Insured pharmacy costs actually fell in N.H., but don’t expect that to last

  • The cost of health care continues to soar, vacuuming up a growing share of the nation's economic output and putting an ever-larger strain on both family incomes and government budgets. (Dreamstime/TNS) Dreamstime

Monitor staff
Published: 12/19/2018 5:47:18 PM

About 10 percent fewer New Hampshire residents bought health insurance through the federal marketplace this year than last, which is less of a decline than had been expected.

According to Covering New Hampshire, 44,930 residents signed up for a plan for 2019 through the Health Insurance Marketplace between Nov. 1 and Dec. 15.

That number is below last year’s figure of 50,275 but is higher than many had expected because of changes to the Affordable Care Act pushed by the Trump administration. They include a much shorter open-enrollment period than last year, a 90 percent in the federal government’s publicity program, and the lack of any penalty for being uninsured.

Other factors may have played a role in the decline, including the strong economy.

“It’s possible that more people are getting coverage through an employer, which is what we hoped to see,” said ​​​​​​Zandra Rice Hawkins, project manager at Covering New Hampshire, an advocacy group for health insurance.

New Hampshire’s expansion of Medicaid may also have contributed, as it provided another outlet for health insurance.

Covering New Hampshire noted that last week’s decision by a federal district court judge finding the Affordable Care Act to be unconstitutional, shortly before open enrollment ended Saturday, added to the confusion. That decision is being appealed and the law remains in effect.

In other health insurance, a report from the New Hampshire Insurance Department about health insurance coverage and payments indicates that average costs for common medicines went down slightly this year for state residents, but that trend seems unlikely to continue.

“The expectation, the assumption, is that we’re not going to see declines in the future. We don’t feel this is indicative of a longer trend, at least at this level,” said Tyler Brannen, health policy analyst for the NH Insurance Department.

The decline was reported as part of an annual report by the department on health care premiums and the items that drive changes in costs. It covers claims filed by people who have health insurance purchased not just through the federal Marketplace but also through private companies and through their employers.

The report found that in 2017, total costs for drugs were one-half of one percent lower than in 2016, driven by declines in non-specialty pharmacy claims, both generic and brand-name. Not everything went down, however: The cost of specialty pharmacy products, meaning high-end and rarer medicines, rose 9 percent.

Brannen said it wasn’t clear why the non-specialty costs had dipped.

Other findings in the report included:

■Average premiums in 2017 increased about over 6.5 percent compared to 2016, driven by increases in several areas, such as inpatient and outpatient facilities and professional fees.

■About 5.8 percent of the state population lacked health insurance either through private or company-supplied insurance, the federal marketplace, or Medicaid. This is about half the rate that existed in 2013, before the Affordable Care Act began to be implemented, but is almost unchanged from 2016.

■For coverage starting next year, rates on the federal marketplace for the middle-of-the-road silver plan, the most common choice, fell 15 percent. However, the report notes, that falls well short of compensation for the 76 percent increase that the plan’s rate saw this year. The report also notes that deductibles – the amount that must be spent before the plan kicks in – have continued to rise.

■Approximately 820,000 people, or 62 percent of state residents, received health insurance through the private insurance market, either through their employer or by purchasing their own coverage.

■The average premium for people in the state was $412 a month, well below the national average of $472. This is a sharp change from two years earlier: In 2015, New Hampshire average premiums were slightly above the national average.

■The entire report can be seen online 2018-nhid-annual-hearing-final-report.pdf

(David Brooks can be reached at 369-3313 or or on Twitter @GraniteGeek.)
David Brooks bio photo

David Brooks is a reporter and the writer of the sci/tech column Granite Geek and blog, as well as moderator of Science Cafe Concord events. After obtaining a bachelor’s degree in mathematics he became a newspaperman, working in Virginia and Tennessee before spending 28 years at the Nashua Telegraph . He joined the Monitor in 2015.

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