Two health insurance companies in Montana will be allowed to refile their rates to account for the Trump Administration’s decision to end payments for some individual policies.
The Center for Medicare and Medicaid Services contacted the Montana Department of Insurance and reversed a decision that said states would not be allowed to adjust their rates, according to a statement released Monday.
President Donald Trump announced last week he would immediately end subsidies paid to insurance companies to offset costs for people with lower incomes who buy insurance on exchanges. In Montana, nearly 64,000 people buy health insurance on the exchange. About 25,000 benefit from the subsidies, called cost-sharing reduction payments. Average payments are $1,147.
Both the Montana Health Co-op and PacificSource Health Plans are expected to raise their rates to make up for the loss of the subsidy payments, Dan Stusek, a spokesman for the department, said on Monday.
Blue Cross Blue Shield, the other participant in Montana's exchange, accounted for the possibility of no subsidies when it set its 2018 rates. The company’s average rate increase was 22.3 percent, while the Co-op's was 4 percent and PacificSource’s was 7.4 percent.
Karen Early, director of operations for Montana Health Co-op, said the company will refile rates for mid-range plans at an additional increase of 24 percent. Other plans will stay at the 4 percent increase.
Todd Lovshin, PacificSource's vice president and Montana regional director, told the Associated Press the company has filed for an average 11 percent rate hike for a standard "silver plan" atop the 7.4 percent increase. That hike applies to about 43 percent of PacificSource's Montana marketplace, Lovshin said.
Commissioner of Securities and Insurance Matt Rosendale said he was disheartened that two companies would change their rates at the last minute.
“My department was advised by both companies just months ago, that with or without CSR payments, they would be able to honor the rates they provided to us and the public. Today, by their actions, they inform me that was not true,” Rosendale said in a statement. “These last minute adjustments will cause increases in the amount of premium many individuals will be required to pay for health insurance from those two companies. I caution consumers who have already made decisions to purchase plans to go back and re-evaluate their options before open enrollment begins.”
But without refiling its rates, the Montana Health Co-op said it would be forced to drop from the insurance exchange. The Co-op covers 20,000 Montanans through the exchange.
"Our rates assumed the cost-sharing reduction payments would be paid," Early told Lee Newspapers last week. "This is a significant amount of money. It would be impossible for the Co-op to remain in business in Montana without raising rates."
According to the AP, Lovshin said "We have been clear in rate hearings and our public presentations that our rates were assuming the present healthcare law would continue and that the (federal reductions) would continue to be paid. We have worked really hard to minimize the impact to our members."
Cost-sharing reduction payments are required by law, so insurance companies must keep making them even when federal reimbursements end. The payments have been called into question since 2014, when House Republicans filed a lawsuit saying the payments were illegal. The Obama administration appealed the ruling. Nationally, payments were expected to be $9 billion in 2018.
Last week, Democratic U.S. Sen Jon Tester said ending the payments undermines the system when health care costs are already too high. Republicans Sen. Steve Daines and Rep. Greg Gianforte said the move ends unconstitutional funding for a program that used taxpayer money without Congress’ approval.
Rosendale said the new premium information will be available as soon as possible.
“I strongly encourage you to shop, shop, shop,” he said.