ACA a costly failure in and beyond S.C. (copy) (copy)

Health insurance enrollment opens Nov. 1 through the federal marketplace. Customers who want to purchase coverage for 2018 must do so by Dec. 15. File/AP Photo/Andrew Harnik

As Congress once again turns its focus toward health care reform, the S.C. Department of Insurance posted some sobering news about 2018 health insurance prices. 

The agency confirmed on its website Thursday that average premiums for HealthCare.gov polices will skyrocket 31 percent in South Carolina next year, confirming information the federal government published on the future of health insurance costs earlier this summer. 

Some customers will face higher increases than others. A 60-year-old patient in Charleston County who doesn't use tobacco and wants to buy a "silver" plan next year will pay about 28 percent more. His monthly premium will increase from about $837 a month this year to $1,068 a month next year. 

Meanwhile, a 40-year-old customer in York County who doesn't use tobacco and wants a "bronze" plan will only end up paying about 8 percent more. 

Congress could repeal the Affordable Care Act next week, but these latest numbers, which were approved by the Insurance Department, wouldn't automatically change. The proposed Obamacare replacement bill, as written by U.S. Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., wouldn't immediately impact the price of HealthCare.gov policies. 

The numbers published by the Department of Insurance don't reflect the amount employees will pay for coverage through work or the significant discounts that most HealthCare.gov shoppers qualify for based on their income. In fact, a spokeswoman for BlueCross BlueShield of South Carolina said that most people who rely on the federal marketplace for coverage will only end up paying about $10 more per month next year.

BlueCross BlueShield is the only company that sells Affordable Care Act plans in this state. 

“To remain as the lone health insurer in the South Carolina public exchange market BlueCross BlueShield of South Carolina had to factor in the volatility of the marketplace," said Patti Embry-Tautenhan, a spokeswoman for BlueCross BlueShield South Carolina, in a prepared statement. 

Insurance Director Ray Farmer said his agency wouldn't have needed to approve the 31 percent increase if federal lawmakers had moved to extend the Affordable Care Act's "cost-sharing reductions."

That program, which was established by the 2010 health care law to lower the amount most HealthCare.gov customers pay for their policies, needs to be made permanent through 2019, Farmer said. It is currently renewed one month to the next.

President Donald Trump has repeatedly threatened to cut the payments off. That's why health insurance companies across the country had trouble pricing their policies for next year, Farmer said, not knowing if the cost-sharing reductions would continue to exist. 

"That’s just too much uncertainty," Farmer said. 

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About 20 percent of the 31 percent increase is tied directly to this problem, said Farmer, who testified before Congress last week about extending the cost-sharing reductions.

"The best option is for the federal government to pay its obligations under law," Farmer told the U.S. Senate Committee on Health, Education, Labor & Pensions.

Jim Ritchie, a former Republican state lawmaker and the executive director of the S.C. Alliance of Health Plans, blamed Congress for the price increases.

"The inaction by Congress has created uncertainty in the market," Ritchie said. "Insurers have to plan for the most risk when they don’t have clarity."

Farmer explained that BlueCross BlueShield of South Carolina has agreed to lower its prices if Congress acts before the end of the year. He doesn't know if that will happen. 

Approximately 183,000 South Carolinians buy their health insurance through the federal marketplace. Most of them can expect to pay more next year, he said. 

Reach Lauren Sausser at 843-937-5598. 

Lauren Sausser is the Features Editor at The Post and Courier. She also covers health care issues in South Carolina.

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