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CMS Slams Health Insurance Marketplace

Oregon officials argue they’ve kept rates down, despite federal changes that have made the individual market less stable.
July 2, 2018

The Centers for Medicare and Medicaid Services said on Monday that the federal insurance exchange is failing people who purchase their own health plans – despite figures from Oregon’s insurance regulators that appear to tell a very different story.

The data were released along with a press release that praised President Donald Trump’s policy initiatives.

CMS figures show that in 2017, 183,355 Oregonians bought individual health insurance -- but only 87,436 paid the full price for coverage, while the rest got subsidies based on their income. That represents a one-year 36 percent decline in the number of people paying full price for coverage, which CMS blames on unaffordable premiums.

“As the Trump Administration took office, there were warning signs that we were dealing with a crisis in the individual health insurance market and Obamacare was failing its consumers,” CMS Administrator Seema Verma said in a statement. “These reports show that the high price plans on the individual market are unaffordable and forcing unsubsidized middle class consumers to drop coverage.”

But a broader look at Oregon Insurance Division figures suggests that people may be leaving the individual health insurance marketplace because they’re increasingly covered at work – not because they can’t afford their premiums.

From 2016 to 2017, 25,151 Oregonians left behind their individual health plans – and 87,402 were newly enrolled in health insurance at work. Adding up all categories of health insurance, the number of people covered in the state climbed 3 percent.

Across the country, according to CMS, average monthly premiums for health plans purchased on the federal exchange,, and similar state-run sites climbed 27 percent this year, on top of a 21 percent increase in 2017.

Oregon’s individual market insurance rates have bucked that trend. Rate changes ranged from a 1.6 percent decrease at BridgeSpan Health to a 14.8 percent increase for Kaiser Permanente this year, according to the Department of Consumer and Business Services. In 2019, the agency expects rate changes to range from a 9.6 percent decrease to a 10.6 percent increase, according to preliminary decisions announced Friday.

“It is clear that many Americans are being priced out of the health insurance market, especially for employed people who earn too much to qualify for tax credits and have no access to employer-sponsored coverage,” CMS stated in Monday’s press release. “This underscores the need for CMS to continue efforts to stabilize the market and provide all consumers—including those who do not qualify for large premium subsidies—with more affordable health coverage options.”

Oregon’s chief insurance regulator, however, argues that federal changes have made insurance markets less -- not more -- stable in this state.

“Although rates are still rising for many consumers, the Oregon Reinsurance Program is continuing to provide some stability and relief,” Insurance Commissioner Andrew Stolfi said in a statement. “Without this program, Oregonians who buy their own insurance would see much larger rate increases. Actions taken at the federal level have injected instability into the market and resulted in rate increases, and we are committed to protecting Oregonians’ access to affordable, comprehensive coverage.”

Reach Courtney Sherwood at [email protected].


Submitted by Roger Warren on Wed, 07/04/2018 - 00:53 Permalink some factors increase cost, like uncertainty...and other factors decrease people opting to buy from their job coverage and sharing high risks between companies.

I continue to be concerned for my friends and neighbors who are unable to pay their share of actual medical costs.  I hope the $400,000 fund from hospitals in Oregon will help.  I am inquiring now with our appropriate church committee to see if they have money for this personal problem.  Incomes in Oregon are so varied, I would think the church committee could refer people to the hospital fund and only then come in with some additional financial help.