More on Reimbursement

CMS says health insurance premiums down by 1.5 percent under ACA

CMS takes credit for introducing waivers and a reinsurance program for insurers to submit high-cost claims into a risk pool.

Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services announced today that, for the first time since Affordable Care Act plans began to be offered through the federal exchange, premium rates have decreased.

Premium rates for a benchmark silver plan in 2019 are going down a collective 1.5 percent in the 39 states that use the federal platform, CMS Administrator Seema Verma said.

In some states, the decrease is even more, she said. For example, in Tennessee it's 26 percent, New Hampshire is 15 percent and in New Mexico they're down  14 percent.

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Also, 23 more issuers have gotten into the game, including Anthem, which had previously cut back on its footprint, and Cigna.


CMS, under the Trump Administration, is taking credit for  stabilizing the market and lowering premiums by offering states flexibility through seven types of waivers, easing regulations and  allowing limited duration short term plans and association health plans.

The waivers allow states to set up a reinsurance program for insurers to submit their high claims into the risk pool. 

In the coming days, CMS will offer even more flexibility for states to use 1332 innovation waivers, Verma said.

Open enrollment for most states is November 1 through December 15.


Since the ACA, premiums have gone up by double digits, Verma said.

Consumers were told if they liked their plan, they could keep it, but many had their insurance plans cancelled, she said. 

Sixty percent of counties had only one ACA insurance carrier. That's now down to 39 percent.


CMS, under the Trump Administration, said it has been working tirelessly to stabilize the market and pick up the mess left from the Obama Administration. 

"The law needs to change," Verma said. "We've been doing everything we can to mitigate the damage of Obamacare."


Several factors not mentioned Thursday account for the turn-around in the ACA market.

The most significant is the administration's allowance of silver loading, at least for 2019. In August, CMS issued new guidance for insurers to apply the full premium increase to silver marketplace plans to make up for the loss of their cost-sharing reduction payments. President Trump ended the CSRs.

The majority of consumers are not harmed, because nine out of 10 who buy plans in the ACA market get tax subsidies.

Twitter: @SusanJMorse
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