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Health Insurers in Pennsylvania Request Average Premium Rate Hikes of 31%

Approved premium rate hikes in Pennsylvania are as high as 49 percent

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October 18, 2017

Obamacare plan premiums may increase an average of 30.6 percent in Pennsylvania next year due to health care insurers rate hike requests, according to the state's acting insurance commissioner.

There are five health insurers that are participating in the marketplace in 2018, some of whom were approved for even higher rates. For example, Capital Advantage Assurance Company, which participates on the exchanges in the individual market in Pennsylvania, was approved a rate increase of 49.2 percent. UPMC Health Options was approved a rate increase of 41.15 percent, Geisinger Health Plan was approved a rate hike of 31.28 percent, QCC Insurance Company was approved a rate hike of 28.24 percent, and Highmark Inc. was approved a rate increase of 25.27 percent.

"Rates reflect estimates of future costs, including medical and prescription drug costs and administrative expenses, and are based on historical data and forecasts of trends in the upcoming year," the Pennsylvania Insurance Department explains. "The Department considers these factors, as well as factors such as the insurer's revenues, actual and projected profits, past rate changes, and the effect the change will have on Pennsylvania consumers."

According to the state's acting insurance commissioner, the rates were originally projected to increase by only 7.6 percent.

"It is with great regret that I must announce approved rates that are substantially higher than what companies initially requested," said Commissioner Jessica Altman. "Due to President Trump's refusal to make cost-sharing reduction payments for 2018 and Congress's inaction to appropriate funds, it is the reality that state regulators must face and the reason rate increases will be higher than they should be across the country."

The commissioner also noted that those individuals who do not qualify for subsidies should shop off of the exchanges.

"The department worked with each of Pennsylvania's five marketplace health insurers to ensure they would offer an off-exchange only option that is not impacted by the disproportionate rate increases for on-exchange silver plans," the commissioner's office said.

These rate hikes come after the Obama administration announced a year ago that premiums for 2017 would rise by double-digits. According to the Kaiser Family Foundation, rate increases are a result of the increasing number of insurers experiencing losses on the exchanges.

"Nationwide, average Marketplace premiums for 2017 are increasing more than they have in the past two years," the Obama administration said. "For the median HealthCare.gov consumer, the benchmark second-lowest silver plan premium is increasing by 16 percent this year, before taking into account the effects of financial assistance."