Kristi L Nelson, Knoxville News Sentinel
As some of the rest of the country sees uncertainty and rising premium rates for the 2019 Affordable Care Act marketplace, Tennessee may see more options and lower premiums.
Insurers wanting to provide marketplace coverage for 2019 filed premium rates with the state Wednesday, and two, Blue Cross Blue Shield of Tennessee and Cigna, are asking for lower premiums than in previous years. That’s something Tennessee Insurance Commissioner Julie Mix McPeak said hasn’t happened since the ACA took effect.
In addition, two new carriers — Bright Health and Celtic Insurance — have applied to enter Tennessee’s marketplace, while existing insurers Cigna and Oscar Health have applied to expand their coverage areas. This means for the first time in several years, residents in most state counties could have a choice of more than one provider for marketplace insurance.
These rates aren’t set in stone — the state will now have the insurers’ proposals reviewed by actuaries, and McPeak will decide in August whether to approve them. The rates aren’t finalized until the insurers sign contracts with the federal Centers for Medicare and Medicaid Services in the fall.
Two years ago, Cigna and then-provider Humana filed higher, revised rates after the July deadline in response to the instability of the marketplace.
Last week, a Trump administration decision put on hold the “risk adjustment” program in which money is collected from insurers with fewer high-cost plan members and then transferred to insurers with more high-need patients who require more expensive care.
But Mix McPeak said she is “very hopeful” insurers considered the impact of the freeze — which at the present time is temporary — before making their proposals.
“We might even see potentially larger decreases” as the year wears on, she said.
Insurers’ requests are:
Blue Cross Blue Shield of Tennessee, covering statewide except for Memphis and Nashville areas: Proposed 2019 rate request seeking an average decrease of 10.9 percent; premiums $182.91-$3,109.32.
Bright Health, new to the Tennessee marketplace and proposing plans in the Knoxville, Memphis and Nashville areas: Proposed premiums $196.87-$2,780.54.
Celtic Insurance, new to the Tennessee marketplace and proposing plans in the Chattanooga and Memphis areas: Proposed premiums $294-$2,028.
Cigna, continuing coverage in Nashville, Memphis and the Tri-Cities and proposing to expand into Knoxville: Proposed 2019 rate request seeking a premium decrease 4.8 percent; premiums $243-$2,966.
Oscar Health, continuing coverage in Nashville and proposing to expand into Memphis: Proposed 2019 request seeking an average increase of 10.84 percent; premiums $202.99-$2,419.74.
Open enrollment for 2019 insurance plans runs Nov. 1, 2018-Dec.15, 2018 at www.healthcare.gov and community locations staffed by volunteer facilitators who can help individuals decide on a plan and enroll.
McPeak theorized the number of claims on marketplace plans might be “plateauing” as newly insured patients have taken care of longstanding medical issues and overdue procedures and began to shift to preventive care.
She also said the addition of new providers in the state might have encouraged more competitive rates.
She urged legislators to work to stabilize insurance markets and give states “flexibility” to implement the best coverage options for their residents.
“There’s still work to be done,” McPeak said.
Senate health committee Chairman Lamar Alexander, R-Tenn., who with McPeak has testified before Congress, said the news was but states still need “greater flexibility to lower premiums.”
“Today’s news is a welcome step for Tennesseans after facing an over 176 percent increase in health insurance premiums since Obamacare took effect, but the news could have been even better,” Alexander said in a statement.