Business

Trump's move prompts 14 percent rate increase on Blue Cross ACA plans

Posted October 18, 2017 12:24 p.m. EDT
Updated October 18, 2017 6:47 p.m. EDT

— President Donald Trump's decision to halt federal payments to insurers under the Affordable Care Act will cause premiums on Blue Cross Blue Shield of North Carolina health plans purchased through the HealthCare.gov marketplace to increase by an average 14.1 percent next year, the company said Wednesday.

The government has been reimbursing insurers for "cost-sharing reductions," or CSRs, they pay out to people with low to modest incomes to defray the cost of co-pays and deductibles, but the Trump administration said those payments would stop immediately because the government lacks the congressional approval needed to pay them.

"Ending these federal reimbursements will drive up premium costs and make it harder for insurers to participate in the ACA marketplace in the long run," the company said in a statement. "Had CSR payments not been eliminated, Blue Cross NC’s final rate request for ACA customers’ average would have been near zero."

Still, the 14.1 percent increase is less than Blue Cross' initial request for a 22.9 percent increase and is lowest rate increase for the insurer since it started offering ACA plans. Blue Cross credits a stable market for the smaller increase.

"We understand that a premium increase of any amount is difficult for many of our customers. That is why we are working with our partners across the health care industry to slow down rising costs. Higher quality, more affordable health care remains our ultimate goal," Gary Bolt, vice president of the Individual Under 65 Segment for Blue Cross, said in a statement.

Blue Cross insures about 502,000 people through ACA plans, and some people might see larger premium increases, officials said. About 90 percent of those on individual plans receive federal subsidies to help offset the higher rates.

About 50,000 customers are on grandfathered pre-ACA plans that Blue Cross is ending after this year, and officials said they could see "significant premium increases" because those plans covered fewer services than the ACA requires.

Doug Gibbons said premiums for his wife's health insurance will more than triple come January, from $318 to $994, when she has to switch plans.

"It's out of sync because I'm on Social Security, my wife is a year-and-a-half from Social Security, and we figure our total premiums now are going to be around $12,000 a year," Gibbons said. "We're just going to have to do without a lot of things in our lives, and it's a shame because this is our retirement years."

North Carolinians transitioning off grandfathered plans should receive letters from Blue Cross by the end of this month to help them transition into an ACA plan

Blue Cross is the only insurer to offer ACA plans throughout North Carolina. Cigna will offer ACA plans in five counties.

Open enrollment for the ACA marketplace starts Nov. 1, and the deadline for coverage starting in January is Dec. 15.