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Delaware’s Affordable Care plans to drop an average of 1 percent based on 2019 usage

The drop does not look at the current 2020 policies or the effect of COVID-19, which has created extremes in the way policies are used.

Policies sold through the Delaware Health Insurance Marketplace — also known as Affordable Care or Obamacare — will drop by an average of 1 percent.

State Insurance Commissioner Trinidad Navarro said in a press release Monday that Highmark Blue Cross Blue Shield Delaware offered a .5 percent drop, but his office was able to negotiate it to 1  percent.

Highmark is the only company offering policies through Delaware’s health insurance marketplace.

It’s the second annual drop. Last year’s policies dropped an average 19 percent. Both drops reflect the success of a reinsurance program started last year that helps pay for big ticket treatments.

Navarro’s press release said the drop stemmed from an actuarial review of 2019 policies.

The just-announced drop does not look at the current 2020 policies or the effect of COVID-19, which has created extremes in the way policies are used. People who got sick needed those policies, especially if hospitalized. But most people have used far less health care in 2020 because the pandemic shut down businesses and doctor’s offices, and many people have been reluctant to return.

Enough people avoided doctor’s offices that the state Division of Public Health last week issued a call for parents to take kids in to get wellness visits and immunizations, and for adults to resume cancer screenings. While children’s visits have started to rise this summer, adult screenings fell dramatically in March and April and have not begun to rebound, according to Dr. Karyl Rattay, director of the Division of Public Health.

The 2020 policies won’t be reviewed until next year. The policy year ends in 2020.

A different look at the policies and how much money Highmark spent compared to how much it took in will come with another look at the policies called a medical loss ratio after Dec. 31. If Highmark spent less than expected, 2020 policy holders and small businesses could get rebates or price breaks. 

“Amid a global pandemic, it is more important than ever for residents to have access to affordable insurance,” Navarro said in the press release. “Given the difficult economic climate, more people are relying on the Marketplace for the coverage they need. With this decrease, we send a strong message about the effectiveness of the ACA during its 10th anniversary year.”

At the state of the year, 24,000 Delawareans had policies through the marketplace, up 6.3 percent from the year before. 

Open enrollment for the Marketplace takes place between Nov. 1 and Dec. 15 each year. However, residents may qualify to enroll or change plans based on special circumstances, such as a job loss, change of income, becoming a parent and several other qualifying factors. Some people qualify for subsidies that lower their policy costs. Find out here if you qualify for special enrollment.

The proposed rate decrease does not apply to Medicare, Medicaid or those with group or individual policies outside of the Marketplace.

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