Premiums for individual health-insurance plans in Washington will rise by an average of 13.6 percent next year, though rates within the state health exchange are expected to jump about 8 percent for midlevel plans, far lower than national hikes of 25 percent.
Thirteen health insurers have been approved to sell 151 individual and family plans in Washington for 2017, including nine insurers that will sell 98 plans through the Washington Healthplanfinder. Seven insurers will sell 56 plans outside the exchange.
The premium increases range from a 7.35 percent hike for Molina to an increase of almost 25 percent for Group Health and Health Alliance plans offered outside the exchange, according to the figures released Wednesday by Insurance Commissioner Mike Kreidler.
Kreidler attributed the premium increases to insurers getting a realistic view of customers and their costs heading into the fourth year of enrollment under the Affordable Care Act.
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“I do believe this year’s change is a one-time adjustment and that we’ll see premiums level off as insurers gain experience and more people get covered,” he said.
Those rates are lower than premium figures released Monday by the federal Department of Health and Human Services, which showed the cost of a midlevel silver plan would rise by an average of 25 percent in the 38 states served by the federally run programs.
About 70 percent of the 170,000 people who buy plans through the state exchange are eligible for subsidies that will offset the increases, officials said. Premium changes depend on several factors, including where a person lives, their age, whether or not they smoke, which insurer they choose and how many family members are covered.
Open enrollment under the health law begins Nov. 1. Consumers who opt out of insurance next year could face tax penalties of $700 per person or more.
Washington isn’t seeing the high premium increases or drastically reduced options — including a surge in areas where a single plan is available through the federal exchanges created through the ACA — as other places. Those issues have cropped up in states where there were fewer choices than in Washington, Kreidler said.
“We had real competition in our market before the ACA,” he said. “So we had a running start that helped us.”
Two counties in Washington — Klickitat and San Juan — will have just one option on the state exchange next year, officials said.
Another factor in the state’s strong market is that Washington moved early to expand access to the state’s Apple Health Medicaid program, which provides care to low income and disabled people. And the state chose to run its own exchange, instead of relying on the federal option, Kreidler said.
Two insurers have withdrawn from Washington’s individual market, including United HealthCare of Washington and Moda. Two other statewide insurers, Premera and Lifewise, will stop marketing outside the exchange in 2017 and are reducing the number of counties where they sell plans.
Still, the increases in premiums, as well as hikes in co-payments for services and deductibles, hit consumers in the pocketbook.
Linda Deright, 62, of Seattle, said the premiums she and her husband, a realtor, paid for individual insurance jumped from $640 a month two years ago to more than $1,800 last year. Their plans have been canceled three times, she said. They’ve been buying insurance through plans offered for small businesses, but likely will look at the exchange this year.
“It’s just expensive, expensive, expensive,” she said.
In Washington, about 170,000 people were enrolled in the exchange last year, said Michael Marchand, spokesman for the state exchange. Another 170,000 people have private plans outside the exchange.
Most people in Washington — about 3.8 million — have employer-sponsored health insurance, and about 1 million are covered through the federal Medicare program.
Nearly 600,000 people have enrolled in Medicaid through the state’s expansion, driving the total to about 1.4 million.
The number of people without health insurance in Washington dropped from 14.5 percent in 2012 to about 7.3 percent, or about 522,000 people, state figures show.
Following are the average rate changes for insurers offering plans inside and outside the exchange in 2017:
▪ Asuris, outside the exchange, 15.4 percent increase.
▪ Bridgespan, inside the exchange, 11.9 percent increase.
▪ Community Health Plan, inside the exchange, 10.6 percent increase.
▪ Coordinated Care, inside the exchange, 7.43 percent increase.
▪ Group Health Cooperative, inside and outside the exchange, 12.6 percent increase.
▪ Group Health Options, outside the exchange, 24.7 percent increase.
▪ Health Alliance, outside the exchange, 24.6 percent increase.
▪ Kaiser, inside and outside the exchange, 11.34 percent increase.
▪ Lifewise, inside the exchange, 9.30 percent increase.
▪ Molina, inside the exchange, 7.35 percent increase.
▪ Premera, inside the exchange, 18.90 percent increase.
▪ Regence OR, outside the exchange, 15.16 percent increase.
▪ Regence, inside and outside the exchange, 13.35 percent increase.