N.H. to see lowest monthly Obamacare premiums among similar states next year

Monitor staff
Wednesday, October 26, 2016

New Hampshire is an outlier among states, but in a good way, as the nation prepares to enter the latest round of health insurance purchases through the Affordable Care Act.

Next year New Hampshire will see the smallest percentage increase in average premiums among all 38 states using the federal HealthCare.gov marketplace. The state increase is slated at 2 percent, compared with an average of 25 percent for all states, according to data released Monday by the U.S. Department of Health and Human Services.

New Hampshire will also have the lowest average monthly premium among those states: A nonsmoking 27-year-old buying the silver level of insurance will pay $219 a month, the lowest of any state on HealthCare.gov and far less than the average premium of $302.

That’s good news compared with the many states that are seeing double-digit percentage increases in average premiums – six states will have price hikes over 50 percent and one, Arizona, is facing hikes averaging 116 percent – as the ACA struggles to sign up enough healthy people to balance the cost of customers who require more treatment.

Premiums vary depending on insured people’s age and whether they are smokers, as well as the level of coverage and which of four competing companies they buy from. In New Hampshire, the so-called gold package, for example, costs about $80 a month more than the silver package for the same person.

One reason for why New Hampshire’s rates are relatively good compared with other states may be Medicaid expansion, which almost doubled the number of customers buying plans through Medicare.gov and increased competition. Almost 90,000 people had plans through Medicare.gov as of October, and 42,000 of them were Medicare recipients.

New Hampshire is unusual among states in that its Medicare patients use the federal marketplace to shop for health insurance.

New Hampshire also has a relatively robust marketplace, with four companies offering health insurance options: Ambetter, underwritten by Celtic Insurance Co.; Anthem; Harvard Pilgrim; and Minuteman Health. Maine-based Community Health Options withdrew from the New Hampshire market earlier this year due to heavy losses, but it was a minor player in the market.

Many states seeing hefty increases in ACA premiums have seen a decline in the number of competing insurance companies within their borders, especially as insurance giants United Health and Aetna have pulled out due to losses.

New Hampshire’s competitive situation is a contrast to 2014, when just one company was offering health insurance packages in the state.

“What we seem to have done in New Hampshire is we have gone in the opposite direction from what’s happening nationally,” said Jenny Patterson, health policy legal counsel for the New Hampshire Insurance Department. That department checks policies and rates to see that they meet legal requirement, but the federal Centers for Medicare & Medicaid Services has the final say on which policies are offered through HealthCare.gov in New Hampshire.

The sign-up period for 2017 health insurance coverage begins next month. The fine for being uninsured next year will be $695 per adult and $347.50 per child up to a household maximum of $2,085.

New Hampshire is also an outlier among the 38 HealthCare.gov states in another area: The state had almost the highest average household income among those buying policies through the federal marketplace. The median income of customers was 211 percent of the federal income level, bested slightly by Delaware and Oregon. New Hampshire also had the highest percent of customers in the top income bracket (more than 400 percent of poverty level) and was tied with Delaware for the highest percent of customers in the second-highest income bracket (250 percent to 400 percent of the poverty level).

Probably as a result of that, however, New Hampshire was at the bottom of the rankings in terms of percentage of people getting financial assistance through the ACA.

At the same time, only 66 percent of New Hampshire residents who enrolled in the program earlier received the advanced premium tax credit, or APTC, compared with a national average of 87 percent, while only 35 percent of state enrollees received the subsidy known as cost-sharing reduction, compared with 59 percent nationally. New Hampshire’s percentage was the lowest for any HealthCare.gov state in both categories of financial aid.

Open enrollment begins Nov. 1 for people who want to apply for or change their coverage under the ACA. Dec. 15 is the deadline to get coverage that starts Jan. 1, while Jan. 31 will be the last day to apply for coverage in 2017.

Those who wish to enroll for the first time in the insurance marketplace or change their plan can start the process by going to HealthCare.gov. For further help, enrollees can call the federal Health Insurance Marketplace Hotline at 800-318-2596.

A nonprofit called Get Covered America also has an online tool called The Get Covered Calculator at GetCoveredAmerica.org.

(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek)