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As costs rise, insurance department reviews premium trends

  • The Healthcare.gov website is seen on a computer screen Wednesday, Oct. 18, 2017, in Washington. The Trump administration says consumers can start previewing plans and premiums online for health insurance under the Affordable Care Act in 2018. Open enrollment starts Nov. 1. (AP Photo/Alex Brandon) Alex Brandon



Associated Press
Friday, November 03, 2017

Amid growing concerns about higher health insurance premiums next year, the New Hampshire Insurance Department also is taking a look back at past trends.

State law requires the department hold an annual public hearing on health insurance premium rates and factors that affect them. Commissioner Roger Sevigny opened Friday’s hearing by noting that his office has been hearing from consumers since the open enrollment period under the Affordable Care Act began earlier this week for coverage starting in January.

“This year, it’s no secret, has been an exceptionally turbulent one in the health insurance industry,” Sevigny said. “Meanwhile, increasing health care costs continue to be a major concern.”

A recent analysis conducted for the insurance department estimated that among the 97,000 people in the state’s individual market, 74 percent who either get federal subsidies or are part of the expanded Medicaid program likely will see their premiums drop or remain flat in 2018.

But the 26 percent who pay the full cost will see increases averaging 52 percent, in large part because President Donald Trump abruptly ended federal payments that reimburse insurers for reduced copays and deductibles they’re required to provide to people of modest means.

That means someone receiving no subsidies or cost-sharing reductions will pay about 12 times what someone whose income is 150 percent of the federal poverty level, said Jenn Smagula of Gorman Actuarial, who presented further analysis of trends over the last several years.

The company found that the uninsured rate in New Hampshire decreased from 10.7 percent in 2013, before the Affordable Care Act, to 8.6 percent in 2016. Last year, the individual market and large group markets saw average premium increases of 4 percent to 6 percent, while premiums in the small group market were slightly lower than they were in 2015. Actuarial Jenn Smagula said New Hampshire is among the top 10 states in per capita spending on health care, which is in line with its high income levels.

The individual market has seen significant change in both the number of insurers offering plans and the covered population, given that under the state’s expanded Medicaid program, federal money is used to put about 43,000 low-income people on private insurance. The average medical costs for those residents were 24 percent higher than others in the individual market in 2016, their hospital admission rate was 72 percent higher and their emergency department visits were 300 percent higher.

While pharmacy costs continue to be a significant factor in driving up premiums in both the individual and group markets, they were less so in 2016 than in previous years, Smagula said.