Affordable Care Act

People walk past Sunshine Life and Health Advisors in Hialeah, Florida. Rates for health insurance on the Affordable Care Act exchange, part of Obamacare, will go up an average of 36 percent in Wisconsin next year.

ASSOCIATED PRESS

But subsidies will aid most in Wisconsin

Health insurance premiums on the Affordable Care Act exchange will go up an average of 36 percent in Wisconsin next year, but government subsidies will offset the increases for most people, a state official said Thursday.

A major reason for the stiff hikes is that President Donald Trump’s administration hasn’t said if it will continue certain payments to insurers, said J.P. Wieske, deputy commissioner of insurance.

The increases — and the loss of three national insurers in the state from healthcare.gov, affecting more than a third of the 216,000 residents who get insurance that way — also reflect instability in the market, Wieske said.

Too few young and healthy people are signing up for insurance on the exchange, part of what is known by some as Obamacare, making it risky for insurers who have lost $400 million from the business in the state over three years, he said.

“There’s some concern that we’re in a death spiral,” Wieske said. “The increases we’re seeing reflect the increased amount of risk that a smaller number of carriers are going to have to take on.”

Gov. Scott Walker added: “Obamacare is collapsing, and these huge premium increases show the law failed on its promise to deliver affordable healthcare.”

Enrollment for individual coverage at healthcare.gov runs Nov. 1 to Dec. 15. The vast majority of people get insurance instead through their employer or the government programs Medicaid or Medicare.

Molina Healthcare, Anthem Blue Cross Blue Shield in Wisconsin and Health Tradition Health Plan said earlier this year they are leaving the exchange next year. About 75,000 people on those plans will need to select other insurance, Wieske said.

To help stabilize the market, Wisconsin will consider seeking a waiver in 2019 to let the state set up its own system under the federal health care law, he said. Minnesota has done that, and Iowa is requesting permission.

President Trump’s executive order Thursday to allow for the sale of cheaper, less-regulated plans could also help, Wieske said.

“We’re hopeful over the longer haul that some of these pieces will have a positive impact on consumers’ ability to buy health insurance,” he said.

Premiums next year will increase an average of 40 percent for so-called silver plans on the exchange in the state. About 90 percent of people with the coverage get subsidies that will also go up accordingly, so they won’t be directly impacted, Wieske said.

Rates for bronze plans, which offer less coverage, will go up 21 percent. The cost for gold plans, which offer more coverage, will go up 19 percent. People buying those plans will have to pay more.

Trump has threatened to end payments to insurance companies to help cover low-income people, though the payments have continued.

Wisconsin, like some other states, told insurance companies to assume the payments, associated with silver plans, won’t be provided next year. That contributed significantly to their large rate increases for silver plans, Wieske said.

If the payments continue, insurers could be required to lower rates in 2019, he said.

The insurance commissioner’s office provided rates by county for 2018 for a 21-year-old buying the lowest-cost silver plan.

That rate will go up about 51 percent next year statewide. In Dane County, it will increase 61 percent, with an average monthly premium of $353, up from $220 this year.

Dean Health Plan, Group Cooperative of South Central Wisconsin and Unity Health Insurance, which has started using the name Quartz, sell plans on the exchange in Dane County.

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.