Premium Increase Requests Come As Congress Debates Health Care | WABE 90.1 FM

Premium Increase Requests Come As Congress Debates Health Care

Jul 11, 2017

Blue Cross Blue Shield of Georgia is proposing an average increase of 40 percent to insurance premiums on the individual marketplace next year through the Affordable Care Act. The proposed rate hikes come as Congress continues to debate health care.

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Clay Jones, regional director of operations for E.R. Hospitals, helps manage four rural hospitals in south Georgia. In all four counties, he said Blue Cross Blue Shield of Georgia is the only insurance company offering plans on the marketplace exchange through the Affordable Care Act.

“The increase by 40 percent will definitely affect us,” Jones said.

The exchange is for people buying health insurance individually, and not through their employers. Cindy Zeldin, executive director of Georgians for a Healthy Future, said many customers who are low or middle income won't have to pay the entire sticker price because of tax subsidies from the government to help pay for the premiums.

For others who earn more and don’t qualify for subsidies, Zeldin said they’d have to bear the brunt of the increase in premiums.

“That could dampen enrollment and it could also stretch some household budgets,” she said.

Premium increases were expected to be lower next year as the market showed stabilization, said Cynthia Cox, associate director of health reform and private insurance at the Kaiser Family Foundation.

She said as Washington continues to debate health care, double-digit increases are being requested across the country.

“And that seems to be in large part driven by political uncertainty about whether the rules of the game are going to be enforced,” Cox said. “Insurers are pricing cautiously next year because they don't know what the rules are going to be.”

Without knowing those rules, Jeff Fusile, president of Blue Cross Blue Shield of Georgia, told WABE's Denis O'Hayer, pricing health plans becomes very difficult.

“It becomes very difficult to price especially with concerns that there may not be a mandate, or a requirement to buy health care, and that you can end up with a situation where only the sickest of the sick are joining through the exchange and they create a very expensive environment,” Fusile said.

The proposed rates still have to be approved by state and federal officials before open enrollment begins in the fall.