Humana, Anthem and other insurers want you to pay more for health insurance — a lot more.
For months, health insurers have lamented that the costs to care for patients they have gained through the Affordable Care Act have exceeded the premiums those customers have paid — and now they’ve asked to be allowed to raise prices — up to 65 percent.
Health insurers have requested “significant rate increases” for 2017 health plans, the state’s Public Protection Cabinet said — though it emphasized that state officials would scrutinize the proposals to determine whether the hikes are warranted.
State filings show that the insurers have requested that they be allowed to increase their base rates for individual customers between about 8 percent and 65 percent. Rates for small group customers could rise between 7 and 13 percent. The base rate and other factors — age, sex, geographic area — help determine health insurance premiums.
Golden Rule Insurance Co. has requested an increase of 65 percent for individuals. Louisville-based Humana wants to bump its base rate for individuals by nearly 34 percent.
While the state said some of the increases “appear to be” attributable to a bankrupt insurance company created under the ACA, also known as Obamacare, it also pointed to national dynamics that are pushing health insurance premiums higher.
According to a report by the American Academy of Actuaries, major drivers of health care costs this year include the rising prices of prescription drugs and the addition of sicker — and more costly — patients into the insurance pool.
While health insurers have gained millions of customers because of the ACA, the companies have said they have had a tough time figuring out how to recover the costs to pay for those customers’ medical expenses. The struggles have prompted the insurers to closely evaluate in which health exchanges they are participating — if they are participating at all.
Humana said last month — as its first-quarter margins narrowed, cutting earnings nearly in half from a year ago — that it was weighing whether to exit some ACA exchanges for next year. The company, which employs 12,000 in Louisville, said it has set aside $189 million to cover expected losses related to Obamacare customers.
The AAA said that part of the problem stems from patients’ contrasting motivations to sign up for health insurance: Sicker, previously uninsured patients have signed up for health coverage on the exchanges more quickly than healthier patients, simply because the sicker patients have a greater need for health care. That also has meant, however, that insurers have been missing out on at least some of the premiums from healthier patients that normally would have subsidized the health care expenses of some of their sicker brethren.
The AAA said that higher enrollment in the exchanges eventually should push prices lower, but it’s unclear at this point whether recent enrollment increases have significantly changed the risk profile of the customer pool that insurers have gained through the ACA.