Health insurance premiums will likely increase by an average of 76 percent for Oklahomans who buy individual coverage through the Affordable Care Act’s marketplace. The increases for individual market plans range from 58 percent to 96 percent.
“These jaw-dropping increases make it clear that Oklahoma’s exchange is on life support,” said Oklahoma Insurance Commissioner John D. Doak. “Health insurers are losing massive amounts of money. If they don’t raise rates they’ll go out of business. This system has been doomed from the beginning.”
Blue Cross Blue Shield of Oklahoma, the only health insurer offering plans on the federal exchange in 2017, submitted the increases to the Centers for Medicare & Medicaid Services (CMS). CMS will determine if the increases are reasonable.
The increase requests follow many insurers reporting significant losses, lower than expected enrollment by the younger population and new customers being sicker than expected. ACA-compliant off-exchange individual plans sold by Blue Cross Blue Shield of Oklahoma will see the same increases as plans sold on the exchange.
The Oklahoma Insurance Department does not have statutory authority to approve or deny rate premium increases for plans on the federal health insurance exchange. Oklahoma, along with Texas, Missouri, Alabama and Wyoming, is a direct enforcement state and has no authority to enforce provisions of the Affordable Care Act.
At the end of 2016, UnitedHealthcare will exit the individual market in Oklahoma. It had five percent of the state’s 130,178 federal exchange enrollees for 2016.
Blue Cross Blue Shield of Oklahoma had the other 95 percent. UnitedHealthcare enrollees will receive notices from CMS that they have been automatically enrolled into a similar exchange plan.
The increases apply to people buying individual plans, about six percent of the Oklahoma population. Most Oklahomans purchase insurance from an employer plan, a large group plan or through a government program such as Medicare or SoonerCare.
According to the U.S. Department of Health and Human Services, as exchange rates increase, so do the subsidies available to offset the cost of individual premiums.