Insurers to boost rates about 10%; Shift of expenses to workers likely
By Robert Weisman
Globe Staff / September 16, 2009
The state’s major health insurers plan to raise premiums by about 10 percent next year, prompting many employers to reduce benefits and shift additional costs to workers.
Increases will range from 7 to 12 percent, capping a decade of consecutive double-digit premium increases, according to a Globe survey of the state’s top health insurers. Actual rates for 2010 will depend on the size of the employer and the type of coverage, with small businesses and individuals expected to be hit hardest. Overall, premiums are more than twice as high as they were 10 years ago.
The higher insurance costs undermine a key tenet of the state’s landmark health care law passed two years ago, as well as President Obama’s effort to overhaul health care. In addition to mandating insurance for most residents, the Massachusetts bill sought to rein in health care costs. With Washington looking to the Massachusetts experience, fears about higher costs have become a stumbling block to passing a national health care bill.
“It’s all about medical costs going up,’’ said Brian Pagliaro, senior vice president at Tufts Health Plan in Watertown, which predicts an average increase of 9.5 percent for 2010. “The dollar you’re paying now will be $1.09 for the same service next year.’’
Tufts has about 720,000 members in Massachusetts.
Insurers predicted many employers, perhaps a majority, will seek to trim costs by instituting “cost sharing,’’ which boosts copayments for doctor visits, or by offering less comprehensive coverage. That means the effective premium rate increases could fall more on employees than their companies.
If the H1N1 flu proves to be worse than expected this winter or the US government taxes insurers as part of health care overhaul, the state’s premium rates - already the nation’s steepest for family coverage - could rise by even more than 10 percent, insurers warned.
Health care professionals attribute the premium increases to several factors, including greater use of medical services by aging baby boomers and higher bills from doctors using more costly technology and prescribing more expensive drugs.
Some insurers say the Massachusetts law mandating coverage has added to the cost burdens on the health system. At least initially, they said, it encouraged newly enrolled members to flood the offices of primary care physicians and specialists to receive physicals and other exams.
A special state commission studying changes to the payment system has recommended insurers scrap their practice of paying doctors and hospitals fees for individual visits or procedures and instead offer a set amount to cover patients’ care for a year.
“Health insurance is increasingly unaffordable for average working people and for employers, especially small employers,’’ said Drew Altman, president of the Kaiser Family Foundation, a nonprofit research group in Menlo Park, Calif. “It underscores the need to reach a consensus on how to reform health care and provide some help for low- and moderate-income people who can’t pay their insurance bills.’’
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http://www.boston.com/business/healthcare/articles/2009/09/16/health_insurers_plan_10_rise_in_rates/