“In Texas, going through Blue Cross Blue Shield, they just announced a 60 percent increase. On November 1st, you’re going to have new numbers come out for Obamacare, having to do with increases. President Obama is trying to get it moved to December. Because it is election-defying. It is going to be a massive number, the biggest number ever in our country’s history for health care.”
— Trump, news conference, July 27, 2016
This is one of Trump’s go-to lines about premium increases under the Affordable Care Act, or Obamacare. He warns of premium increases of 40, 50, 60 percent — and alleges that the Obama administration is trying to delay open enrollment, scheduled for Nov. 1, until after the election because the drastic rate hikes will be “election-defying.” Are his claims accurate?
A health-care policy adviser for the Trump campaign pointed out examples of proposed and approved rate increases as high as 70 percent for 2017. Among the highest increases is in Texas, where Blue Cross Blue Shield plans to increase its premiums an average of 57.3 percent to 59.4 percent across individual market plans. The campaign also cited a plan in Iowa with a 43 percent increase, three plans in Pennsylvania with requested increases of 40 percent and a 19 percent increase in Florida.
Indeed, premiums are expected to increase overall in 2017 — but Trump is cherry-picking from the highest proposed increases in the insurance marketplace. He has made a version of this claim since June 2015, and our friends at FactCheck.org have been debunking it repeatedly since.
State-by-state weighted average increases range from just 1.3 percent in Rhode Island to as high as 71 percent in Oklahoma, according to calculations by Charles Gaba, who keeps careful track of enrollment figures at ACASignups.net. As of Sept. 22, the average increase across individual markets in 21 approved states is 25.5 percent.
But premiums for the two lowest-cost silver plans — the most common choices in the marketplaces — will increase by a weighted average of 9 percent, according to the Kaiser Family Foundation’s July analysis. These plans have been used as the benchmark to calculate government subsidies.
About eight in 10 marketplace enrollees receive government premium subsidies, and they are protected from a premium increase (and may even see a decrease) if they stay with a low-cost plan. The report says “anecdotal examples of premium hikes or averages across insurers can provide a skewed picture of the increases marketplace enrollees will actually face.”
Colorado, for example, announced its rates on Sept. 20, with a 20.4 percent increase for premiums for individual plans in the marketplace and 2.1 percent increases for the small group market. But recipients of government subsidies will see an average decrease of 11 percent.
Insurers have cited various reasons for increasing their rates in 2017, such as not having enough young and/or healthy people in marketplaces, or their risk pool being sicker than expected.
We asked the Trump campaign adviser to explain the nominee’s claim that the administration is trying to delay the Nov. 1 open enrollment until after the election. The response was that “some rates are still pending approval.”
But state insurance departments are approving those rates now, and rates will be public by the time open enrollment begins Nov. 1. This date is set, per federal regulations published in March. The Obama administration has not indicated that it would move the date. And if the administration wanted to change the date, some type of public notice and comment period would have begun months ago.
“There’s absolutely no reason to believe the open enrollment date will change at this point. It will have to have been announced,” said Drew Altman, president and chief executive of Kaiser Family Foundation.
The Department of Health and Human Services confirmed in a statement that open enrollment will begin Nov. 1: “Dates for the upcoming Open Enrollment are the same as this past year and have already been finalized through rule-making in CMS’ [Centers for Medicare and Medicaid Services] annual payment notice published this spring. They won’t be moved.”
It’s important to remember that most workers (about 155 million people) in the United States get their health care through their employer, so the exchanges, with about 11 million enrollees, are just a small part of the health-care market. (We wrote in-depth about this here.)
The types of large increases that Trump is talking about affects about 18 percent of the overall 11 million people in the marketplaces, mostly in rural areas where there is just one insurer, Altman said.
The Pinocchio Test
This is a classic Trump claim. He cherry-picks the most extreme examples, applies them to the general population, then ascribes nefarious motives that can’t actually come to fruition. He says rates will increase by 40, 50, 60 percent — but the most common plans in the marketplace will see an average increase of 9 percent. The vast majority of marketplace enrollees receive government premium subsidies and will be protected from premium increases.
Trump also says the Obama administration wants to, and is trying to, move the Nov. 1 open-enrollment date because everyone will see the “election-defying” premium hikes on that date. Yet this open-enrollment date is set in federal statutes, and if the administration wanted to move it, it would have needed to tell the public months ago through a public notice and comment process.
Word of advice for Trump: If you’re running for the presidency, it wouldn’t be a bad idea to learn how federal regulations work. And since you claim you want to repeal Obamacare, you might want to learn how it works, too.
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