The Hippo


Jun 27, 2019








How will this affect you?

The rate increases projected for 2018 are mostly for people who do not get their insurance through their employers. And the rate hikes are far higher than what we’ve seen in the past, according to Michael Wilkey, the director of life, accident and health at the Insurance Department.
“I think it would be safe to say that the increases since the onset of the Affordable Care Act in New Hampshire have been in single digits each year,” Wilkey said.
But the projections submitted by the carriers show median rates for four out of five individual health plans increasing by about 35 to 45 percent.
Jennifer Patterson, health policy legal counsel at the Insurance Department, said this would not so much affect people who qualify for subsidies, since subsidies are keyed to cost, but it will affect those who pay full price.
“One of the groups of people that we were concerned about and prompted us to make effort to come up with the reinsurance plan was that group of people that actually paid full price for their insurance plan,” Patterson said.
For example, the median monthly premium for a silver plan covering a 40-year-old non-smoker will go up from $335 in 2017 to $479 in 2018.
As of this month, there are 87,577 Granite Staters enrolled with individual health plans, according to the New Hampshire Insurance Department.

Health care uncertainty
The political ramifications of rising premiums

By Ryan Lessard

 Insurance rates for individual health care purchased through the marketplace seem poised to skyrocket, and as lawmakers let an opportunity to mitigate those costs slip by, analysts say it’s too soon to say whether there will be any political fallout for state leaders in the 2018 elections.

“It’s a real issue that impacts a lot of people, but the political parts of it, it’s a matter of how that is spun by the parties and how plausible the explanations the parties come up with … are that’s going to determine how effective it is as a political issue,” said Andy Smith, political scientist and pollster at the University of New Hampshire.
No reinsurance program
On Aug. 1, a legislative panel voted along party lines not to take steps to mitigate rising premiums, with Republicans in the no column. As a result, Democrats are accusing state Republicans of trying to sabotage Obamacare. Republicans say Obamacare is a dying patient and the proposed remedy would have hurt others and wouldn’t have been a cure. 
Republican Gov. Chris Sununu also opposed the plan to create a reinsurance program, which would have reduced premium increases for the individual insurance market in 2018. The proposal by the New Hampshire Insurance Department would have taxed the insurance carriers in the state and used additional federal funding that, if granted, would have helped cover high-cost claims and enable companies to lower their rates.
Sununu had originally supported the idea of a reinsurance program but decided not to support the specific plan because it would mean taking money from all insurance companies in the state, which could negatively affect businesses that offer insurance to employees. 
A spokesperson at the Insurance Department said most reinsurance mechanisms deployed in the state in the past were funded by taxing the broader market.
In response to the legislative panel’s decision, Democratic state Sen. Martha Fuller Clark released a statement saying “Governor Sununu and his Republican allies are playing dangerous political games with our health care system, risking insurance carriers leaving our state, risking higher premiums for our hard-working families, and creating more destabilization in New Hampshires’s health care system.”
Republicans like Senate Majority Leader Jeb Bradley said the tax would raise costs for employers to “scarcely” lower projected increases, from around 40 percent to about 35.
“That is not our definition of success,” Bradley said.
Political calculus
The increases are high, but tensions are higher and the rhetoric is couched in terms of “political games” in large part because the issue with New Hampshire’s rising premiums is happening against a backdrop of the debate over health care at the federal level. The Trump administration has signaled a willingness to let Obamacare fall apart in time or, through withholding funding, accelerate its demise. 
One specific question that has caused serious uncertainty is whether the federal government will continue to fund cost-sharing reductions, which are subsidies baked into the cost of certain plans for low-income enrollees. 
This is one of the likely factors that carriers have considered when they projected rate increases for next year. A recent study by the Kaiser Health Foundation found that uncertainty in the market caused by mixed signals sent by President Trump have caused double-digit rate increases across the country.
“I think Democrats are concerned that Republicans have talked so much about Obamacare failing that they’re going to kind of nudge it over the cliff by not providing the things that you’re supposed to provide by law to keep them running,” said political analyst Dean Spiliotes.
New Hampshire originally had until Aug. 16 to weigh in on the rate increases by assuring carriers with the certainty of a reinsurance program. That deadline was recently pushed to Sept. 5, but it’s unclear whether the reinsurance plan will be revisited.
When Republicans in the state let that window of opportunity pass by, it seemed to some like it was part of the same strategy of accelerating Obamacare’s failure.
But a failure of the health care market under the Republicans’ watch could hurt state residents and look bad politically. 
For his part, Sununu has sent letters to Trump asking him to take the steps necessary to maintain stability, including funding CSRs, at least until broader reform is possible. 
But the parties remain divided on how they define the nature of Obamacare’s problems.
Democrats say it’s not perfect and needs to be shored up and fixed. Republicans say its demise is inevitable and it’s not worth saving long term. They both blame each other for the problem, and that will shape the debate in the coming elections in 2018.
“I’m sure there will be finger-pointing between the two sides,” Spiliotes said.

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