Harvard Pilgrim Seeks 39.7% Premium Increase in the ACA Marketplace, Smaller Increases Sought by Anthem and CHO
Republican efforts in Washington to replace the ACA has resulted in uncertainly about the future of the subsidies and the large increases are partially a result of this uncertainly. Nearly 90 percent of the 86,000 Mainers who receive coverage in individual plans through the exchange receive a subsidy to help with the cost of the premium. The subsidies are available to individuals earning between 100 percent and 400 percent of the federal poverty level.
Community Health Options stated 15 percent of its requested premium increase is due to
individual plans issued to “an anticipated smaller, and sicker, pool of
insureds.” CHO has approximately 42,000 policyholders in Maine. It said its need for this level of rate increase is basically driven by the lack of an
insurance mandate and the resulting impact of higher premiums. The CHO small group rate increase (for those plans
continued from 2017 into 2018) is 7.8%.
Harvard Pilgrim and Anthem cited higher costs and market instability as reasons for their rate increases, and Harvard Pilgrim also suggested it may leave the Maine marketplace completely. A Harvard Pilgrim spokesperson said, “While we remain committed to the principle of everyone having access to
affordable coverage, we can only continue to participate in the
exchanges if there is stability in this market, and that will only come
with immediate action from Washington.”
In prior years federal subsidies based on income have largely offset
increases in out-of-pocket costs for low- to moderate-income
policyholders. Those subsidies are now in doubt based on recent efforts in Congress to repeal the ACA and its associated subsidies.
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