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Ohio Obamacare 2019 costs rise, but not as much; more options available

October 7, 2018

Ohio Obamacare 2019 costs rise, but not as much; more options available

CLEVELAND, Ohio – Ohioans who have Obamacare plans will see premium increases averaging 6.3 percent for health-insurance coverage in 2019, according to the Ohio Department of Insurance. They’ll also have more coverage options.

Insurers say a stabilizing marketplace has allowed them to increase premiums less and expand coverage to more counties in Ohio for 2019, after a year in which insurers largely blamed instability in Washington, D.C., for cost increases averaging 21 percent.

Obamacare marketplace plans are typically purchased by those who are not insured through work, Medicaid or Medicare, roughly 230,000 Ohioans. Open enrollment runs Nov. 1 through Dec. 15.

Rising premiums

The biggest premium increase in northeast Ohio was requested by New York-based Oscar Insurance Corp., a health insurance tech startup that entered the Ohio market with an insurance offering with the Cleveland Clinic for 2018 coverage. According to federal filings, its Classic Gold Plan will increase premiums 22.27 percent over last year. 

“For most insurers, not just Oscar, premiums are going up because prices for drugs and services are going up,” said Kyle Estep, Ohio market director for Oscar Health. He also attributed rising rates to “misguided decisions in Washington to eliminate the individual mandate and create short-term plans that are a poor substitute for ACA (Affordable Care Act) plans.” 

Other insurers also attributed higher costs to a number of changes at the federal level. Congress in 2017 repealed the individual mandate, which required that everyone have health insurance, or pay a fine. The mandate was intended to keep healthier people on the insurance market, which lowers costs for all insured people. Repeal of the mandate goes into effect for 2019 coverage.

President Donald Trump this summer expanded Association Health Plans, through which small businesses can purchase insurance together, as well as short-term insurance plans. Those plans, however, aren’t required to honor the same coverage guarantees as exchange plans. Coverage gaps in the cheaper plans, insurance experts say, could send sicker people to Obamacare plans. 

“With the short-term plans and with these association plans, basically the only people who might be attracted are those who don’t have significant health concerns. Conversely, people more interested in traditional marketplace plans have significant health concerns,” said Loren Anthes, a public policy fellow at the Center for Community Solutions, a nonpartisan think tank. Without healthier people enrolled to stabilize rates, he said, costs rise.

Robert Brett, vice president of Marketplace for CareSource, a Dayton-based nonprofit health care insurer, also pointed to the elimination of the individual mandate and the rising costs of medical services and prescription drugs as the reason for premiums’ increases.

CareSource, which offers exchange plans in 60 of Ohio’s counties, including Cuyahoga, plans to increase premiums just shy of 18 percent for its plans.

“It’s these factors and other federal policy changes that will most likely cause consumers with the greatest health care needs to enroll, creating a gap in Marketplace participation and ultimately a greater risk for insurers,” Brett said.

Expanding coverage

Nationwide, 19 states, including Ohio, will have new insurance plans or expanded coverage by existing insurers on the marketplace in 2019, according to a September report by Avalere, a Washington, D.C.,-based healthcare consulting firm.

“In many states, the individual market will offer stability for consumers in 2019, despite significant policy change,” Elizabeth Carter, senior vice president of Avalere, said in a report. “Insurers that continue to offer plans have learned what to expect from the market.”

In Ohio, 10 insurers will participate in the exchange in 2019, compared to eight this year, according to the state insurance department. In all, 16 counties will only have one insurer, down from 42 in 2018.

Locally, Obamacare plans will be offered by Buckeye Community Health Plan, CareSource, Medical Health Insuring Corp. of Ohio, Molina Healthcare of Ohio and Oscar.

Two new players in Ohio are Indianapolis-based Anthem Blue Cross Blue Shield and a new arm of Oscar. Neither will offer plans in Northeast Ohio.

Under the name Community Insurance Co., Anthem will offer individual health plans in 25 counties in the state next year, one year after exiting the state’s marketplace over uncertainty in Washington.

Anthem spokesman Jeff Blunt said the company did a “thoughtful review of marketplace stability in Ohio” before re-entering the state’s exchange.

“As far as how the decision was made, Anthem assesses the market each year and participates where the company believes there is sufficient stability,” Blunt said.  Anthem plans for 2019 are mostly limited to the southeastern part of the state.

As Oscar Buckeye State Insurance Corp., Oscar will expand into the Columbus market next year. This is one of six new markets the company will enter.

“Unlike last year, we are seeing more insurers join us in entering new markets, a clear sign that the markets are stabilizing and we remain confident that this trend will continue. The health care system as a whole is finally beginning to move in a more consumer-centric direction,” Estep said. 

Oscar will offer plans in Delaware, Fairfield, Franklin and Licking counties. Until now, the insurer only offered plans in five counties in Northeast Ohio: Cuyahoga, Lake, Lorain, Medina and Summit.

Oscar’s co-branded plans with the Clinic had 11,000 enrollments in 2018, three times the company’s expectations, Estep said.

People can enroll in marketplace plans using the federal site www.healthcare.gov or CuidadoDeSalud.gov or by calling the national hotline at 1-800-318-2596. 

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