Some Louisvillians will see lower health insurance premiums in 2020, based on preliminary rate filings from insurers CareSource and Anthem.
However, other Kentuckians, including some in the western half of the state, will have to deal with an average increase of 12%.
Insurance companies have proposed rates for next year for individual plans, which cover Kentuckians who get health insurance through the Affordable Care Act. Only two insurers, CareSource and Anthem, offer ACA plans in Kentucky.
CareSource has proposed that its rate for individuals be lowered by an average of 4.5%, while Anthem has requested a 12% increase. The Kentucky Department of Insurance said it would review the new rate proposals before finalizing them next month.
The rates represent averages, which means individual premiums can be different as they will depend on factors including age, smoking habits and geographic location.
The rates affect nearly 85,000 Kentuckians who get insurance through the ACA. They do not affect people who get insurance through government programs such as Medicare and Medicaid or the roughly 500,000 Kentuckians who get insurance through their employers.
ACA customers can generally choose from four plans — bronze, silver, gold and platinum — with varied monthly premiums, deductibles and health care costs. For example, bronze plans allow consumers to pay low monthly premiums, but require a high share of cost participation, generally 40%, when those customers need care. On the flip-side, platinum plans have the highest monthly premiums, but require consumers to pay only 10% of health care costs.
The Kentucky Department of Insurance said that 90% of Kentuckians who get insurance through the federal exchange choose silver or bronze plans.
“From our initial review, it appears that the popular silver and bronze plans offered by both insurers receive either a much smaller average increase or comprise the majority of the decreases when compared to other plans,” Kentucky Insurance Commissioner Nancy Atkins said in a news release.
CareSource, which expects its rates to decline, offered plans in 61 counties last year, including Jefferson and Bullitt and much of the eastern part of the state. Anthem, which is proposing a 12% increase, covered most of the eastern border counties, and south of Bullitt County, every Kentucky county west of Interstate 65.
While some Louisvillians will see lower health insurance premiums in 2020, it was unclear from the initial filings whether the insurers planned to increase the territory in which they’re offering plans. If that happened, consumers could choose among plans from different insurers — rather than from bronze, silver, gold and platinum plans of the same insurer.
Anthem told Insider via email, “While we have filed rates in Kentucky, it’s important to note that this is a normal course of business and it would be premature to comment about specifics in the filing.”
CareSource and the Kentucky Department of Insurance could not be reached.
Open enrollment for the 2020 plans begin Nov. 1.
The modest increase and slight decrease proposed for next year stand in stark contrast to large increases the insurers have proposed in the last few years as they struggled to price their plans appropriately to make sure the revenues covered the expenses incurred by the patient pool. Two years ago, the DOI approved increases of 41.2% for Anthem and 56% for CareSource.
No other insurance company is providing health insurance plans for Kentucky under the federal health care exchange set up under the ACA, informally known as Obamacare. Some insurers, including Louisville-based Humana, have exited the market because the exchanges have primarily attracted sicker people whose health care premiums were not enough to pay for their health care.
Humana left the individual market at the beginning of last year because of hundreds of millions of dollars in losses in that market and because of uncertainty about the ACA’s future. Republicans have repeatedly tried to dismantle the law, which is former President Barack Obama’s signature piece of legislation. Last week, judges at a federal appeals court in New Orleans listened to oral arguments in a case that could mean the end of the law, though legal experts said the case could end up before the U.S. Supreme Court.