Individual health insurance premiums are likely to take another sharp jump in 2019, the state’s top regulators said Friday, and might have done so even if a reform bill had not failed in the U.S. Senate Thursday night.
Oklahoma Insurance Commissioner John Doak said he was “disappointed” the so-called skinny Affordable Care Act repeal-and-replace bill failed because he believed passage would have brought Congress closer to an ultimate solution to problems caused by the ACA.
“We missed a chance (Thursday) night to say, ‘We have a game plan. Here’s what we’re going to do,’” said Deputy Commissioner Mike Rhoads.
Doak and Rhoads agreed, though, that passage would have brought no guarantee of more stable markets. At the end, insurance and medical associations came out against the bill, saying they were afraid it would create new uncertainties.
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Blue Cross Blue Shield of Oklahoma, the only insurer offering policies on the government exchange and one of two offering them outside the exchange, said it has already filed its proposed products and premiums for 2018 and remains committed to them.
“Thursday night’s vote has no immediate effect on our priority of serving our members across the state,” Melissa Clark, BCBSOK senior manager for public affairs, said in an email.
“We have been fully committed to this market from the outset,” Clark said. “This decision was and is central to our purpose to provide long-term stability and offer valuable products that give our members access to quality, cost-effective care.”
Premiums for individual polices rose 76 percent in the most recent policy year, and Rhoads said he expects they will rise another 30 percent to 40 percent in the next few years.
Individuals qualifying for federal premium subsidies through the health insurance exchange are shielded to a large extent from those increases, but those who do not qualify are paying $15,000 a year and more.
The increases are driven by steep losses in Oklahoma’s individual insurance market. The number of exchange insurers has fallen from five to one since the ACA’s implementation, and that one — Blue Cross Blue Shield — has been losing money.
Until that changes, premium increases are likely to continue, Rhoads said.
Uncertainty, meanwhile, creates instability in the insurance markets, Rhoads and Doak said. Insurers cannot act with confidence if they don’t know what the law is going to be.
“The uncertainty and instability rises from the conflict at the federal level,” Rhoads said. “That’s where the instability comes in.”
Many Republicans, including Doak, want states to have more flexibility in fashioning health insurance policy. For instance, he favors allowing the high-deductible, bare-bones policies outlawed by the ACA.
“Not everyone wants to drive a Cadillac,” he said.
Rhoads agreed, saying those policies were popular before and offer a more affordable alternative for individuals who now may be paying the federal penalty rather than buying health insurance.
In theory, that brings more people into the risk pool and brings down premiums for those who have — and in many cases need — more extensive coverage.
The flip side of the argument comes from those who say such policies will draw healthy individuals now paying for more expensive plans into cheaper ones, and reduce overall revenue.
They also theorize that it will lead to more uncompensated care because some people with high-deductible polices will simply walk away from bills not covered by insurance.
Doak points out that even with the ACA, Oklahoma medical providers are absorbing around $400 million a year in uncompensated care.
Meanwhile, in Washington, Thursday night’s failure seemed a particularly bitter pill for Sen. James Lankford.
Lankford took to Facebook and Twitter and was heard on National Public Radio voicing his frustration with the Senate setback and how it was being discussed.
“Some media pundits have focused on who won and who lost,” Lankford wrote on Facebook. “This reaction is frustrating to me. This debate is not about what politician won and who lost or what political party won and which party lost, this healthcare conversation is about people’s lives.
“We must realize that many Americans have been helped by Obamacare, but also admit that many Americans have been hurt by the law. This issue is complicated and is not as easy as some make it seem.”
