State to delay higher health premium announcement

As many as 80,000 people could be affected

BOSTON (SHNS) – Tens of thousands of Massachusetts consumers will have to wait a little longer to learn how high their health insurance premiums will rise.

The Massachusetts Health Connector indicated last week that consumers would have to wait until Tuesday to find out if the premium for their insurance purchased through the state agency would go up by as much as 26 percent next year. As many as 80,000 people could be affected.

With uncertainty around federal health care changes looming and the start of an open enrollment period right around the corner, the Massachusetts Health Connector and Division of Insurance prepared two sets of rates for 2018 to account for the possibility that the federal government will stop making monthly cost sharing reduction (CSR) payments.

The Connector administration expected to settle on a set of 2018 rates for its silver tier plans by Tuesday morning, with the decision determining whether consumers will see average premium increases of 26.1 percent or 10.5 percent, but no ruling has been made.

“We anticipate a decision, made in coordination with the Division of Insurance and carriers, by the end of the week,” Jason Lefferts, director of communications for the Connector, said in a statement.

Health Connector Executive Director Louis Gutierrez said last week that the decision must be made by Tuesday morning in order to meet deadlines associated with the Nov. 1 start of the open enrollment period, but the Connector was able to extend its own deadline by at least two days.

If the CSR payments are eliminated, members enrolled in silver tier plans — which, according to the Connector “have lower premiums but higher costs when you get health care services” — could see average premium increases of 26.1 percent, the Connector said. If the standard rates are used, the average premium increase would be about 10.5 percent.

In a letter to the Massachusetts congressional delegation last week, Gov. Charlie Baker said CSR payments to Massachusetts are estimated to be $146 million and said the uncertainty around the payments is a threat to tens of thousands Massachusetts residents.

“As we approach the start of Open Enrollment on November 1, it is critical for federal cost sharing reduction payments to be resolved affirmatively in order to maintain market stability and to constrain rate increases,” Baker wrote. He continued, “If Congress does not act to stabilize the insurance market by funding the CSRs, then 80,000 Connector members would directly experience premium increases of 20 percent or more in addition to potential disruption in their health care provider.”

The CSRs are available for individuals and families with incomes up to 250 percent of the federal poverty level, or about $60,625 for a family of four. According to Massachusetts insurers, 244,400 enrollees in 2016 benefited from cost sharing subsidies that go toward lowering out-of-pocket expenses such as co-pays and deductibles.

The fate of the CSR subsidies partially hangs in a lawsuit, House vs. Price, initially filed by House Republicans against the Obama administration. The Trump administration has also threatened to end monthly CSR payments as a way to sabotage the Affordable Care Act and compel Congress to pass health care reform.

At least two senior Republican senators — Tennessee Sen. Lamar Alexander and Wisconsin Sen. Ron Johnson — have indicated that they support continuing the subsidies as a way of preventing premiums from skyrocketing.