ACA rate reviews being used by insurers in unforeseen way
The rate review mechanism enacted by the Affordable Care Act was intended to shame health insurers that asked for large premium hikes, but as the New York Times reports, insurers are trying to use it to their advantage for 2017.
According to the NYT, insurers are using the rate reviews to show the large losses they’re taking for offering coverage on the ACA exchanges. In one example, Highmark tried to back up its request for a 41 percent increase in premiums in Pennsylvania to the state’s insurance commissioner.
“There were close to 250 individual ACA policyholders in Pennsylvania who incurred over $100,000 each in claims and then canceled coverage before the end of the year,” Jeff Scheib, the vice president in charge of actuarial services at Highmark, said. “This behavior drives up the cost to insure the entire pool, because people use insurance benefits and then discontinue paying for coverage once their individual healthcare needs have been temporarily met.”
For more on how insurers are highlighting their exchange losses, click on the link below:
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.