote Republican. But recent poll numbers for New Hampshire’s two Democratic senators show some shifting tides.

According to a UNH/Granite State Poll released Oct. 19, while both Sens. Maggie Hassan and Jeanne Shaheen enjoy at-or-above 50 percent approval ratings, support among 18- to 34-year-old voters is sagging slightly.

Just 44 percent of that age group have a favorable opinion of Shaheen, and 41 percent of Hassan; despite the two commanding favorable ratings among those 65 and older (73 and 65 percent, respectively).

The development is new – as recently as February, both senators commanded approval ratings near 50 percent for young Granite Staters.

Some of it can be explained by low name recognition, says Andrew Smith, director of the UNH Survey Center. But it’s also part of what Smith says is a national shift. In the years since 2004 to 2008 – when young Americans fervently supported Democrats in response to an aversion to former President George Bush, and helped push Barack Obama to victory – the enthusiasm has waned, millennials have increasingly been turning their backs on Democrats, Smith says.

A lot of that has to with the gradually fading appeal of the Obama administration, he added.

“This generation is much less Democratic than were people coming of political age, say 10, 12 years ago,” he said, describing the Iraq war and market crash as seminal drivers. “This new group of young people didn’t grow up in that era.”

But while October’s numbers are illustrative, he added, it’s difficult to extrapolate to 2020 – the next election year for Shaheen. To start, it remains to be seen whether or how Donald Trump’s presidency sways young opinion. Secondly: “They don’t vote,” Smith laughed.

Answers at last

Finally, a long-standing State House mystery – and pet project by Speaker Shawn Jasper – may finally be nearing conclusion. Exactly what remains in an antiquated vault in Room 103 is set to be unveiled soon, after the Joint Legislative Facilities Committee approved a request to send in a locksmith to pry in.

The 6-by-10 foot space, residing in the room since the 1800s, has been sealed for decades. Originally serving the state treasury, it’s last thought to have been used for the Department of Motor Vehicles – and last entered in the mid-1900s. Jasper, who may soon be leaving his post, has had his sights set on opening the room for years.

A House spokesman said a date has not been set for the unveiling.

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at
@edewittNH.)