One Affordable Care Act insurer in Kentucky wants a 12% rate hike next year; the other one has asked for a decrease of 4.5%

By Melissa Patrick
Kentucky Health News

One of the two insurers offering government-subsidized individual health plans in Kentucky for 2020 is asking for a 12 percent increase, while the other is asking for a 4.5% decrease.

Insurers offering plans for small groups under the Patient Protection and Affordable Care Act are asking for average hikes of 10.5%. These overall percentages reflect an average that will vary, depending on whether individuals smoke, how old they are and where they live.

Anthem Health Plans of Kentucky requested an average 12% increase for the 13 plans to be offered.

CareSource Kentuckyrequested an average rate decrease of 4.5% for its 12 individual plans.

The requests are preliminary and subject to change. The Kentucky Department of Insurancecan approve, lower or raise the rates. The department said in a press release that it expects to finalize the rates by August, which is also when it will finalize any expansion of the plans’ service areas.

This year, Anthem offered plans in 93 of the 120 counties, and CareSource offered plans in 61. In 34 counties, both insurers offered plans, but in 16 of those the Anthem plans have a narrow network of providers.

“From our initial review, it appears that the popular silver and bronze plans offered by both insurers receive either a much smaller average increase or comprise the majority of the decreases when compared to other plans,” Insurance Commissioner Nancy G. Atkins said in the release. “Over 90% of the participants select one of these plans, and we anticipate this trend to continue.”

Last year, Anthem asked for an average 3.5% increase and CareSource asked for a 19.4 % hike. The Insurance Department gave Anthem a higher increase than it asked for at 4.3% and CareSource got the 19.4% it requested.

Kentucky saw 84,620 residents enroll in subsidized coverage via Healthcare.gov during the open enrollment period for 2019. That was a 5.5% decrease from 2018, when 89,569 Kentuckians enrolled, but up 4.3% from 2017, when 81,155 enrolled. Kentucky has yet to reach the same number of enrollees as it did in 2015, when 106,330 enrolled. The state shifted enrollment to the federal exchange in 2016, away from the state-based exchange called Kynect. Open enrollment for 2020 begins Nov. 1.