Without congressional action, companies offering health insurance on the Affordable Care Act exchange in North Dakota will absorb the loss of cost-sharing reductions rather than passing the cost to consumers.
North Dakota Insurance Commissioner Jon Godfread announced he will hold insurance companies to previously filed rates for the ACA, also known as Obamacare, exchange.
“This is an issue that is between insurance carriers and the federal government,” said Godfread, adding that, last summer, he asked insurance companies to develop two sets of numbers — rates that assumed CSR renewal and rates that did not.
Following President Donald Trump’s announcement last week that his administration would no longer pay cost-sharing reductions, Godfread said he reopened the rate filings for companies. Those filings included an 8 to 10 percent increase request across the board.
Godfread said "due diligence" is what prompted him to reopen the filings despite ultimately deciding to deny increases for this year.
Godfread said he acted in order to protect the 22,000 North Dakotans who don’t buy coverage on the health care exchange from an increase, along with the 5,000 to 10,000 who buy on the exchange but do not receive premium subsidies.
Those eligible to receive premium subsidies were not affected by Trump's announcement and will continue to receive aid.
The president’s announcement shifts the decision to Congress, which could choose to fund the cost-sharing reductions. Lawmakers in both parties had urged the administration to continue the payments. Despite Republicans' opposition to the payments, many realize ending them suddenly throws the market into chaos.
Congress likely will come forward, making the issue moot, according to Godfread, who opted to leave the uncertainty with the insurance companies rather than consumers.
Trump had been maintaining CSR payments on a month-to-month basis. Democrats are likely to attempt funding them through a spending bill aiming to keep the government operating after Dec. 8.
Trump's move complicates the finalizing of the spending bill, which Republican senators were aiming to use as a platform for tax reform.
Depending upon the plan, health insurance rates will still increase by an average range of 2.3 percent to 11.8 percent for about 30,000 North Dakotans enrolled in a small group plan, according to rates previously approved by Godfread's office. Rates for about 42,000 North Dakotans enrolled in individual plans will increase by an average range of 7.9 percent to 22.6 percent. About 84 percent of North Dakotans are covered by health insurance plans offered through employers.