Insurance

TRENTON — New Jersey residents getting health insurance in the individual marketplace would have seen premiums rise much higher in 2019 if the state had not preserved some parts of the Affordable Care Act, state officials said.

The premium price for individual health coverage plans will go up at an average of 5.8 percent, according to the state Department of Banking and Insurance, which is much less than if the state did not enact its own individual mandate law, which requires residents to buy health insurance.

“Under the leadership of Gov. Phil Murphy, New Jersey is leading the nation in its efforts to create stability in the market and to combat the uncertainty created in Washington (D.C.),” Commissioner Marlene Caride said in a statement. “Carriers were clear that without state action, the average increase requested in the individual market would have more than doubled.”

Nearly 275,000 New Jersey residents selected health plans on the federal exchange during last year’s enrollment period, according to the U.S. Centers for Medicare and Medicaid.

The Trump administration repealed part of the Affordable Care Act that required all residents to have health insurance or pay a fine, which some experts say helped balance out the market between sick and healthy patients.

The elimination of a nationwide individual mandate is set to go into effect in 2019, but New Jersey legislators passed a law earlier this year to keep the policy in place for state residents.

Without an individual mandate, Banking and Insurance Department officials said premium prices would have increased, on average, by 12.6 percent.

Insurers in the small-employer market have requested a 5.2 percent average increase in plan rates.

Horizon BlueCross BlueShield of New Jersey and AmeriHealth New Jersey, which insure the majority of Affordable Care Act enrollees, requested rate increases for its Exclusive Provider Organization plans of 9.2 percent and 0.8 percent, respectively.

Proposed rate increases for their Health Maintenance Organization plans stand at 0.3 percent and 1.4 percent, respectively.

Those rate increases could have reached as high as 15.4 percent without an individual mandate, according to insurance companies.

Other insurers offering EPO and HMO plans in the individual market for 2019 include Oscar Health and Oxford Health Plans.

Additional steps the state has taken to decrease premium rates and costs for Obamacare enrollees include submitting an application to the federal government for a state innovation waiver to allow for a reinsurance program, which would help reduce premium increases.

The Banking and Insurance Department also seeks federal funding to get a 15 percent reduction in plan rates for 2019, without a reinsurance program.

Final plan rates in New Jersey will be finalized and released in the fall, state officials said.

ACA open enrollment begins Nov. 1.

Contact: 609-272-7022 NLeonard@pressofac.com Twitter @ACPressNLeonard

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