Commissioner Navarro releases Highmark Blue Cross Blue Shield ACA rate

Rate increase of 25 percent for Obamacare approved
October 6, 2017

Delaware's Affordable Care Act Marketplace rate for 2018 was announced Oct. 5 by Delaware Insurance Commissioner Trinidad Navarro.

Highmark Blue Cross Blue Shield of Delaware on June 14 requested a 33.6 percent rate increase for ACA (Obamacare) individual marketplace policies.

A rate increase of 25 percent was ultimately approved following months of review, examinations, public feedback and meetings between Navarro and Highmark executives. This rate filing has no impact on Medicare, Medicaid or coverage by private and government employers. Aetna had been participating in Delaware's ACA market since the ACA's inception, but withdrew May 10 without submitting a rate filing proposal for 2018. That left Highmark as the only insurer providing coverage under the ACA in Delaware in the coming year. Last year, there were approximately 27,000 Delawareans insured under the ACA, or about 3 percent of the state's population.

Navarro said, "These 27,000 people are among those who can least afford a rate increase. There were almost 200 public comments that my staff and I carefully reviewed and took into consideration. I anguished over this rate filing, particularly after reading the comments we received. I thought about how this affects those with limited income, but I also had to consider the possibility of Delaware not having any marketplace option should Highmark withdraw from the ACA market. I would also like to express my appreciation to our federal delegation for their assistance with our efforts to reduce the initial rate filing request by Highmark."

After receiving Highmark's rate request, the department performed an internal examination of the filing. The department then contracted with one of the most experienced, highly credentialed, and qualified independent actuaries in the region to examine information and other factors that went into the formulation of Highmark's request. The findings of the independent actuary determined that Highmark's request was slightly higher than warranted. Also, Highmark's request was based partially upon the assumption that the federal government would not be making cost-sharing reduction payments next year, and also would not be enforcing the individual mandate component of the ACA. Those two components had a substantial impact on the filing rate, and are not subject to any regulation by the Delaware Department of Insurance. Although both the CSR payments and individual mandate are currently contemplated under federal law, the president has made statements indicating that he would not enforce those provisions. To date, the CSRs have been made, and it is Navarro's contention that rates should be based on the assumption that they will continue to be made. After he held several face-to-face meetings with Highmark executives, Highmark amended its rate filing to reflect the lower request, which has now been approved by CMS, the federal agency overseeing the ACA.

Navarro said, "It is unfortunate that all of the uncertainty in Washington regarding the ACA has such a devastating impact on Delawareans, as well as citizens of other states across the nation. Maryland just announced an increase of 47 percent for most ACA plans. There are some states seeing increases of 40 percent or more. I pledge to continue to work with our congressional delegation in fighting to provide Delawareans affordable and accessible health insurance."

For updated ACA rates for all states, go to after Wednesday, Nov. 1.