美国国家公共电台 NPR Analysts Predict Health Care Marketplace Premiums Will Stabilize In 2019（在线收听）

DAVID GREENE, HOST:

All right, consumers who buy their insurance through the Affordable Care Act markets might be pleasantly surprised about their premium costs come this fall. The price of premiums could actually drop in several states, as NPR's Alison Kodjak reports.

ALISON KODJAK, BYLINE: Prices for Affordable Care Act health plans look like they're going to rise less than 4 percent next year. That estimate, based on the website acasignups.net, is based on insurance companies' early filings in all 50 states.

KATHERINE HEMPSTEAD: The news about the marketplace this year is very good, both in terms of the premium increase and the extent of carrier participations.

KODJAK: That's Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, which supports NPR's coverage of health. She says premiums are rising on average at about the same rate as medical inflation. That's a big change from the double-digit rate increases in the last few years.

HEMPSTEAD: And we're seeing that the double-digit kinds of increases are occurring in a small handful of states...

KODJAK: For example, Kentucky and Connecticut.

HEMPSTEAD: ...But they're definitely the exception. In quite a few states, we're actually seeing premiums going down.

KODJAK: Like in New Hampshire, where prices are expected to fall about 13 percent, and Tennessee, where they could drop 11 percent. And, Hempstead says, more insurance companies are offering more policies in more states.

HEMPSTEAD: After a very sort of tortured birth and infancy, it sort of seems like the market is, in some ways, you know, at a - at a very stable place right now.

KODJAK: She says insurance companies have figured out how to make a profit from the policies they sell on the ACA exchanges, so now they're expanding their offerings. But premiums would actually be falling next year but for the actions of the Trump administration and Republicans in Congress, says Charles Gaba, who tracks just about everything about the ACA on his website, acasignups.net. Those actions include getting rid of the tax penalty for those people who don't buy health insurance and encouraging insurers to sell stripped-down, short-term policies. Both moves are draining healthy, young people out of the ACA market.

CHARLES GABA: The reality is that if you didn't have those factors, if you didn't have the expansion of short-term plans and especially the repeal of the mandate penalty for next year, average premiums would most likely be dropping by a good 4 or 5 percent.

KODJAK: Whether premiums go up or down, consumers who qualify for a subsidy will likely pay just about the same for their insurance next year as they're paying now. Open enrollment on the federal exchange and in most states begins November 1. Alison Kodjak, NPR News.

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