Health insurers in Florida request premium hikes

Faced with questions and confusion about the cuts, Blue Cross told providers in a letter late last week that “unusually high claims trends” required a reset of rates to “appropriate” levels. The insurer said last week that it rolled back some of the rate decreases and that it will delay until January a cut that would reduce payment for the standard hourlong therapy session by about 18 percent.

“We have tried to listen and made essentially a good-faith effort to phase in these changes,” said Eric Hoag, vice president for provider relations at Blue Cross. “Looking back, we could have done a better job with the communications.”

Advocates, however, argue that the cuts are shortsighted. By underpaying for therapy, Blue Cross risks incurring higher costs later, said Thomas Belcher, chief financial officer for Greater Minnesota Family Services, an agency that provides in-home therapy for at-risk children in 34 counties.

“These kids are not going to go away if we can’t provide services,” said Belcher. “They are going to get placed in treatment facilities ... at a higher cost to society. How is this helpful long term?”

In addition to the rate reductions, some providers would be getting paid less because the insurer discovered that it had mistakenly overpaid them by nearly 24 percent for the past two years. As a result, the affected providers will be asked to repay a total of $4 million in overpayments made between last September and June. Blue Cross will work out repayment details with each provider separately.

Premiums for 2018 will range from an average increase of nearly 3 percent to a decrease of more than 13 percent, though consumers’ final prices will vary widely based on their plan selection, age and location when open enrollment begins Nov. 1. The largely stable rates came as little surprise — insurers released preliminary rates in July that more or less mirrored Monday’s release.

But as states brace for the premium hikes of 50 percent or more that Minnesota has weathered in recent years, Minnesota’s top insurance regulator pointed to lawmakers’ efforts to control health insurance costs as the main factor behind dropping costs.

“This is positive news for Minnesota,” Department of Commerce Commissioner Mike Rothman said. “The numbers show that the new state reinsurance program will help stabilize rates for 2018.”

Still, many residents won’t see a decrease even if the sticker price of their plan drops, because a one-time, 25 percent discount for shoppers who don’t get federal subsidies won’t carry over into 2018. Open enrollment for choosing plans begins Nov. 2.

Four percent of Minnesota residents buy health care on the individual market, either through the state health insurance exchange called MNsure or directly through insurers and brokers. But that market was fundamentally reshaped by the Affordable Care Act, and it has consumed state politics for years.

Just a year ago, Minnesota prepared for premium hikes as high as 67 percent and every insurer selling plans planned to flee the individual market, leading Rothman to call it an “emergency situation” and Democratic Gov. Mark Dayton to declare that President Barack Obama’s health care law was “no longer affordable for increasing numbers of people.”

Minnesota’s Legislature responded by creating a new, $549 million reinsurance fund to help insurers cover costly claims and bring down premiums. The federal government finally signed off on that program late last month.

Rothman said premiums would be 20 percent higher or more without that funding.