It might seem counterintuitive to praise Health Insurance Commissioner Marie L. Ganim for keeping the average cost increases in 2018 for the benchmark silver plans on the state’s health insurance marketplace, HealthSource RI, to 18-20 percent. And yet that is exactly what should be done.
The significant increase in plan premiums is the result of the decision by President Donald Trump to end the cost-sharing reduction payments created by the Affordable Care Act that go to health insurers. The CSRs allow insurers to keep premiums and other health plan costs at a more affordable level.
Ms. Ganim asked the state’s insurers to raise premiums for the silver plans to reflect the full costs without the CSRs, knowing that another piece of the Affordable Care Act would require the federal government to offer tax credits to many insurance purchasers who earn below a certain threshold to make up the difference. Not all people facing the increase will qualify, but the financial pain will not be as widespread.
Those tax credits, by the way, are expected to cost the federal government $194 billion over the next decade, far more than the CSRs would cost over the same time period.
The CSRs were one tool to try and make health care affordable; they were not a payoff to health insurers to get them to buy into the ACA’s approach.
Health care and health care payment reform require hard work and difficult choices, not campaign slogans that miss the point. Until that time, Rhode Island is fortunate to have the health insurance commissioner on the job.