Affordable Care Act premiums rise as insurers fret over law's future

Health insurers are asking for sharp increases in the cost of their Affordable Care Act plans next year, thanks to instability in the law's coverage markets that's been compounded by the Trump administration.

In Maryland, Virginia and Connecticut — the first states to make filings public — premiums for Affordable Care Act plans will rise more than 20 percent on average, according to data compiled by ACASignups.net and Bloomberg. The increases follow years of rising premiums under ex-President Barack Obama.

The increases can be blamed in part on uncertainty among insurers about the strength of the law's requirement that people carry insurance. The Trump administration has raised doubts about whether it will enforce what is considered by some insurers to be an already insufficient penalty.

"Failure to enforce the individual mandate makes it far more likely that healthier, younger individuals will drop coverage and drive up the cost for everyone," Chet Burrell, chief executive of CareFirst, said in a statement. The insurer is asking for an at least 50 percent increase in premiums in Maryland. Burrell said uncertainty over the mandate played a "significant role" in the insurer's rate requests.

The Affordable Care Act is at a critical juncture. Republicans and Trump want to repeal much of the law, and say the rising premiums are proof it isn't working. At the same time, many insurers point to a lack of support for Obamacare's programs as a reason for the increases, and have asked for help.

"It would be good to have some more aggressive stabilization efforts going on," said Joel Ario, a managing director at Manatt Health who previously worked on the Affordable Care Act at the Department of Health and Human Services. "Uncertainty equals higher premiums."

Health and Human Services Secretary Tom Price has said the administration will do what it can administratively to "support the reform effort by reviewing and initiating administrative actions to put patients, families and doctors in charge of medical decisions, bring down costs, and increase choices." Alleigh Marre, an HHS spokeswoman, didn't respond to a request for comment.

"We are seeing claims experience that reflects increased medical and prescription drug costs along with higher utilization," Connecticut Insurance Commissioner Katharine Wade said in a statement.

That's true in Maryland, too, said Insurance Commissioner Al Redmer. There, carriers are requesting average rate increases from 18 percent to 59 percent. That means in the Baltimore area next year, a 40-year-old could buy a basic "silver" plan for $714.95 a month from CareFirst, or one from Kaiser Permanente for $359.25 with a more limited network of doctors.

"If carriers in Maryland are losing just on medical claims you can't point to the current political climate and say, 'Now things are worse,' " he said.

The rates are preliminary, and regulators often have the power to change them. Most other states will report their rates over the next several months.

CareFirst is a major insurer in Maryland, Virginia and Washington, D.C., and sells coverage under the Blue Cross and Blue Shield brand. The company said its premiums still fall short of covering its customers' medical costs. It projects its accumulated Obamacare losses from the start of the program through the end of 2017 will reach $600 million.

"Insurance companies are fleeing ObamaCare — it is dead. Our healthcare plan will lower premiums & deductibles — and be great healthcare!" Trump tweeted on May 4, the day House Republicans narrowly passed a bill to repeal much of the ACA. While the legislation faces a difficult time in the Senate, the premium increases are likely to remain a part of the debate.

It's too early to say whether the results from the three states are indicative of broader trends. An analysis of Blue Cross and Blue Shield plans by S&P Global Ratings showed that insurers' results were generally improving and the market stabilizing in the law's third year.

That analysis, however, didn't include Anthem, which sells insurance under the Blue Cross and Blue Shield brand in 14 states. In Virginia, where it has 165,000 customers in the individual market, Anthem is raising rates about 38 percent. In Connecticut, the insurer has 35,000 customers and is raising rates 34 percent.

"We are forecasting that the individual market will continue to shrink, and that those individuals with greater health-care needs will be the most likely to purchase and retain their coverage," Anthem told Connecticut regulators.

In some cases, rather than raising rates insurers are dropping out. Humana is withdrawing from Obamacare's individual market entirely. Aetna has quit Virginia and Iowa has experienced broad pullouts. In an interview on ABC's "This Week," House Speaker Paul Ryan said the withdrawals showed the law is failing.