Beth Miller

The News Journal

The cost of most Obamacare health insurance plans in Delaware would rise by about 5 percent next year if proposed rates are approved by the state Department of Insurance.

The new rate requests are the insurers' first filings since the tumultuous start of the health insurance reforms mandated by the 2010 Affordable Care Act – also known as Obamacare – which requires all to have health insurance or face tax penalties.

The new rate requests, released publicly online this week, are the insurers' first filings since the tumultuous start last fall of the health insurance reforms mandated by the 2010 Affordable Care Act – also known as Obamacare – which requires all to have health insurance or face tax penalties.

The documents include rates from Aetna, which acquired Coventry and its policies last year, and Highmark Blue Cross Blue Shield.

Independent broker Nick Moriello of Health Insurance Associates said he was hoping more insurers would join the pool, but "the first-year debacle, combined with us being a small state – I'm not shocked that there aren't more."

Highmark wrote the majority of Delaware's 2014 plans – more than 13,000 of the state's 14,397 Obamacare policies – and requested an average 5 percent rate hike to cover the state's "prevalence of chronic illness, an aging population and the increased cost of new medicines, procedures and technologies."

Highmark said it expects to face an 8 percent price increase from 2013 to 2015, including 5 percent for health care costs and 2.9 percent for "increased utilization." The insurer also projects about $45 more in monthly claims per member.

Aetna was the only other insurer to file rate requests. It filed requests for two plans, both under the Aetna banner instead of Coventry for 2015. It requested an average $406.35 per month for preferred-provider options, claiming an average reduction of about 2.5 percent for the 2,000 policyholders that now hold similar plans. It also proposed an HMO option for 2015, with an average monthly rate of $394.23. Aetna spokesman Walt Cherniak wouldn't say whether its comparisons were on the old Coventry plans or how many policies the company has overall. He would not provide demographics on Aetna's customer pool.

Demographics are important indicators, because they can predict the level of health care an insurer may have to cover. Highmark now is covering thousands who might not have had health insurance for years.

Even with a 5 percent increase, Highmark's customers probably will pay less than Aetna's, Moriello said, because so many qualified for tax subsidies. Those subsidies have been challenged in court, though, which puts another wrinkle in the calculations. Still, compared with rate increases in the past – typically 15 percent a year – a 5 percent hike is "better than expected," he said.

"For those who don't get government assistance, 5 percent is better than the 100 percent increase of a year ago or the 15 percent historical average," he said.

Delaware premiums are higher than the national average, but include mandated coverages specific to the state. And the difference decreases as subsidies are factored in.

Rita Landgraf, secretary of the state Department of Health and Social Services, said reform of Delaware's health care system is underway and should help to reduce overall costs in the future.

Department of Insurance staff will accept public comment on the rate filings by email – at rate@state.de.us – through July 28. The state will review the rates and Commissioner Karen Weldin Stewart will determine the numbers to forward to the feds, which will review them. Final rates will be set this fall. The next enrollment period begins Nov. 15.

Contact Beth Miller at 324-2784 or bmiller@delawareonline.com. Follow on Twitter @BMiller57.