HELENA — The three health insurance companies in Montana that offer individual plans through the Affordable Care Act are proposing wildly different rate increases next year, underlining the insurance market's uncertainty about the future of the federal law.
Blue Cross and Blue Shield of Montana, the state's largest insurer, is proposing an average 23.1 percent rate increase in 2018 for its nearly 32,000 enrollees in the individual market, Commissioner of Securities and Insurance Matthew Rosendale's office said Tuesday.
The Montana Health Co-op and PacificSource, the state's two other insurers on the federal health exchange, are taking a different approach. The co-op proposes to raise its rates just 4 percent for its 20,000 individual market enrollees, while PacificSource wants a 7.4 percent increase for its 12,000 individual policyholders.
Insurance companies must file their final plans for 2018 with the state in August, after which those rates will be locked in regardless of whether the Republican-led Congress successfully strikes a deal to repeal and replace former President Barack Obama's Affordable Care Act.
Senate Republicans plan to release revisions to their health care bill later this week after failing to muster enough support for their original proposal. Senate Majority Leader Mitch McConnell canceled the first two weeks of the Senate's August recess to work on the bill and other legislation.
Blue Cross is factoring in possible changes to the federal law into its 2018 proposal. Those changes include potential cuts in federal funding that lowers the cost of deductibles and payments, and lifting the Affordable Care Act's individual mandate, said Blue Cross spokesman John Doran.
Even if a bill doesn't pass, Blue Cross still wants federal health officials to clarify whether they will continue to fund cost-sharing reductions and enforce the individual mandate, he said.
"We built into our rates the risk of the marketplace," Doran said. "Where we receive regulatory clarity, we will review and adjust our rates accordingly."
The proposed hike comes on top of Blue Cross' 58 percent increase last year and a 20 percent increase the year before that for individual plans mainly sold through the federal exchange.
The Montana Health Co-Op and PacificSource are taking the opposite approach from Blue Cross, and their lower rate increases assume that the Affordable Care Act will remain intact next year.
"We're really diligent in the rate increases we ask for," said Todd Lovshin, PacificSource's Montana regional director. "We put forward a fair and just proposal based on current law."
That approach carries the risk of setting a rate that could be too low if a bill passes that cuts cost-share reductions and lifts the individual mandate without any offsetting funding.
If that were to happen, the Montana Health Co-op would have to drop out of the exchange, President and CEO Jerry Dworak said.
"We would just say we're done," he said.
The rate increases don't affect people with health coverage through their employers. Rosendale has set two public hearings on the rate proposals, one on July 24 in Billings and the other on July 26 in Helena.