New York regulators snubbed health insurers by slashing proposed premium hikes for Obamacare plans sought for next year, the state Department of Financial Services announced Friday. Insurers requested an average 20.6 percent increase in the individual market and a 23.7 percent increase in the small-group market, POLITICO Pro’s Katelyn Cordero reports. DFS approved average increases of 6 percent and 8 percent, respectively. DFS estimates its decisions will save individual market consumers $324 million and small businesses $1.25 billion compared with the rates insurers requested. The agency noted that the lower rates are part of efforts to address rising health insurance costs. The New York State Conference of Blue Cross and Blue Shield Plans said it raised concerns about health care affordability with the state Legislature, but proposals to drive down hospital and pharmaceutical costs have been left unaddressed. Lev Ginsburg, executive director of the conference, told POLITICO that he’s concerned by the “artificial rates” approved by DFS. “The requested rates were a reflection of the real cost of health care. We saw it last year that the requests were cut and again this year,” Ginsburg said in an interview. “You end up with a product that is costing more than they can charge in premiums. So you have plans that run into the red. It puts huge pressure on plans; you can only function in the red for so long.” Of the 12 insurers in New York State of Health’s individual market, which currently includes roughly 224,000 New Yorkers, four received no increase at all. Anthem was approved for a 3.1 percent decrease — far from the 11.3 percent premium hike requested. In the small group market — which covers 630,000 New Yorkers — a majority of the 11 insurers received increases lower than requested. Highmark received no increase, and Emblem was given a 0.7 percent cut. Anthem was approved for the greatest increase in the small group market, receiving a 14.4 percent rate, which was still 6 percent lower than requested. Friday’s rate announcement is a win for health care advocates and lawmakers who called on DFS to lower the rates late last month. A letter from more than 70 state lawmakers implored the state to reduce or reject the requested rates. Health Care for All New York, a coalition of more than 170 organizations, also submitted a letter to the state urging DFS to scrutinize insurers’ medical-cost projections, administrative expenses and profits. IN OTHER NEWS: — Mount Sinai struck a deal with the Department of Justice agreeing to end gender-affirming care services for minors, the DOJ announced Friday. The health system agreed to end gender-affirming services to minors, which include administering puberty blockers and cross-sex hormones and performing surgical procedures. The hospital will also pay a fine and allocate $2 million to provide free medical care to individuals who may have been negatively impacted by gender-affirming care received as a child. LGBTQ+ advocates bashed the hospital for striking a deal with the Trump administration. The New Pride Agenda, an LGBTQ+ advocacy group, said the deal sets a dangerous precedent that other health care institutions in the state may feel pressured to follow. Kei Williams, the executive director of New Pride Agenda, called on the state to step up and ensure that access to services for minors is protected. “This settlement underscores a growing threat here in New York. If hospitals and providers stop offering gender-affirming care because they fear federal investigations, funding threats, or political retribution, access disappears,” Williams said in a statement. “From Western New York to New York City, more and more providers are ceasing gender-affirming care for young people. The end result will be a shadow ban on care access in a state that has promised transgender New Yorkers and their families that they would be protected within our borders.” GOT TIPS? Send story ideas and feedback to Maya Kaufman at mkaufman@politico.com and Katelyn Cordero at kcordero@politico.com. Want to receive this newsletter every weekday? Subscribe to POLITICO Pro.
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