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N.H. Predicts Lower Cost For ‘Obamacare’ Plans



Valley News Staff Writer
Wednesday, August 08, 2018

West Lebanon — In the short term, New Hampshire residents who buy health insurance through the federal marketplace can expect lower rates. In the longer term, there’s a good chance they’ll have more plans to choose from, although there’s disagreement about whether that’s a positive development.

Rates for the coming year won’t be available until enrollment begins on Nov. 1, but the New Hampshire Insurance Department predicts a 6.75 percent rate decrease between 2018 and 2019, according to a news release issued on Monday. 

The decrease, which is based on median premiums for silver-level plans purchased on the exchange for a 40-year-old, non-tobacco user, is in contrast with the double-digit increases many saw between 2017 and 2018, which in some cases were more than 50 percent. 

“Despite uncertainty at the federal level, a modest decrease in premium rates for New Hampshire residents is a move in the right direction,” Insurance Commissioner John Elias said in the release. “Rates are still high, particularly for (New Hampshire) residents who do not qualify for premium assistance, but we will continue to work collaboratively with insurance companies and pursue other efforts to improve market stability in New Hampshire.”

In the future, residents may have the choice to purchase short-term and association health plans made possible by new rule changes by the Trump administration. The White House has described the plans as “more affordable” options, but others have questioned what consumers will be getting for their money.

The expansion of the short-term plans, announced by the U.S. Department of Health & Human Services earlier this month, means that customers can purchase them for up to 12 months at a time, up from a current limit of three, and renew them for up to 36 months. 

The change in rules relating to association plans, announced by the U.S. Department of Labor in June, makes it easier for small businesses to buy insurance and allows self-employed people to purchase such plans.

Neither short-term plans nor association plans need comply with the Affordable Care Act’s requirement that health plans include 10 categories of “essential benefits,” including maternity care and mental health services, as the Washington Post reported earlier this month. 

Short-term plans also can charge higher prices to customers with certain medical conditions, deny such customers coverage or avoid covering pre-existing conditions, the Post reported. 

“We continue to see a crisis of affordability in the individual insurance market, especially for those who don’t qualify for large subsidies,” CMS Administrator Seema Verma said in the HHS release issued on Aug. 1. “This final rule opens the door to new, more affordable coverage options for millions of middle-class Americans who have been priced out of ACA plans.”

Vermont passed a law, Act 131, earlier this year that prevents short-term plans from extending beyond three months and doesn’t allow them to be renewed. Through related rules promulgated by the Vermont Department of Financial Regulation, the state is also requiring that association plans cover all essential health benefits. 

Department Commissioner Mike Pieciak, in comments to VtDigger earlier this month, said the state exercised its right to regulate these insurance plans without going against the federal rules.

“We think we went right up to the line and created a very robust regulatory framework,” Pieciak said.

In New Hampshire, no such framework exists, but Jenny Patterson, director of health policy for the Insurance Department, said in an email that the department will work with the governor’s office, legislators and stakeholders to “to bring forward a proposal that meets the needs of (New Hampshire) residents” during the 2019 legislative session.

Short-term and association plans may have the effect of providing consumers with additional options, Patterson wrote.

However, “consumers should understand that if they choose this type of coverage, there may be limitations in terms of what benefits are covered and NHID will endeavor to ensure there are sufficient communications to consumers,” she wrote.

In addition, the expansion of the short-term and association plans may mean that healthy people leave the individual market and drive up premium costs for those who remain on the exchange, she wrote. 

It is possible that these changes could make a difference in rates in years to come.

“To the extent that there are changes to (the) risk pool over time, there could be an impact for rates for 2020 but at this time it’s difficult to say what that would look like,” she wrote.

Sunapee insurance broker George Curt saw at least one advantage to the recent changes.

“At the very least there are more choices coming down the pike,” he said.

While the lower prices of the short-term and the association plans are likely to appeal to customers, their decisions of whether to buy them may come down to the fine print.

“The most important thing about all of that is that the consumer understand it,” he said.

For example, it would be important for customers to know whether conditions that crop up during the first 12 months of coverage under a short-term insurance plan would be covered if the customer opts to renew for another year, he said.

These are discussions for another time, however. On Tuesday morning, Curt sent out an email notifying his customers of the likely rate decrease for the coming year. 

Though he noted that a small decrease wouldn’t make up for the steep increases that people saw last year, it will make it easier to renew.

“Most people are going to be relieved,” he said.

Valley News Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.