(HELENA) Agents of the state Wednesday released the final 2017 rates for health insurance on Montana’s individual market, with average increases ranging from 27 % to 58 %.
State Auditor Monica Lindeen, whose office regulates insurance, also announced that she had found the increases from Blue Cross Blue Shield of Montana to be “unreasonable” – although she has no power to reduce them.
“Our insurers need to charge premiums high enough to pay all their claims and stay in business, but some of Blue Cross’ rates for 2017 go beyond that goal,” she said in a statement.
The average increase for Blue Cross policies on the individual market is 58.4 percent.
For the Montana Health Cooperative, the average is a 30.7 percent increase; for PacificSource, 27.6 percent. Increases for small-group policies for all three companies range from a low of 2 percent to a high of 29 percent, with Blue Cross again the highest.
Blue Cross spokesman John Doran told MTN News Wednesday that the company “respectfully disagrees” with Lindeen’s determination that its rates are unreasonable.
The company hired an outside actuary to review the rate increases, and the actuary found that the company’s rate increases are justified, he said.
“We need adequate rates that cover the true costs of medical services and the true costs of doing business,” Doran said. “We are confident that (our) rates are reasonable.”
The individual policy rates are for health insurance policies sold to about 80,000 Montanans buying on the individual market – a relatively small sector of the overall health insurance market.
Lindeen noted that they don’t affect people on larger private group policies or government-financed programs like Medicare or Medicaid – all of which, combined, insure the majority of people who have health coverage.
She said her office would release its findings on the Blue Cross rates next week, showing how it believes the company could have reduced the increase further. Blue Cross originally had proposed an average increase of more than 60 percent, on individual policies.
Health insurers have said the increases are needed to cover rising medical costs and unexpectedly higher costs in a relatively new market.
The individual policies are sold directly to consumers or through the online “marketplace,” which was created by the 2010 Affordable Care Act in Montana and other states.
Most consumers buying through the marketplace can get a federal subsidy to offset the cost of the policy.
Lindeen said those getting subsidies probably won’t see much of an increase if they buy a policy for next year because the subsidies will increase the price of the policy. However, for the 35,000 Montanans not buying on the marketplace, the increases “could present serious financial challenges,” her office said.
She also told MTN News that she agrees with Blue Cross that the primary culprit for the increases is rising health-care costs, which need to be addressed by Congress.
“If they don’t start putting aside the partisan politics and actually addressing these issues head-on, whether it’s the pharmaceutical business and what they’re doing to consumers, or the Affordable Care Act and making changes that would be positive, it’s going to continue to be the consumers and Montana families that are going to pay the cost,” she said.
Reporter: Mike Dennison