by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
In a media briefing this morning, Brian Tajlili, director of actuarial pricing services with BCBS NC, announced that the state’s largest health insurer is asking the Department of Insurance (DOI) for an average 18.8% rate increase for its 2017 Obamacare plans sold in the individual market.
The projected rise in premiums is far less than last year’s approved average rate increases of 32%. Nevertheless, the request is in the double-digit range. Tajlili mentioned that premiums were more steep for 2016 plans to make up for higher-than-anticipated medical claims incurred by Obamacare policyholders in the year prior. With more data on health care service usage from this line of business, the insurer now has a better grasp on how to price the pool. Today’s press release notes the following:
“In 2015, we saw rising prices for many drugs, both generic and name brand drugs, that a large number of ACA customers use,” said Brian Tajlili, director of actuarial and pricing services for BCBSNC. “In fact, seven drugs cost our company over $139 million to cover ACA customers last year .” Blue Cross’ ACA customers:
- Use the emergency room more frequently
- Consistently take expensive drugs
- Receive a higher volume of orthopedic procedures.
“Since the ACA’s first enrollment period, we’ve continued to see a large number of older and less healthy customers enroll in our individual ACA plans as compared to our other customer groups,” Tajlili added. BCBSNC plans to sell ACA health insurance plans on and off the Exchange1 in all 100 North Carolina counties, but the company will make its final decision on ACA participation later this year.