The Centers for Medicare & Medicaid Services, or CMS, said 106,475 Connecticut individuals and families enrolled in a health insurance plan through Access Health CT this year. That’s up from 92,697 in 2017. Those figures were based on enrollees who had paid at least one month of premiums.
The average ACA health premium in Connecticut rose from $545.41 in 2017 to $689.26 this year, CMS said.
But for 75 percent of Access Health CT enrollees, the federal government paid most of that premium, an average of $611.56. In 2017, the average subsidy was $438.99.
CMS said the number of enrollees in Connecticut who received subsidies dipped slightly. It was 76 percent in 2017.
The percentage of people who receive help purchasing insurance in Connecticut was higher than in some states – in New York only 57 percent of enrollees qualify for that help – and lower than others. In Florida, for instance, it is 94 percent and in Alabama 92 percent.
Individuals and families earning 100 to 400 percent of the federal poverty level – now $25,100 a year for a family of four – are eligible for ACA subsidies.
Access Health CT said “it is not clear” where CMS got the date for its report, called the “Early 2018 Effectuated Enrollment Snapshot” and said the date was not submitted by Access Health CT. It said its count shows that about 73 percent of those enrolled in a plan in the ACA marketplace received federal subsidies to buy insurance in both 2017 and 2018.
“However, that said, all data including that from CMS is very important and helpful as we prepare our strategy for the upcoming 2019 open enrollment,” Access Health CT said.
Those who don’t receive help buying their premiums are likely to experience a sharp rise in premiums again this year. And the federal government will spend more and more subsidizing health coverage as premiums rise.
“Rising premiums have left unsubsidized people with poor health coverage options and dramatically increased the federal cost of premium subsidies,” CMS said.
Insurance companies selling policies on Access Health CT – as well as those selling individual policies outside the ACA marketplace – have a deadline of July 16 to submit new rate proposals to the Connecticut Insurance Department for approval.
CMS administrator Seema Verna said, “As the Trump Administration took office, there were warning signs that we were dealing with a crisis in the individual health insurance market and Obamacare was failing its consumers.”
“These reports show that the high price plans on the individual market are unaffordable and forcing unsubsidized middle class consumers to drop coverage,” Verma said.
Larry Levitt, senior vice president at the Kaiser Family Foundation, disputes that. He tweeted Monday in response to the CMS report that, “the individual health insurance market under the ACA is financially sustainable as subsidies rise to match premium increases.”
“However, the lack of affordable insurance for middle-class people ineligible for subsidies does not seem politically sustainable,” Levitt said.
While Republicans are blaming the increase in premiums on deficiencies in the Affordable Care Act, Democrats say GOP efforts to “sabotage” Obamacare are to blame.
The GOP has taken several steps that will result in taking younger, healthier people out of insurance risk pools, raising the cost of health insurance for everyone else, analysts say.
One step was to abolish the ACA’s “individual mandate,” which punished those who did not have health insurance with an Internal Revenue Service penalty. The abolition of the mandate was included in the huge federal tax overhaul Congress approved last year.
Another proposal by the Trump administration allows insurers to sell short-term policies, whose terms are less than 364 days.
Those policies appeal to younger, healthier people who need less coverage, which is what most of these policies offer.
“There are storm clouds ahead with repeal of the individual mandate penalty and expansion of short-term plans,” Levitt warnedin another tweet Monday.
President Donald Trump also used his authority to end federal “cost-sharing” payments to insurers that helped them offer lower co-payments and deductibles to low-income people.
The end of those subsidies led to sharp price hikes in 2018 policies because insurers must continue to offer them, under law, even though the federal government no longer reimburses the companies for the money they lose offering lower co-pays and deductibles to low-income people.
According to CMS, 67 percent of the enrollees in Access Health CT receive lower co-payments and deductibles through the ACA’s cost-sharing program.
This story was updated on July 3, 2018, with a response from Access Health CT.