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Amy Goldstein
Reporter covering health policy and other social policy issues
The average price of the most popular insurance level sold in the federal markets of the Affordable Care Act is down slightly, the first time rates have stopped rising since the creation of health plans half a dozen years.
According to federal figures released Tuesday, in the 39 states that rely on HealthCare.gov, the monthly premium drops 1.5% in 2019 for a level of coverage that forms the basis of the federal insurance subsidies for the province. 39; ACA.
The figures also show that after several years of defections, some insurers are returning to sell ACA health plans and fewer consumers across the country will have only one insurance company in their market.
By releasing this new portrait of the markets at the dawn of the November 1 annual registration period, government officials have flip-flopped from statements by President Trump since his campaign which the ACA was "dead" and its insurance exchanges collapsed – a popular refrain among Republicans.
Seema Verma, Medicare and Medicaid Services Administrator for the Ministry of Health and Social Services, congratulated the administration for improving the affordability and provision of ACA coverage. She said the recent policies of the Trump administration had stabilized the markets and that she had focused on changing regulations to facilitate the use of short-term health plans with relatively low price and without consumer protection.
"While some are publicly accusing us of sabotaging, we are doing everything in our power to limit the damage caused by Obamacare," Verma said during a conference call with reporters.
Non-health policy analysts, however, questioned the administration's reasoning, claiming that ACA's health plan tariffs had been raised last year due to a exaggerated reaction of the maneuvers of the administration and that the prices would have been even lower for 2019 if Trump and his caregivers had not changed the law.
Political analysts cited the president's decision a year ago to abolish a type of subsidy that the 2010 law gave insurers to amortize expenses related to offering discounts to low-income customers for their direct expenses, such as deductibles. In response, insurers have increased rates. But the loss of "cost-sharing reduction grants" has resulted in higher premiums for most consumers – and unexpected benefits for some insurers.
"The main reason that average benchmark premiums have gone down in 2019 is that premiums have increased so much in 2018," said Larry Levitt, executive vice president of the Kaiser Family Foundation, a health policy organization.
And while Verma said more and more insurance choices are limiting ACA rates, Levitt said the longer, longer-term health plans she talked about were just beginning. .
Insurers have also benefited from other measures taken by the administration at the industry's request, including the reduction of the annual registration period to six weeks and the increased difficulty for clients to change their coverage at another time. 'year.
The decline announced Tuesday is less than what HHS secretary Alex Azar described in a speech last month in Nashville, in which he predicts a 2% reduction in the average premium of the most popular coverage: the second lowest level of "silver plans". . "
Federal figures show a wide variation from one state to another, with average rates of the popular coverage level dropping 26% next year in Tennessee, while they increase by 20% in North Dakota. The figures cover states that use the ACA HealthCare.gov registration system. They exclude other states and the District of Columbia, which manage their own ACA registration systems.
The rate analysis also does not cover the other two main levels of coverage offered to ACA customers.
Nevertheless, the moderate prices of the most popular coverage will be useful, especially for middle-class Americans – about 1 in 5 ACA clients – whose incomes put them above the threshold of legislated insurance subsidies. .
Last year, Trump officials predicted market collapse due to insurers continuing to exit stock exchanges, leaving an increasing number of counties and states with a single insurance company selling insurance plans. ACA health. At the meeting on Tuesday, Mr Verma said the trend had reversed. About two out of five countries will have one insurer in the market, compared with more than half of last year, as well as four states, up from 10 last year.
During the registration period last year, ACA supporters had warned that the actions of the administration would cause a collapse in listings, but the number of Americans benefiting such a blanket, intended for people not having access to affordable coverage through a job, has decreased only slightly – to nearly 12 million.
Verma said Tuesday that federal officials had not estimated the number of people who would sign up for the coming year, but that "when you increase your premiums or reduce your premiums, it could attract more people to trade ".
Read more:
The Trump administration proposes to further dismantle the law on affordable care via Medicare
The administration removes subsidies to help Americans benefit from the coverage of the Affordable Care Act
One year after the end of the GOP measure, Democrats consider health care a winning issue
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