While BCBSRI’s requested increase is significant at 10.7 percent, Tufts Health Plan HMO beats it at 10.9 percent with NHPRI following at 8.7 percent. U.S. Rep. David Cicilline (D), 1st Congressional District, expressed the concerns of many, stating that if approved, the increases will have a direct impact on the cost of health insurance, making it “more difficult for residents to afford health care.”
Rhode Island’s double digit increase requests are painful for the state’s health insurance consumers, but they fall far short of the increases requested by some insurers in Maryland and Virginia. CareFirst, a major insurance provider in the Mid-Atlantic States with over 3 million member customers, has requested a 91 percent rate increase for one of its Maryland plans and 64 percent for another in Virginia. At the heart of the rate increase requests is the uncertainty of the future of the Affordable Care Act along with increased health care and prescription medication costs.
As the Health Insurance Commissioner’s Office takes the rate requests under review, BCBSRI’s spokesperson, Jill Flaxington pointed out that rate increases are driven by a number of factors, including the very high health care costs of the seriously ill members of the BCBSRI plans. She further indicated that loosening reinsurance restrictions on health insurance providers could reduce the increases in consumer rates by as much as 10 percent.
At NHPRI, Director of Operations, Elizabeth McClaine pointed out that the rate requests submitted by Neighborhood for 2019 were among the lowest in the country. McClaine explained that Neighborhood’s relatively lower rate requests were due to the company’s efforts to control prescription costs along with member wellness programs.
State Representative Aaron Regunberg (D) from Providence has called for a single-payer health care system in response to the potential rate increases, calling it a Rhode Island Medicare-for-All system. Regunberg called for the state to “put those resources where they belong.” He suggested that consumers already pay enough for health care and that he felt money was being spent on items not directly related to their health care, such as administrative costs and advertising.
BCBSRI’s Jill Flaxington pointed out that the insurer paid in excess of $805 million in claims during 2017. Almost half of that amount went to hospital care, emergency room treatment and in-patient and out-patient surgeries. The balance went for prescription medications, medical lab work, x-rays and specialist care and therapy.
While the health commissioner is expected to rule on the requested increases this summer, other long-term solutions such as reinsurance have become the focus of insurers and regulators. Reinforcing BCBSRI’s call for stabilization of health care costs by modifying reinsurance prohibitions, Maryland legislators are seeking a modification of the Affordable Care Act rules that could lower premiums by 30 percent. The modification would allow health plan providers to reinsure their risk, reducing their claim exposure and potentially reducing insurance rates for consumers.
