Health Insurance Premiums Rising as High as 265% in Virginia This Year

Mackenzie Kappa, left, a first-year physicians assistant graduate student, takes a blood pressure reading from patient Gary Dean at the Harrisonburg-Rockingham Free Clinic in downtown Harrisonburg, Va., on Feb. 15, 2017. (Nikki Fox/Daily News-Record via AP)

WASHINGTON – Health insurance premiums in Virginia’s individual marketplace are set to rise as high as 265 percent in this new year.

According to the Virginia State Corporation Commission’s Affordable Care Act filing data, the maximum allowable premium hike for Optima Health Plan customers is 265.5 percent, which represents the largest increases in the Virginia individual market next year. Some Cigna Health and Life Insurance Company health plans on the individual market are set to rise 168.6 percent in 2018.


The maximum allowable increases for Group Hospitalization and Medical Services, Inc. customers will be 213.2 percent in 2018, and some CareFirst BlueChoice, Inc. customers will be paying 162.5 percent more than they did in 2017.

Thee Virginia State Corporation Commission explained that the sharp increases are legal in the state because they follow “federal uniform modification guidelines.” Insurance companies such as CareFirst provided reasons for the rate changes such as the “age factor.”

“It is possible that a CareFirst member may receive a 162.5 percent rate increase. The maximum percentage change of 162.5 percent is based upon the company’s reported data in their rate filing,” the spokesperson said.

Individuals enrolled in some Piedmont Community HealthCare HMO plans will have to pay 161.7 percent more in 2018. The maximum increase affecting Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. customers is 107.8 percent in 2018. The smallest increase will be for HealthKeepers, Inc. customers at 64.1 percent.

Democratic leaders in Congress such as Senate Majority Leader Chuck Schumer (D-N.Y.) have attributed the sharp 2018 premium increases to President Trump’s decision to rescind the Obamacare cost-sharing reductions.


Last month, PJM asked Schumer if the 2018 premium hikes set for next year are evidence that the Affordable Care Act is not working as intended.

“It’s because of sabotage from the Trump administration. They’re trying to reduce enrollment time. They’re not advertising about it. They’re doing everything to undue it and the increased premiums will be on President Trump’s back,” Schumer said on Capitol Hill.

Senators reached a bipartisan agreement in November to reinstate the cost-sharing reductions but legislation addressing the issue has not yet reached Trump’s desk.

Republicans like Sen. Bill Cassidy (R-La.) argue that the law should be replaced because steep increases have taken place each year with Obamacare fully implemented. The national average for premium increases in the individual market for 2018 is reportedly 37 percent.

“I’m hoping everybody that thought the status quo was wonderful looks at these 37 percent premium increases and says ‘we should do something different’ – and instead of bashing alternatives, which give patients the power and states the power, they say, ‘hmm, we’d better give somebody the power because right now whoever has the power is raising rates 37 percent,’” Cassidy told PJM in November. “So, I am sure hoping the working family unable to afford their insurance gets more sympathy than the actors in the status quo.”


According to the Centers for Medicare & Medicaid Services (CMS), 8.8 million Americans enrolled in health insurance plans on the online marketplace as of Dec. 15, when the enrollment period in most states ended. Last year, 9.2 million enrolled during a longer sign-up period. Enrollment figures are expected to increase since states such as Florida and Texas extended deadlines to Dec. 31 because of hurricanes Harvey and Irma.

The offices of Sens. Mark Warner (D-Va.) and Tim Kaine (D-Va.) could not be reached for comment on the 2018 premium increases in Virginia.



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