NY health insurers seek an average 17% rate increase

ALBANY – Health insurers in New York are seeking an average rate increase of 16.6 percent next year for individual plans, according to their filings with a state agency.

The increases range from 47 percent for the Buffalo-based HealthNow New York to 4.4 percent for the Rochester-based Excellus.

On average, the insurers are also seeking an 11.5 percent increase in small group rates.

The increases come amid uncertainty over the future of the federal Affordable Care Act, which many of the insurers participate in. They are also dealing with Gov. Andrew Cuomo's recent regulations that mandate certain coverage and threaten to drop companies from publicly-funded programs if they do not comply.

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The insurers said their requests for higher rates to the state Department of Financial Services reflect growing expenses, higher taxes and government mandates.

"Plans continue to contend with ongoing costs of health care that keep going up unchecked — drug costs, provider consolidations, mandates, health care taxes," said Leslie Moran, spokeswoman for the New York Health Plan Association, which represents insurers.

The Department of Financial Services will rule in August on whether to grant the rate increases sought by insurers, but the agency usually lowers the request.

Last year, the agency agreed to a nearly 17 percent leap for 2017 for individuals. Insurers sought a 19 percent hike.

The proposed increases come at a volatile time for the health care in the state and the country.

New York has one of the nation's most robust health exchanges through the Affordable Care Act, known as Obamacare. About 3.6 million New Yorkers — roughly 18 percent of the state's population — are enrolled in the NY State of Health exchange, up 800,000 enrollees from a year ago.

Congress is debating a repeal and replace of Obamacare, but Cuomo on Monday said he would install emergency regulations to protect coverage for New Yorkers if the federal laws are changed.

Cuomo's plan includes requiring insurers in the health exchange to cover 10 basic health services now mandated under the Affordable Care Act. He also ordered insurers to be banned from participating in the state's other public insurance programs if they drop out of the health exchange — as some insurers have done around the nation.

Insurers said in their proposals they are trying to account for a variety of factors in seeking rate increases.

"The proposed rate adjustments sought in this application are calculated to maximize benefits for our members by exceeding state standards in paying the rising costs and utilization of medical care, cover numerous federal and state mandated taxes and fees, and achieve a 2 percent margin for our business," Excellus Health Plan Inc., which has 1.5 million upstate New York customers in 39 counties, said in its proposal.

Proposed rates

Here are the proposed insurance rate for individuals for 2018, according to the state Department of Financial Services: