After steep price increases that health insurance companies attributed to turmoil from the Trump administration’s attempts to dismantle the Affordable Care Act, premiums for plans on the exchange market are set to decrease in Georgia in 2019. In this photo, Insure Georgia representatives in Macon offer information about ACA plans during open enrollment in 2017. (PHOTO by Audra Melton/The New York Times)

A first: Obamacare premiums to decline in Georgia

The Obamacare rates for next year are in, and it’s a first: Rates are going down.

Following years of steep price hikes, two of the four companies that offer plans on the Affordable Care Act exchange in Georgia, also known as Obamacare, have proposed to lower their rates next year from what they charged in 2018.

According to figures for the individual insurance market released Thursday by the state Department of Insurance, Blue Cross Blue Shield of Georgia is proposing a tiny decrease in premiums for next year, with 2019 premium prices that are on average 0.3 percent lower than 2018’s premiums. Alliant Health Plans is decreasing its premiums by 10 percent.

Moreover, a spokesman for the state Insurance Department confirmed that Blue Cross still intends to return to metro Atlanta, except for Clayton and Rockdale counties. All Georgia counties will be covered by at least one policy option. The program insures more than 480,000 Georgians.

The four companies in the state market filed initial proposals for 2019 in early July, and those mostly contained mild single-digit increases over 2018 rates. The final state proposals come after the companies saw what their competitors proposed and spent the summer negotiating with the state.

The Georgia proposals now must be reviewed by the U.S. Department of Health and Human Services and can still change, though they do so less often at this point.

“They’re decreasing their rates? Huh!” said Bill Custer, a health care finance expert at Georgia State University.

“This is good news on two fronts,” he said. It won’t have much effect on customers who qualify for the subsidy, which goes to people with working-class incomes. But people just above that level, say those who make just over $64,000 for a two-person household, “they have borne the entire brunt of the increases in the past. People just above the income level for the subsidy may be able to purchase coverage now if they haven’t in the past without these stable prices.”

Custer acknowledged that prices are so high that Thursday’s news was not a panacea, but it’s something, he said.

Moreover, he said, taxpayers win. For those who receive the subsidy, less subsidy will be required. “That means actually the taxpayers save money,” Custer said.

Dan McBrayer, an insurance broker whose Obamacare customers are mostly above the subsidy cutoff, was relieved the rates have plateaued.

“This is great that it’s not going up,” McBrayer said. “I would think that at least it’s moving in the right direction. But rates are still very high for people to be able to afford health insurance if they don’t get help from the government.” He called the overall system right now “a mess” when looking at what people can afford.

It won’t do much to stop the bleeding at rural hospitals, which are awash in uncompensated care for people who don’t have insurance, said Monty Veazey, the president of the Georgia Alliance of Community Hospitals. But at least it’s not more bad news.

“That means that it is going in the right direction,” Veazey said. “And it means that more people maybe can afford to get coverage. And they have more money to spend elsewhere — so it should help the economy.”

The remaining two insurers on the state exchange, Ambetter and Kaiser Permanente, have not changed their July rate proposals for 2019. Kaiser is still proposing a 14.7 percent increase for 2019, making up for 2018 when it raised prices far less than the other companies. Ambetter is raising prices 8.8 percent.

This follows a year when Georgia’s ACA price increases were among the nation’s top 10, according to the consulting firm Avalere.

The increases of 2018 over 2017 were brutal, prompted by turmoil from Washington. The Trump administration, newly elected partly on promises to dismantle Obamacare, set to work. The GOP effort failed to ultimately repeal the law, but it scored successes such as repealing one of its funding mechanisms and gutting the mandate that every American have health insurance. Those actions prompted insurers to say they would have to spike prices to deal with the business uncertainty.

Neither Ambetter’s nor Kaiser’s increase for 2019 is anything close to what policyholders saw this year, when prices mostly went up about 50 percent, with Kaiser holding back at just about half the other companies’ increases.

All indications are that the industry has now baked into its rates the expectation of what the patient population will be with the individual mandate gutted, Custer said.

“We’d expect other insurers may look at this and decide to come back in the market in future years,” he said.

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