Still, this year is notably different. That’s because this is the first year in which insurers have a full year’s worth of claims data to support their rate requests. And where these big rate hikes are concerned, what the claims data consistently shows is that the people on these plans are much sicker and much more expensive to cover than expected. A financial official for Arches Health Plan, which covers a quarter of the Obamacare exchange enrollees in Utah, tells the Times that expenses were 24 percent higher than expected when rates were set. Arches is requesting hikes averaging 45 percent next year.
This is the story all over. At one Obamacare plan in Minnesota, the Times reports, “the ratio of claims paid to premium revenues was more than 115 percent, and the company said it lost more than $135 million.” A representative from Tennessee’s BlueCross BlueShield plan says the plan lost $141 million “because we were not very accurate in predicting the utilization of health care.” In Kansas, a Blue Cross and Blue Shield plan cover 28,000 people is requesting a 37 percent hike because the people who “purchased these individual plans since 2014 were older, in general, than expected and required more medical services than anticipated.”
And that brings us to Oregon. As the Times reports, the state’s insurance commissioner found that the cost to provide care in the state was about $830 million—$127 million more than the $703 million collected in premiums.