Health Care Act

Affordable Care Act premiums in SC could rise by 31 percent. Will NC follow suit?

A file photo from Blue Cross Blue Shield's South Carolina Blue retail center at Columbiana Centre mall.
A file photo from Blue Cross Blue Shield's South Carolina Blue retail center at Columbiana Centre mall. File photo

South Carolina approved an average 31.3 percent increase for insurance premiums for about 200,000 residents insured through the Affordable Care Act’s individual marketplace the state Insurance Department announced Thursday.

BlueCross and BlueShield of South Carolina, which offers the only individual Affordable Care Act plan on the exchange in South Carolina, had requested a 33.4 percent hike, saying premiums last year did not cover claims paid, administrative costs, commissions, taxes and fees.

In North Carolina, Blue Cross and Blue Shield has requested to increase premiums by 14.1 percent, a decrease from its initial request of 22.9 percent. That rate has not yet been approved by the N.C. Department of Insurance, which will announce the increase next month.

More than 500,000 N.C. residents have the ACA plan provided by Blue Cross, the only provider to offer insurance through the marketplace at in all 100 N.C. counties.

The hikes come as the fate of the Affordable Care Act and continued funding of federal subsidies remains uncertain.

A “cost sharing reduction” subsidy reduces the amount that patients pay for deductibles and copays. About 20 percent of the 31 percent increase in premiums for S.C. residents is attributed to the uncertainty of funding for that subsidy, said S.C. Department of Insurance Commissioner Ray Farmer.

If the federal subsidies are funded then the S.C. premiums will not be increased as much. “We will do everything in our power to get ... the rates reduced by 20 percent,” Farmer told the Observer.

Premiums will vary depending on the person’s age and the type of plan they get, said Patti Embry-Tautenhan, spokeswoman for BlueCross and BlueShield of South Carolina. “Most members will see an average increase of $10 or less in their (monthly) premium.”

But if the federal government fails to reimburse health insurers for that subsidy, insurers could stop selling plans on the exchange or in the individual market, or significantly increase premiums, Farmer told the U.S. Senate Health, Education, Labor and Pensions Committee last week.

Meanwhile, a new U.S. Senate bill is being pushed by Republicans to replace federal insurance premium subsidies now available under the Affordable Care Act, as well as Medicaid funding, with block grants to the states starting in 2020.

Under that plan, North Carolina would lose $5.7 billion by 2026, according to a report released Thursday by the Kaiser Family Foundation. But South Carolina would gain $4.5 billion.

Neither state has expanded Medicaid.

Staff writer Jim Morrill contributed.

Cassie Cope: 704-358-5926, @cassielcope