Consumers buying health insurance in the individual market in the central San Joaquin Valley will see rate increases for monthly premiums in 2019 — but less than the statewide average.
In Tulare, Mariposa and Merced counties, consumers will see an average rate increase of 6.8 percent. In Fresno, Kings and Madera counties, the average increase will be 3.2 percent.
Insurance premiums will increase an average of 8.7 percent statewide, Covered California announced Thursday. California California is the state’s insurance exchange created for the Affordable Care Act.
Despite concerns about uncertainties of the future of the Affordable Care Act, the 2019 rate increases are less than what consumers experienced this year. Tulare, Mariposa and Merced counties had rates increase on average of 24 percent for 2018; and Fresno, Kings and Tulare counties increased 4.7 percent.. Statewide, the 2018 rates increased on average 12.5 percent.
Covered California negotiates with insurance plans, but regions have different rates based on enrollment and the health of those enrolled. In the case of the Valley, the increases in 2019 likely reflect that “the plans felt confident about their enrollment in the Central Valley and they have a healthy consumer pool in the Central Valley,” said James Scullary, a Covered California spokesman.
Peter V. Lee, executive director of Covered California, said steady enrollment in California has helped offset rate increases, but in other parts of the country people are being priced out of coverage. “Covered California’s strong enrollment, low premiums and healthy consumers are the result of promoting competition that focuses on lowering costs,” Lee said.
Consumers will have the same health plans to choose from in 2019. All 11 plans in the state renewed contracts with Covered California. In Fresno County, for example, consumers will continue to have the choice of plans from Blue Shield or Kaiser Permanente. People in Tulare will have choices in plans from Anthem Blue Cross, , Blue Shield, Health Net and Kaiser.
People who receive subsidies to offset the cost of premiums will continue to get that help in 2019, which will increase to cover the rate increases, Covered California said. About 88 percent of consumers statewide receive subsidies. In the Valley, about 93 percent qualify for the help.
Covered California said insurance carriers added between 2.5 percent and 6 percent to their rates as a result of the federal government’s elimination of the individual mandate penalty for people who choose not to buy health insurance in 2019. The overall effect was about 3.5 percent on premium rates, Covered California said. The concern is without the threat of a tax penalty, healthy people won’t buy insurance, leaving only the more ill in health plans.
The elimination of the penalty is expected to reduce enrollment in the individual insurance market, both through Covered California and plans bought off of the exchange. Covered California said enrollment statewide could be reduced by as many as 262,000 people, which is about 11 percent of the 2.4 million total enrollment.
Covered California has not looked at the potential loss of enrollment by region, Scullary said. The Valley had 101,491 people enrolled in Regions 10 and 11 as of April.
Removing the mandate also could increase premium costs for people who receive insurance through employers, Covered California said. An analysis showed uncompensated care rising by $1,000 for each newly uninsured person, increasing the cost of employer-sponsored coverage by between 2 and 4 percent.
Enrollment in health plans will begin in October, but people with special qualifying life events, such as loss of employer-sponsored insurance, can enroll year-round.
Consumers can go to the Covered California website to find out if they qualify for subsidies and to check out health plans. Assistance also is available from Covered California call centers at 800-300-1506.