Health insurance companies that sell coverage to Idahoans say they’re still losing money on their plans, so they want to raise individuals’ premiums an average of 27 percent next year.
That would be the second straight year of double-digit increases for some plans.
Six companies sell plans for individuals in Idaho, five on the state’s insurance exchange, Your Health Idaho. They proposed similar rate increases last year.
Insurers said there are several reasons they need the increases in 2017, including:
▪ The loss of two federal programs that were created by the Affordable Care Act to help insurers weather unexpectedly high medical costs in the early years of the law. Both programs expire this year.
▪ Patients needing more medical treatment.
▪ Higher medical costs, including prescription drug prices.
Under state law, the Idaho Department of Insurance can review rates before they take effect and deem a rate increase unreasonable. However, it cannot set or disapprove those rates.
The department seeks public comment on the proposed rates.
For the Southwest Idaho region, which includes Ada and Canyon counties, insurers’ proposed rate changes range from a 4 percent decrease for PacificSource’s PSN Value Bronze 3500 plan to a 98 percent increase for Blue Cross of Idaho’s Bronze Connect Southwest plan.
“We acknowledge that rates are reflective of provider costs and plan networks,” Idaho Department of Insurance Director Dean Cameron said in a news release. “We recognize that all carriers have lost significant amounts in the individual market. However, rate increases to make up for past years’ losses are not allowed.
“We will aggressively challenge these proposed increases in the individual market and continue to fight against abusive practices which contribute to these losses and ultimately to rate increases.”
Here are the average rate increases Cameron’s department is reviewing:
▪ SelectHealth, the Utah health insurer, is seeking an average 32 percent increase. It paid about $15 million more in medical claims than it collected in premiums during the first quarter of this year.
▪ Blue Cross of Idaho seeks a 28 percent increase. It paid about $6 million less in medical claims than it collected in premiums during the quarter.
▪ Mountain Health CO-OP seeks a 21 percent increase. Its premiums and claims were nearly equal.
▪ BridgeSpan Health Co. seeks a 12 percent increase. It paid about $2 million less in claims than it made in premiums.
▪ PacificSource Health Plans seeks an 8 percent increase. It paid $1.1 million in claims, nearly twice as much as it collected in premiums,.
A consumer’s actual premium can vary greatly based on geographic area, tobacco use, a plan’s benefits, premium tax credits and other factors.
The rates also apply just to the individual market, which is mostly composed of plans sold on Idaho’s exchange. The rates revealed Monday do not include large-group or small-group plans, including the Blue Cross of Idaho plan that covers state employees.
Proposed rate hike
Claims in 2015
Premiums in 2015
$49.2 million (Jan-Mar 2016)
$34.4 million (Jan-Mar 2016)