Feds Say Exchange Plan Enrollees No More Costly Than Before

But Minnesota is one of only 10 states where exchange plan claims rose more than 3 percent.

Countering the complaining, pull outs and double-digit premiums requests from health insurers, the federal government released new figures that show that enrollees in health plans sold over state and federal health insurance exchanges last year were no more costly than the enrollees in 2014.

“Available evidence indicates that the slow ACA individual market cost growth resulted at least in part from a broader, healthier risk pool,” said the Centers for Medicare & Medicaid in a seven-page report.

Specifically, the CMS said per member per month claims paid by exchange plans fell by 0.1 percent from 2014 to 2015 compared with a 3 percent to 6 percent increase in the overall health insurance market over the same period.

The report contradicts claims by private health insurers that the pool of exchange enrollees is getting sicker and more costly, justifying their requests for big premium increases for the 2017 enrollment year or their decisions to stop selling health plans on some or all state and federal exchanges.

In March, for example, the Blue Cross and Blue Shield Association released a 10-page report that said members who bought individual coverage from Blue’s plans in 2014 and 2015 through and outside of state and federal exchanges were sicker, used more medical services and incurred higher medical costs than those who bought individual coverage previously or were insured by a Blue plan through their employer.

In Minnesota, though, the new government report backs up the decision by Blue Cross and Blue Shield of Minnesota to stop selling individual health insurance policies in 2017, including individual plans sold on the state’s exchange with the exception of the Blue Plus HMO.

The CMS said that Minnesota was one of 10 states where per member per month claims paid by exchange plans rose more than 3 percent in 2015 compared with 2014.