Health insurance rates in flux amid federal uncertainty
Louis Gutierrez is the executive director of the Massachusetts Health Connector. The state health insurance exchange is preparing for potential lost federal subsidies for plans offered through the Connector.
As uncertainty looms around federal healthcare policy, the Massachusetts Health Connector and Division of Insurance (DOI) have prepared two sets of rates for 2018 to account for the possible loss of revenue that would affect federal subsidies for plans offered through the Connector.
The Health Connector Board had canceled its September meeting -- at which it typically approves rates for the coming year -- as the state worked with carriers to chart a pathway to deal with the uncertainty. At the outset of Wednesday's morning's meeting, Health and Human Service Secretary Marylou Sudders said Gov. Charlie Baker lobbied for continuation of cost sharing reduction (CSR) payments, as recently as Tuesday evening, while DOI and the Connector prepared options.
"Faced with this uncertainty and challenges, the Health Connector and Division of Insurance have worked extremely closely with carriers all summer to develop two potential pathways with the guiding principle of protecting members first and always," Sudders said. She said the loss of the federal payments "could put our members and the coverage gains Massachusetts has worked so hard to achieve at risk."
One set of rates assumes that CSRs are eliminated and would set higher rates for the Connector's silver tier plans. Sudders said that option "would seriously disrupt coverage for up to 80,000 members." The second set of rates does not take the loss of CSRs into consideration.
"It is our ardent desire that we can work with carriers to avoid exercising the higher rate contingency unless and until such a time as CSR withdrawal, if it happens," Health Connector Executive Director Louis Gutierrez said.
The Division of Insurance is expected to make the details of the rate options public later Wednesday, Sudders said.
The CSRs are available for individuals and families with incomes up to 250 percent of the federal poverty level, or about $60,625 for a family of four. According to Massachusetts insurers, 244,400 enrollees in 2016 benefited from cost sharing subsidies that go toward lowering out-of-pocket expenses such as co-pays and deductibles.
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