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Obamacare rate could see big spike in NH next year

New Hampshire Union Leader

May 20. 2017 9:59PM

Greg Moore, NH director of Americans for Prosperity, said the premium increase is not surprising. 

Some Obamacare exchange premiums could increase an average of 44 percent next year in New Hampshire due in large part to Medicaid expansion and the opioid and mental health crises, according to a document obtained by the New Hampshire Union Leader.

The document - stamped "Confidential" and marked "Draft Only" and "not for distribution" - hints that New Hampshire soon could be hit with health-care premium increases it has not experienced since Obamacare coverage started in January 2014. Provided by a government official, the document appears to be written by an insurance carrier to explain the expected double-digit increase.

State officials confirmed the document's veracity.

State Insurance Department officials have said the market here is relatively healthy, given the high number of insurers in New Hampshire and relatively low premium increases.

For example, monthly premiums for a 27 year old increased only $5 this year, according to statistics reported by the U.S. Department of Health and Human Services. But the department also has cautioned about inflationary factors in both medical care and pharmaceuticals, and has warned about possible losses of Obamacare subsidies from the federal government.

The document is based on claims data. The bottom line: rates could increase by an average of 44 percent, nearly a third of that to correct for low premiums this year and another third in anticipation of upward trends in medical care and pharmaceuticals, the document states.

In the last few weeks, early indications of similar increases have been made public in several other states.

In a statement, Gov. Chris Sununu said he's had preliminary discussions with state officials and he expects that premium increases on the Obamacare exchange will be substantial.

"Unfortunately, it is possible that some of the most serious consequences of Obamacare will likely to be felt in New Hampshire next year," he said. "Rates have been spiking across the nation because of Obamacare and New Hampshire is not immune to those realities."

The document focuses on the Premium Assistance Program, the portion of Medicaid expansion that sends enrollees to the Obamacare exchange and uses Medicaid dollars to cover their costs. The PAP started in late 2014.

During a 14-month period ending in February, claims increased 38 percent when Medicaid expansion is taken into account, the document said.

If Medicaid expansion clients are taken out of the mix, claims would rise 17 percent.

The document goes on to detail the costly nature of the Medicaid expansion clients: monthly claims are 80 percent higher than those not on Medicaid expansion.

Mental health and substance abuse claims are eight to 10 times higher than those for other people on the exchange. Half of the emergency room visits for those patients were deemed unnecessary.

The two biggest needs for prescription drugs were for hepatitis and opioid addiction, according to the report.

Greg Moore, state director of Americans for Prosperity, said the premium increase is not surprising.

"I don't know how you can look at this document and say Medicaid expansion did not have an impact on the cost of insurance in New Hampshire," Moore said.

The New Hampshire Insurance Department would not discuss the document nor confirm if it has ever seen it.

"The document appears to be confidential, and as such, it would be inappropriate for the New Hampshire Insurance Department to comment on it," spokesman Danielle Barrick wrote in an email.

By this time of year, insurance carriers usually file proposed rates with the Insurance Department, which starts reviewing them and eventually makes them public.

The Insurance Department has moved the deadline back to June 2 while it awaits guidelines to be published by the U.S. Centers for Medicare and Medicaid Services, Barrick said.

Because of that, comprehensive information about average rate increases and other details were not immediately available.

Last week, the department announced that the four insurers currently offering plans have filed to remain in the New Hampshire marketplace next year.

The state's largest insurer, Anthem Blue Cross, wouldn't say whether it is experiencing hefty increases in claims data.

"We have yet to finalize or file our rates for 2018," spokesman Colin Manning said in an email.

He and Barrick noted the state has created a commission to consider the future of Medicaid expansion.

"We expect they will examine the issue closely," Manning said.

Last week, Democrats tried to tie Gov. Sununu to the American Health Care Act, the Obamacare replacement that has passed the U.S. House but faces an uncertain future in the Senate.

"He wants to support efforts to dramatically undermine health insurance and make it more expensive for people without suffering the political consequences of doing so," said New Hampshire Democratic Party Chairman Raymond Buckley.

In his statement, Sununu said reforming Obamacare is essential.

"Failure to reform the system will result in Granite Staters on the health care exchange getting hammered with higher costs," he said.

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