North Carolina's largest health insurer is requesting a nearly 23 percent rate increase for its ObamaCare exchange plans for 2018, citing uncertainty over the future of the law.
BlueCross BlueShield of North Carolina requested an average rate increase of 22.9 percent for coverage purchased on and off the exchanges. The company said in a statement that while it felt the increase was too steep, it was necessary due to the assumption that federal cost sharing reduction (CSR) subsidies won't be made next year.
The company said it would have filed an average increase of just 8.8 percent for 2018 if it knew the federal funding would continue. The rate increase would have been even lower if Congress delayed or repealed an annual tax on health insurers.
The company also noted that there is no guarantee it will continue offering coverage on the exchanges, saying it will "continue to evaluate the market and make and announce a final decision this fall."
Insurers participating in ObamaCare rely on the subsidies so they can reduce customers' out-of-pocket costs, such as deductibles for low-income people. As a result of an ongoing federal lawsuit, the Trump administration has been making the payments rather than Congress.
However, President Trump has publicly waffled on whether he will continue the payments. At times, he’s threatened to withhold them, let the ObamaCare markets collapse and blame Democrats. Other times, he’s acknowledged the political risks and said the payments would continue. The administration earlier this week delayed a decision to fight the lawsuit and made no guarantees the payments would continue beyond May.
Blue Cross Blue Shield of North Carolina noted Thursday that the ObamaCare exchanges in state are otherwise stable, and "with the right actions coming out of Washington to stabilize the market, the rate increase from Blue Cross NC would have been between 5 percent and 6 percent."
Most other insurers who have submitted rate requests for 2018 have assumed the CSR payments would continue, but have warned that premiums could be 15 to 20 percent higher without them.