Oregon Approves Final 2019 Health Insurance Rates

Regulators say federal uncertainty will push costs up on the individual marketplace

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Health insurance costs will go up next year for most Oregonians who buy their own coverage, according to rate decisions announced Friday.

But after successives years of double digit price hikes under the Affordable Care Act, the overall increases are relatively modest this year state, insurance officials said.

A 40-year-old Portland resident buying a silver-tier health plan with no subsidy can expect to pay between a minimum of $415 a month for Kaiser Permanente coverage, and at most $486 a month for Health Net. That’s up from a range of $381 per month for this year’s cheapest plan to $484 for the most expensive.

Republican efforts to undermine the Affordable Care Act are one reason rates are climbing this year, said Andrew Stolfi, Oregon’s chief insurance regulator. An end to the mandate that every American obtain health insurance means it’s harder for health plans to woo healthy customers – who help keep rates down. The end of federal funding to subsidize insurance costs for some families is also pushing up the cost of plan for people who do not get subsidies.

As they were setting rates, the Trump administration suspended a $10 billion risk-adjustment program, which some insurers worried would push up premiums in this state. Stolfi said insurance regulators did not incorporate that shift into their final rate calculations – a choice that seems vindicated by news this week that the Centers for Medicare and Medicaid Services may restart the program after all.

"If it was not for all this federal uncertainty, rates would be even lower for Oregonians,” Stolfi said. “We are hopeful to see that uncertainty come to an end."

Oregon’s own reforms have helped counter the pressure created by the feds – including a state program that kept next year’s rates 6.3 percent lower. Called the reinsurance plan, the program spreads the cost of expensive claims across all insurers, so no individual company has to bear abnormally high unexpected costs alone.

Few Pay Full Price

Slightly more than half of the roughly 185,000 Oregonians who buy their own health insurance pay below full price. State and federal rules lower the costs based on income. A person who earns less than $48,000 a year will pay less than the list price for coverage – as will a family of four with a household income of under $98,000

For those who must pick up the full tab, the exact price depends on age and location. Here’s a look at what a 40-year-old non-smoker in the Portland area can expect next year, from most expensive to least expensive plan:

  • Health Net: $486 per month.

  • Moda: $450 per month.

  • Providence: $437 per month.

  • BridgeSpan: $437 per month.

  • Regence: $425 per month.

  • PacificSource: $425 per month.

  • Kaiser Permanente: $415 per month.

The gap between the most expensive plan and the cheapest is about $70 – half what it was a few years ago. Stolfi applauded that trend as a sign that the insurance market is more stable, with better data allowing insurance companies to better predict their costs.

Small Business Trends

Small businesses will reap the rewards of that more stable market sooner than individuals. For decades, these employers have seen their costs go up nearly every year. But rates announced Friday will drop or hold steady for four of the nine insurers offering these plans in the Portland metro area.

Here’s what it will cost a small business next year to insure a 40-year old in the Portland area:

  • Moda: $387, down 1.8 percent.

  • Health Net: $373 per month, down 4 percent.

  • PacificSource: $366, up 1.1 percent.

  • Samaritan: $358, unchanged from the previous year.

  • United Healthcare, which offers two plans: $343, up 8.9 to 9.4 percent, depending on the plan.

  • Providence: $345, up 8.2 percent.

  • Kaiser Permanente: $295, up 1.8 percent.

“Our small group market has been stable, and most carriers continue to cover the entire state,” Stolfi said.

About 174,000 Oregonians get health insurance from small group plans, which cover 50 or fewer people. Another 1.5 million people are covered through large employers, whose insurance costs are not regulated by the state.

Insurance division officials expect to release detailed age and county rate charts for the entire state in August. Open enrollment for 2019 plans will be from Nov. 1 to Dec. 15, 2018.

Reach Courtney Sherwood at sherwood@thelundreport.org.

 

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