Insurance rates for some individuals purchasing plans through the state's Health Connector could jump by as much as 26 percent for 2018 if insurers no longer receive the federal subsidies that President Donald Trump has blocked.
A spokesman for the state's health insurance exchange says the higher could be felt by up to 80,000 people during the open enrollment period beginning Nov. 1. Initially, rates had only been expected to rise by 8 percent.
Continue Reading Below
The federal cost-sharing program made payments directly to insurers to cover costs for people who obtain insurance through the connector and have incomes under 250 percent of the federal poverty level — around $30,000 for an individual and $62,000 for a family of four. Those payments helped cover out-of-pocket costs, including deductibles, copayments and coinsurance.
The payments were included in former President Barack Obama's 2010 health care law, the Affordable Care Act. Massachusetts health officials estimate the federal government would have paid $146 million in cost-sharing expenses in 2018 in the state without the change Trump wants.
The state will offset the losses for the remainder of 2017, estimated at $28 million.
Republican Gov. Charlie Baker has called on Congress to act.
On Thursday, Baker sent a letter to the state's all-Democratic delegation urging them to work with other members to approve a bipartisan agreement negotiated by Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington. Baker said he wants to protect the Massachusetts health care marketplace and the 257,000 individuals in Massachusetts who receive health care coverage through the Health Connector.
On Wednesday, Baker joined a bipartisan group of 10 governors who sent a letter to Republican and Democratic congressional leaders also urging them "to quickly pass legislation to stabilize our private health insurance markets and make quality health insurance more available and affordable."
Trump, a Republican, has said Obama's health care law is imploding. He has portrayed the subsidies as insurance company bailouts.
"I don't want the insurance companies making any more money ... than they have to," Trump said Thursday.
The payments reimburse insurance companies for lowering co-payments and deductibles for about 6 million lower-income customers.
The White House has also said the government cannot legally continue paying the cost-sharing subsidies because there is no formal authorization from Congress.
Democratic U.S. Sen. Edward Markey said Trump is to blame for the rate hikes.
Markey said while most Massachusetts residents purchasing insurance through the connector will be shielded from the increase, that isn't the case for the estimated 80,000 who will see their rates increase.
"Massachusetts is a health care leader and success story, but even we are not immune to President Trump's efforts to sabotage the Affordable Care Act," Markey said. "When Bay Staters see their premiums spike next year, they can place the blame squarely on President Trump."
Attorneys general in nearly 20 states — including Massachusetts — have sued the Trump administration to keep the money flowing, contending that the president is not following a legal requirement to pay the subsidies.
Massachusetts approved a state law in 2006 signed by Republican Gov. Mitt Romney that became the blueprint for "Obamacare."