Oregon officials are giving the public more time to comment on proposed increases for individual and small-group health insurance plan premiums for 2024 that range as high as 12.4%.
The proposed premium increases for small-group plans in particular have sparked concern among some consumer advocates. Small group insurance is available to businesses with 50 or fewer employees.
All told, the rate hikes would affect about 290,000 Oregonians who either buy their own individual commercial insurance policies or obtain coverage through a small employer. Increases in this small segment of the market are often a bellwether of pressures facing the broader system that covers most of Oregon’s 4.2 million residents.
The virtual public hearings have been rescheduled for Aug. 4, 8:30 a.m. to 11:30 a.m. and 1 p.m. to 4 p.m., according to the Oregon Department of Consumer and Business Services. The hearings had previously been set for mid-July. Comments can be submitted here through Aug. 3.
Already, the Oregon State Public Interest Research Group is urging the state to carefully scrutinize the 12.4% hike proposed by Portland-based Providence Health Plan for its small-business plan, which covers 52,655 individuals.
“As rates rise, Oregonians spend more and a higher portion of their income on health care. It is vital that the department ensure consumers aren’t being gouged by these rate increases.”
“As rates rise, Oregonians spend more and a higher portion of their income on health care. It is vital that the department ensure consumers aren’t being gouged by these rate increases,” wrote Maribeth Guarino, OSPIRG’s health care advocate, in comments the group submitted to the state.
In small-business plans, the premiums may be shouldered entirely by workers or employers, or shared between them. Overall, the six companies offering small-group health insurance plans in Oregon are seeking an average increase of 8.1%, up from 6.9% they had requested for the current year. About 140,000 Oregonians are covered via small-group plans.
Details of each insurer’s application, plus public comments, can be found here. In a comment to the state, Oregon resident Glenn Fithian-Barrett echoed OSPIRG’s worry.
“The proposed premium increases for small business owners are especially concerning, with more than half of the insurance carriers proposing increases of more than 6%,” he wrote. “Small businesses are already struggling to provide health benefits to their employees; these rate increases and high monthly premiums could prevent Oregonians from maintaining health benefits with their employer.”
Providence, in its rate filing, said the proposed increase reflects rising prices being charged by health care providers and drug companies, as well as an expected surge in health care usage by members.
“Anticipated year-over-year increases in the utilization and costs of medical and prescription drug services are the main contributor to the rate increases,” the company wrote. “This estimate is based on expected changes to provider contract arrangements and utilization increases that includes both the volume and the mix of services.”
The requested increase would take the monthly premium for a silver-rated plan for a 40-year-old Portland man to $410 a month, the state said. Among the six insurers, the monthly premium for silver plans would range from $397 to $459 after the requested increases, the state said. Metal ratings, which also include gold and bronze, indicate the richness of plan coverage.
Pandemic drives up costs
During and after the pandemic, health care providers have faced rapidly rising labor and pharmaceutical costs, which they are seeking to pass along to insurers and patients. The state is trying to hold per-capita health care cost increases to an average of 3.4% a year, but officials acknowledge that price spikes plus increased care usage by patients may render that impossible.
The insurance division said that in the individual market, six companies submitted premium increase requests ranging from 3.5% to 8.5 %, for a weighted average of 6.2%. Last year they requested a weighted average increase of 6.7%. About 150,000 Oregonians who are not on Medicare buy their own individual policy, either directly from an insurer or via the online health insurance marketplace.
That is just one piece of the broad insurance picture. Large-employer insurance plans for public and private sector workers are negotiated between insurers and employers. The state oversees the Medicaid-funded Oregon Health Plan, which covers nearly 1.5 million low-income residents. The federal government regulates Medicare coverage for the elderly and people with disabilities. And some businesses and government agencies are self-insured.
The insurance division delayed the hearings because it had been unsure whether the Oregon Legislature would pass a particular bill, House Bill 3008, that would affect rates, said agency spokesman Mark Peterson. The bill, which ultimately passed, relates to payments co-payments for certain primary care visits.
A web address to watch the insurance division’s public hearings will be posted at oregonhealthrates.org. At the hearings, each insurer will make a brief presentation, answer questions from Division of Financial Regulation staff, and hear public comment.
In analyzing the requested increases, the state is required to ensure that insurers remain financially strong, have sufficient reserves, can cover their members’ health care costs, and are fair to policy holders.
The state will announce its preliminary decision later this month and make final decisions after the August hearings.
