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OKLAHOMA - Oklahomans on Obamacare may see their insurance rates skyrocket.

Blue Cross Blue Shield of Oklahoma, the only health insurer offering plans on the federal exchange in 2017, has submitted increases for individual market plans ranging from 58 to 96 percent.

This will affect about 130,000 Oklahomans who have individual plans through the Affordable Care Act’s marketplace.

Chris Riggs is the owner of Speed By Design, a small business in Tuttle.

“Health insurance right now for us has been honestly a scary thing,” Riggs said.

He was not happy to hear his insurance premium could go up an average of 76 percent next year.

“Literally, my decision for next year is do I hire or do I pay my health care. And, that’s a very scary situation to be in,” Riggs said.

His premium right now is about $650 a month.

If it increases by 76 percent, it would be over $1,100 a month.

“It’s more than most people’s mortgages, you know, it’s more than an apartment,” Riggs said.

“Many folks believe that this is kind of a financial death spiral to the Affordable Care Act. But, it’s getting very, very expensive,” said Oklahoma Insurance Commissioner John Doak.

Doak said part of the problem is there is only one option left for Oklahomans with individual Obamacare plans – Blue Cross Blue Shield of Oklahoma.

“We have one market left in the state of Oklahoma, which puts us in a difficult position,” Doak said.

Consumers can shop around, but it’s important to point out ACA-compliant off-exchange individual plans sold by Blue Cross Blue Shield of Oklahoma will see the same increases as plans sold on the exchange.

According to the U.S. Department of Health and Human Services, as exchange rates increase, so do the subsidies available to offset the cost of individual premiums.

Riggs, however, said he does not qualify for those subsidies.

Blue Cross Blue Shield of Oklahoma sent us this statement:

Blue Cross and Blue Shield of Oklahoma (BCBSOK) has been serving the state for 76 years and is committed to providing quality health insurance options to Oklahomans in a sustainable way. Since the implementation of the Affordable Care Act (ACA), we have been successful in helping more Oklahomans get individual health coverage -- many of whom have never been insured and had pent up health care needs. Rates are based on several factors, including anticipated medical care costs, pharmaceutical cost and utilization, among other variables. Our increase is an average, and rates may be well below or above this rate. The rate increases only apply to 20 percent of our members who purchase individual coverage – not members who have group coverage through their employers. About 86% of BCBSOK members who purchase an individual plan on the Health Insurance Marketplace receive a premium subsidy, and for many of them, the subsidies will cover the bulk of the premium increase. As rates increase, so do the subsidies available to offset the cost of individual premiums. Although more Oklahomans are receiving health coverage than ever before, BCBSOK has experienced significant losses in the individual market. Since the 2014 implementation of the ACA, BCBSOK's combined losses are more than $300 million. While other insurers have exited the Health Insurance Marketplace in Oklahoma, we continue to offer coverage in all 77 counties, which shows our commitment to the health and wellness of all Oklahomans. In order to provide sustainable health insurance coverage for all Oklahomans, we must raise rates to meet the demand of increasing costs.

Doak sent out this press release about the rates:

Health insurance premiums will likely increase by an average of 76 percent for Oklahomans who buy individual coverage through the Affordable Care Act's marketplace. The increases for individual market plans range from 58 percent to 96 percent.

“These jaw-dropping increases make it clear that Oklahoma’s exchange is on life support,” said Oklahoma Insurance Commissioner John D. Doak. “Health insurers are losing massive amounts of money. If they don’t raise rates they’ll go out of business. This system has been doomed from the beginning.”

Blue Cross Blue Shield of Oklahoma, the only health insurer offering plans on the federal exchange in 2017, submitted the increases to the Centers for Medicare & Medicaid Services (CMS). CMS will determine if the increases are reasonable. The increase requests follow many insurers reporting significant losses, lower than expected enrollment by the younger population and new customers being sicker than expected. ACA-compliant off-exchange individual plans sold by Blue Cross Blue Shield of Oklahoma will see the same increases as plans sold on the exchange.

The Oklahoma Insurance Department does not have statutory authority to approve or deny rate premium increases for plans on the federal health insurance exchange. Oklahoma, along with Texas, Missouri, Alabama and Wyoming, is a direct enforcement state and has no authority to enforce provisions of the Affordable Care Act.

At the end of 2016, UnitedHealthcare will exit the individual market in Oklahoma. It had five percent of the state’s 130,178 federal exchange enrollees for 2016. Blue Cross Blue Shield of Oklahoma had the other 95 percent. UnitedHealthcare enrollees will receive notices from CMS that they have been automatically enrolled into a similar exchange plan.

The increases apply to people buying individual plans, about six percent of the Oklahoma population. Most Oklahomans purchase insurance from an employer plan, a large group plan or through a government program such as Medicare or SoonerCare.

According to the U.S. Department of Health and Human Services, as exchange rates increase, so do the subsidies available to offset the cost of individual premiums.

The U.S. Department of Health & Human Services released this statement:

“Consumers in Oklahoma will continue to have affordable Health Insurance Marketplace options next year. Headline rate changes do not reflect what these consumers actually pay because tax credits reduce the cost of coverage below the sticker price and shopping helps consumers find the best deal. Meanwhile, for the 51 percent of people in Oklahoma with employer coverage, premiums have grown at some of the slowest rates on record since the Affordable Care Act was enacted. All Oklahoma consumers, no matter where they get their coverage, are benefiting from ACA protections like no more exclusions for preexisting conditions, no annual limits on coverage, and no cost sharing for preventive services.”

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