Payers probably won’t pass COVID savings onto members, despite pandemic-driven boon

July 31, 2020

Payers were prepared for skyrocketing medical costs due to COVID, but the opposite happened: people consumed less healthcare, on average.  This resulted in large savings for health plans.  Will consumers see lower premiums next year? Numerous insurers across the country have announced plans to hike rates next year, though some have proposed cuts. Many state Affordable Care Act exchanges are likely to announce 2021 health plan rates next week.

A KFF analysis last week of proposed 2021 rates in the exchanges of 10 states and the District of Columbia showed a median increase of 2.4%, with changes ranging from a hike of 31.8% by a health plan in New Mexico to a cut of 12% in Maryland. Among the roughly one-third of filings that stated how much COVID-19 added to premiums, the median was 2%, with estimates ranging from minus 1.2% at a plan in Maine to 8.6% at one in Michigan.

On the other hand, hospitals and doctors have lost money, and the ones whose contracts with health plans are up for renewal will be looking to make up those losses, Melnick said.

“Providers could be asking for 20-25% increases next year,” he said, “and if they’ve got market power, they can make it stick.”

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(Source: Wolfson BJ, Kaiser Health News, accessed July 31, 2020)

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