Washington State: APPROVED 2019 #ACA rate hikes: 13.8% (w/caveat) vs. likely FLAT w/out #ACASabotage

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

 Back in June, Washington State delivered the bad news: They were expecting 2019 ACA-compliant premiums to increase by another 19.1% (due primarily to this year's sabotage of the law by Donald Trump and Congressional Republicans) on top of this year's 36% increase (10 points of which was due specifically to Trump's CSR reimbursement cut-off).

Today, Washington insurance commissioner Mike Kreidler announced the approved 2019 premium changes, and while the news certainly isn't great, it's not quite as bad as expected earlier this summer:

Kreidler approves 7 insurers, 13.8% rate increase for Washington's health exchange
Insurers requested 19.8 percent rate increase in May
September 12, 2018

OLYMPIA, Wash. - Washington state Insurance Commissioner Mike Kreidler approved seven health insurers to sell 40 health plans for 2019 in Washington Healthplanfinder, the state's health insurance exchange. The average approved rate increase for insurers that sell inside the Exchange is 13.8 percent. Plans will be available in all counties. Insurers initially requested a 19.8 percent rate increase.

“The fact that we’ve been able to lower some of the insurers’ rate requests after our review will be welcome news for consumers,” said Kreidler.

The Washington Health Benefit Exchange board is scheduled to certify the approved plans at its Sept. 13 meeting.

“The individual market is still vulnerable and I recognize many people struggle to afford coverage – especially if they don’t receive a subsidy," Kreidler said. "We’re doing what we can to hold down costs, but it’s a struggle. Insurers need stability and we’re still facing inaction at the federal level as well as targeted hits on the Affordable Care Act that increase the uncertainty."

However, there's a catch...this isn't a complete picture:

The remaining individual market plans--those sold outside the Exchange--are still under review by Kreidler's office. Once all of the plans and rates are approved, Kreidler will release the average rate increase for the entire individual market and a list of insurers that will sell in each county.

...More than 60 percent of the 207,000 people who purchase health insurance through the Exchange receive a subsidy to help lower their premiums.

Open enrollment for the 2019 individual and family health insurance market is Nov. 1 - Dec. 15, 2018.

According to the June press release, Washington's total individual market is around 268,400 people, so around 23% of the enrollees are missing from the 13.8% approved average. The final, complete average probably won't change that much one way or the other but it could be a point or two higher or lower.

As for the impact of the mandate being repealed by Congressional Republicans and/or the expansion of #ShortAssPlans by the Trump Administration, until I hear otherwise (via the WA insurance dept. or the individual carriers in the state), I'm going to stick with my assumption of roughly a 14 percentage point factor (2/3 of the Urban Institute's 21% estimate from last spring).

If accurate, that means that without those factors, unsubsidized premiums would be essentially flat year over year...a difference of $858 per year per enrollee on average.

Here's what the requested rate increases looked like back in June...

...and here's what the approved rate hikes look like, assuming the 4 missing carriers have their requested increases approved as is:

In other words, assuming the 4 unreviewed carriers don't have their requested rates modified, the statewide average increase should be around 13.3% vs. the 13.8% across the 7 which have been approved so far.