CMS Says ACA Premiums will Drop 1.5 Percent In 2019

October 2018 ~

CMS announced that average premiums for benchmark silver plans on the Affordable Care Act (ACA) Exchanges will drop 1.5% in 2019, compared to a rate increase of 37% in 2018. CMS stated, in the press release, that the drop marks the first time average premiums have dropped since the implementation of the Federally-facilitated Exchange in 2014.

CMS Administrator Seema Verma commented, “Despite predictions that our actions would increase rates and destabilize the markets, the opposite has happened. The drop in benchmark plan premiums for plan year 2019 and the increased choices for Americans seeking insurance on the exchanges is proof positive that our actions are working. While we are encouraged by this progress, we aren’t satisfied. Even with this reduction, average rates are still too high. If we are going to truly offer affordable, high quality healthcare, ultimately the law needs to change.”

According to the release, after the Patient Protection and Affordable Care Act (PPACA) regulations took effect in 2014, average individual market premiums more than doubled from $2,784 per year in 2013 to $5,712 in 2017, an increase of $2,928 or 105%. Between 2017 and 2018, the average premium for the second-lowest cost silver plan increased by 37%. And between 2016 and 2017, the hike in average premiums was 25%.

CMS states, as part of the ongoing effort to address market stability issues and to improve the performance of the Federally-facilitated exchanges, for this upcoming Open Enrollment, Americans will, on average, experience lower premiums on health plans purchased on the federal exchange. There are 23 more medical QHP issuers for 2019 than were participating during open enrollment in 2018 and 29 current medical QHP issuers are expanding their service area into more counties. The number of counties with only one insurer has dropped from 56% in 2018 to 39% in 2019, and only five states will have only one insurer, compared to ten in 2018.

To determine the year-over-year changes, the agency analyzed Exchange individual plan year 2019 premium data submitted as of September 28, 2018, as part of the QHP certification process. Average premiums were then weighted, based on 2018 Exchange enrollment data. Data is subject to change due to plan withdrawals.

View the full table of average premiums,here.

Source(s): CMS Press Release; Healthcare Finance;