Insurers setting rates for health coverage options on the 2018 individual market have faced substantial uncertainty regarding whether or not the federal government would continue to make payments for cost-sharing reduction subsidies to insurers, as well as whether or not the administration would continue to enforce the Affordable Care Act’s individual mandate. Following the September 27th deadline for insurers planning to offer coverage on the ACA’s federal marketplace to finalize premiums and sign contracts, the federal government announced on October 12th that cost-sharing reduction (CSR) payments would end, effective immediately, unless Congress appropriated the funds. In some cases insurers also increased rates due to concerns that the individual mandate might not be enforced, although no formal change in enforcement has been announced.Insurers – often under the guidance or direction of state regulators – have taken one of four general approaches to the end of CSR payments:
- Not adjust rates at all in response to the termination of CSR payments. Only two states (North Dakota and Vermont) are known to have prevented insurers from adjusting rates.
- Increase premiums for all ACA-compliant individual market policies across-the-board, both inside and outside the marketplace.
- Increase premiums for silver-level plans inside and outside the marketplace. Silver plans are relevant because cost-sharing reductions for low-income marketplace enrollees are only available in those plans.
- Increase premiums only for silver-level plans inside the marketplace, under the logic that cost-sharing reductions are only available in marketplace silver plans.
Michigan Plans Increases:
| Blue Care Network of Michigan | Silver – Both on and off-exchange | 14.8% added to silver plans |
| Blue Cross Blue Shield of Michigan | Silver – Both on and off-exchange | 9.9% added to silver plans |
| McLaren Health Plan Community | Silver – Exchange only | 19% added to silver exchange plans |
| Meridian Health Plan of Michigan | Silver – Both on and off-exchange | 38% added to silver plans |
| Molina Healthcare of Michigan | Silver – Both on and off-exchange | 28.1% added to silver plans |
| Physicians Health Plan | Silver – Exchange only | 20% added to silver plans |
| Priority Health | Silver – Both on and off-exchange | 21.7% added to silver plans |