Affordable Care Act Open Enrollment for 2020 begins Friday, and North Carolina residents are expected to see rate reductions, on the whole.
Blue Cross Blue Shield North Carolina, one of two marketplace insurers in the state, has lowered premiums for individuals for the second year in a row, said company spokesman Austin Vevurka.
“This is the first time we’ve had an individual market decrease for all 100 counties in Blue Cross’s history,” Vevurka said. “Statewide, our average rate decrease pre-subsidy is minus-5.5% this year. In the Charlotte region, it’s actually even greater. It’s minus-14.2% average reduction, pre-subsidy.”
Those expected lower rates follow an average reduction of 4.1% last year for BCBSNC. The continued decline in average premiums is because of two major factors, Vevurka said: a better understanding of those that they insure, and a change in reimbursement policies (a move to value-based provider reimbursement).
“Rates are forward looking,” Vevurka said. “When we file them, we base them on our best predictions that our customers will incur.”
In the sixth year of ACA, BCBSNC has learned more about the 435,000 people who they insure in the state, and has more insight from which to draw when calculating rates.
Vevurka cautioned that not all customers will see rate reductions, though, after subsidies are applied. Because the subsidy is calculated based on the cost of the second-lowest priced Silver Plan in the market, many could see a subsidy reduction. Customers can receive a subsidy estimate at bluecrossnc.com/subsidy.
Insurance will still be offered through the ACA through 2020 even as a decision on the latest court case could come soon. A panel of judges in the 5th Circuit Court of Appeals heard oral arguments in July in Texas v. Azar; the Trump administration decided in June not to defend the ACA.
"That ruling would not change anything for people's 2020 ACA plans," Vevurka said. "It's likely going to take a long time for this issue to wind its way through the courts.