For more than 100,000 individuals in Oregon who buy their own health insurance policies but are not on Medicare, everything is in flux when it comes to the premiums they’ll need to pay next year.

Why? Because of changes stemming from the new federal administration and Congress in Washington, D.C.

Generally, it’s looking like Oregonians’ base premiums will go up less than in other states — and the same goes for small business policies and larger employer-based plans.

But many individuals’ real-life coverage costs could rise far more than the basic rates do. That’s due to a wild card that hasn’t been played yet. A portion of the federal subsidies offered through the state health insurance marketplace website are slated to expire, which is expected to cause 4 million people in the U.S. to drop their coverage and another 20 million to pay more.

Democrats in Congress have been pushing to extend the subsidies, but it’s unclear when that might happen and whether it would happen in time to affect the premiums available on the Marketplace.

Meanwhile, there’s a whole different wild card — also stemming from political changes. Unlike in many states, Oregon regulators have balked at issuing final insurance rates — meaning not all the hikes have been finalized. 

That’s because there’s a high-stakes national court case that still hasn’t been settled, meaning it’s unclear if federal rules issued under the Trump administration, which are opposed by some consumer advocates and local governments, will take effect.

“We are waiting for the before-mentioned court case to be settled,” said Jason Horton, a spokesperson for the Department of Consumer and Business Services. “Some insurance carriers have said that outcome may cause them to re-file rates … To minimize consumer confusion we will release rates once litigation has been resolved.” 

Oregon rate hikes smaller than elsewhere

So far Oregon’s health insurance rate hikes are looking lower than in other states.

Oregon insurance regulators have tentatively approved average base premium increases of 9.7% for individual market consumers who buy their own coverage but are not on Medicare.

That’s significantly better than the 18% nationwide average found by Kaiser Family Foundation and less than half the 21% average approved in Washington state.

Meanwhile, Oregon health officials have tentatively approved an average hike of 11.5% for so-called “small group” plans serving small businesses. Again, that’s smaller than the rate hikes approved in many states, according to media reports.

State regulators declined to comment on why Oregon’s rate hikes are smaller than other states.

But because the trends in individual and small businesses tend to mirror the rates charged to large employers, the relatively small rate increases could mean good news for people who get their coverage through their employers — as well as for an Oregon economy that’s been reeling due to layoffs at Intel and Nike.

Jack Friedman, a longtime health insurance executive, isn’t sure what explains the lower-than-average hikes. But he expects most plans would see significant hikes the following year if Congress doesn’t act to extend premium subsidies.

That’s because the people who drop their coverage due to higher costs would likely be the healthy ones, leaving sicker and costlier consumers behind.

“You could have a much smaller pool of people that are a lot sicker, because the ones that stay are the ones that are using the care,” he said.

This article was republished with permission from The Lund Report, an independent nonprofit health news organization based in Oregon. Nick Budnick can be reached at [email protected].

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