Talkin’ bout insurance rates

My Files

The New York State Department of Financial Services is currently reviewing insurance companies’ rates for the coming year, 2015. Overall this year, 11 insurers asked for rate increases and four asked for decreases. You can read insurer rate applications here. Members of the public have the chance to comment on the rates. HCFANY recently submitted seven letters about these plans:

Aetna Health

Empire HealthChoice

Excellus Health Plan

Health Republic Insurance of New York

Metro Plus Health Plan

Oscar Insurance Corporation

United Healthcare

2014 insurance rates on NY State of Health, our State’s health plan Marketplace, declined by 53%. These affordable rates were an important reason for the enrollment of over one million New Yorkers. The Department of Financial Services has an important role in ensuring that health plan rate increases are in line with actual medical cost changes, and that rates remain as affordable as possible for consumers.

HCFANY’s comments first discuss the broader context that the Department should consider and then additional specific carrier issues. In addressing the broader context, HCFANY notes:

  1. Health care costs have been rising at slower rates for the past several years, and have been under 10% for the last 12, according to National Health Expenditures data. The California Marketplace held health insurers to a maximum 4.2% increase for 2015.
  2. It’s reasonable to expect the 2015 risk pool will be healthier than 2014, because less healthy consumers are likely to have already enrolled.
  3. The ACA “risk” programs should mean lower risk for insurers and lower prices for consumers. The ACA includes special programs – risk adjustment, risk corridor, and reinsurance programs – to compensate insurers for any increased risk they take on as a result of new enrollees. The programs were designed specifically to ensure stable insurance rates for consumers.
  4. Insurers should have lower administrative costs as a result of the ACA. Significant money and energy is being put into marketing and outreach for health insurance because of the ACA, which means insurers can spend less time and money marketing their products.

The Department of Financial Services should post the final rates sometime in the early fall.

keep calm_know you're covered

Guest post: Jessie Kavanagh, Health Policy Intern at Community Service Society of New York

Last week, a 3-judge panel of the U.S. Court of Appeals for the District of Columbia ruled 2-1 that states using the federally-facilitated marketplace (healthcare.gov) cannot offer government subsidies to their residents. The same day, a 4th U.S. Circuit Court of Appeals in Virginia unanimously came to the opposite conclusion– that the states using the federal marketplace should be able to offer subsidies.

What to make of this conflict? Regardless of the disagreement, the bottom line for New Yorkers is simple: the decisions have no immediate impact on New Yorkers’ eligibility for the ACA tax credits and subsidies.

The main issue in these cases concerns the language in the ACA regarding the subsidies. The language states that subsidies are only available “through an exchange [aka marketplace] established by the state.” The U.S. Court of Appeals for the DC Circuit argued that this language means subsidies should be available only to people who enroll through a state-based marketplace. However, the 4th Circuit Court said that the law was ambiguous, and that the IRS was entitled to its interpretation that the federal marketplace acts as a state’s marketplace, and therefore all states can offer subsidies to their residents.

Ultimately, the ACA was written with the intent to make insurance more affordable for all Americans. And, it seems to be working. In New York, 3 out of 4 enrollees in commercial Qualified Health Plans during open enrollment- or 274,247 New Yorkers – were eligible for tax credits that made insurance more affordable.

 

surprised_kid

Guest post: Sarah Fishman, Intern at Raising Women’s Voices – New York

Have you recently received a letter from your health insurance company about a rate increase for next year? Don’t panic! This is only a proposed rate increase that must be reviewed by state officials, and you have the right to weigh in on whether it should be approved or not.

New York State law says that the Department of Financial Services (DFS), headed by Superintendent Benjamin Lawsky, has the authority to review all insurer rate change requests and can deny or reduce any that it deems excessive. Consumers have a 30-day period to voice their concerns to the DFS, and this year that period ends on August 1. Your comments can make a difference, saving consumers millions of dollars in premium costs. For example, in 2013, DFS only approved the rate increases after reducing them by 5% in the individual market.

Some of the plans being sold in New York State have proposed large rate increases for the next year. Many are requesting increases in the range of 15-20%, with some as high as 28%. Others are requesting decreases. Find your plan’s request here.

Take action by submitting your own comments. Remember to act quickly to meet the August 1 deadline. Below is a sample letter you can adapt and submit to the Department of Financial Services.  You can also download the sample letter by clicking here. After editing the letter with your information, you can copy and paste it to be submitted here.

SAMPLE LETTER TO DEPARTMENT OF FINANCIAL SERVICES RE: HEALTH INSURANCE RATE INCREASE

Dear Superintendent Lawsky:

I write to file an objection on the proposed premium rate increase of [insert percent or amount of increase here], recently filed by [insert insurance company name].

I have been a customer for [x number of years].  I need health insurance because [explain why you need coverage, list special health conditions for yourself, your family or employees who are covered by your insurance plan].  This proposed rate increase will be a major hardship for me.

I believe that my carrier’s profits, administration, and executive compensations costs are too great and urge you to require it to invest more premium dollars into its customer’s health expenses.

I strongly support the Department of Financial Services’ efforts to make more insurance more affordable and information about rate increases more accessible.  Thank you for your attention to this matter.

If you need more information about my situation, please feel free to contact me at: [insert your email or phone number or address here].

girls_doctor_officeThe Alliance for Health Reform and Kaiser Family Foundation held a briefing on Monday about the Children’s Health Insurance Program (CHIP). CHIP provides quality health coverage for over 8 million kids – including nearly 500,000 in New York under Child Health Plus.

The Program was extended in the ACA through 2019, but unfortunately funding for the program expires next September without congressional action. This would be bad news for kids - many could lose coverage (some due to the “family glitch“) or pay more for comprehensive coverage. Not to mention it would cut short a program that has been enormously successful in reducing the child uninsurance rate, which fell by half since the program began in 1997.

A summary of the briefing and all materials are available on the Alliance for Health Reform website, including background materials, videos, and speaker presentations. Speakers included Joan Alker, executive director at Center for Children and Families at Georgetown University, Robin Rudowitz, associate director for Kaiser Commission on Medicaid and the Uninsured, Robert Stewart, analyst at the Congressional Budget Office, and Cathy Caldwell, director of the Bureau of Children’s Health Insurance in the Alabama Department of Public Health.

Check it out!