By Erin Mershon, CQ Roll Call
May 31, 2016 -- Republicans in Congress are beginning to escalate their attacks against proposed health insurance premium hikes, months before the election and long before full data on the proposals is available.
Energy and Commerce Committee Chairman Fred Upton, R-Mich., highlighted one 89 percent requested increase in a press release. Republicans on the Senate Finance Committee blasted similar increases late last week. And Sen John Barrasso, R-Wyo., the GOP policy chairman, brought up the issue in weekly press conferences for each of the last three weeks. Last week, he blasted an 80 percent proposed increase. Those proposed rates could be lowered before the premiums are finalized but provide fodder for GOP criticism.
The critiques are even louder off the Hill. Republican presidential frontrunner Donald Trump highlighted premiums that are "through the roof" in an interview with Fox News earlier this month. A National Republican Senatorial Committee (NRSC) Thursday highlighted 40 percent proposed rate hikes in Florida, where there's a contentious battle for the seat being vacated by Republican Sen. Marco Rubio.
It's "unequivocably" going to be a big issue on the trail, NRSC spokesman Greg Blair said.
"Costs continue to rise and insurers continue to leave state exchanges and cancel plans because Obamacare has regulated them out of the market," he said. "Any Democrat who loyally stands by this unmitigated disaster will be held accountable by voters."
The rate setting season, launched last month, provides Republicans with an easy opening to launch further attacks against the Affordable Care Act. Most people who bought insurance on the law's public exchanges are satisfied with that coverage, but affordability issues, like rising premiums and deductibles, remain a key concern, a Kaiser Family Foundation survey of enrollees found earlier this month.
Reasons for Rising Rates
The affordability issue is especially potent this year, and not just because it is an election year. Premiums are expected to rise by higher percentages than in the past, according to recent analyses from the health consulting firm Avalere and the data blogger Charles Gaba, who is a supporter of the law. Gaba looked at proposals in 15 states and is projecting a 15.6 percent average increase across the country. The separate Avalere analysis, which examined all the plans on the so-called "silver" level in nine states, found plans requested hikes averaging 16 percent. The increases were much lower, though, for the least expensive silver plans, which are more popular.
Last year at this time, Avalere was predicting increases around 5.8 percent. A few months later, Gaba was projecting an 11.9 percent increase nationwide, based on 25 states. Ultimately, the average increase last year was 11.6 percent.
The higher hikes come in part because insurers are still figuring out how to adjust to the new insurance markets. And they come in part because of the expiration of two programs that were intended to help mitigate some of the uncertainty insurers faced, the reinsurance and risk corridor programs. Those programs protected insurers from steep losses. An American Academy of Actuaries report pointed to those factors, as well as higher medical costs, as key drivers of the expected increases.
"For the individual and small group markets as a whole, the factors driving premium increases dominate," said Cori Uccello, a senior fellow at the American Academy of Actuaries, in a statement.
Democrats argue that Republicans don't have a viable alternative to the law they have spent the last six years opposing—and that they have put up roadblocks to Democratic efforts to protect Americans from premium increases.
"Simply put, Democrats remain the only ones fighting to make health care as accessible as possible, and that's the choice voters will have this November," Democratic Senatorial Campaign Committee spokesman Sam Lau said.
The Obama administration got in front of the issue in statements and reports beginning last month that emphasized that for most exchange customers, even double-digit premium increases won't hit as hard—because as premiums rise, so do the premium tax credits that the vast majority of enrollees receive. Those subsidies reduce the final costs for consumers.
Consumers facing higher premiums can also switch their plan during open enrollment, as many did last year.
Administration officials also note that the premium increases are still merely proposals, and that in some states, regulators have the power to reject hikes they feel are not actuarially sound. Insurers might also walk back hikes that spike public outcry. Final rates won't be available in some cases until the exchanges open for 2017 enrollment on Nov. 1, a week before the election.