Vermont regulators pare back health insurance hikes

(The Center Square) — Vermont regulators have trimmed down rate increases proposed by two insurance companies that offer health care plans through the state’s marketplace.

In a pair of rulings released this week, the Green Mountain Care Board significantly cut back rates requested by Blue Cross Blue Shield and MVP Health for their individual and small group plans provided through the state’s health care exchange.

Under the rulings, Blue Cross Blue Shield individual plan premiums are authorized to rise by 14% and the small group plans by 13.3%, according to the board. Meanwhile, the board will; allow MVP Health plans to increase the cost of its health plans by 11.4% for individuals and 11.5% for small groups, the board said.

The changes will impact more than 68,000 Vermonters who get health coverage through the exchange, or about 11% of the state’s population.

Despite the move, Vermonters who purchase health plans through the state’s marketplace will still be paying some of the highest rates in years. The board still allows health plans for individuals and small groups to increase an average of at least 11.4% — possibly by as much as 14% — depending on which insurer and kind of health plan.

The board said the decision means the average premium for an individual plan with Blue Cross Blue Shield would go up by $105 a month next year and around $90 per month for MVP Health’s individual plans. The increases would range from $78 to $89 monthly for single-group plans.

“While we were able to reduce these rate requests, we know that Vermonters will still struggle to pay for their health care,” Board chairman Owen Foster said in a statement.

Last year, the board approved rate increases for both insurers for the current year, which averaged 11% to 13% higher for individual plans. Blue Cross Blue Shield’s small group plans decreased by 7% this year, while MVP’s small group rates increased by 1%, according to the board.

In its reports on the proposed rate increases, the board concluded that both companies have “failed to satisfy its burden of justifying the requested rates because insufficient evidence demonstrates the rates are affordable and promote access and quality.

“Negotiated rate increases that award more money to an entity simply because it is regulated by the Board — as opposed to whether an entity provides affordable services, has high quality, and is accessible — are highly unlikely to result in affordable rates that promote access and quality,” the board wrote.

Still, board members added that rejecting the proposed rate increases outright “could negatively impact solvency and/or access,” even though it may be warranted.

The board also urged the two insurance companies to consider “affordability, quality and access” when negotiating rates on behalf of their members.