Dean Cameron, director of the Idaho state Department of Insurance, announced today that health insurers offering plans on Idaho’s state insurance exchange have proposed premium rate increases next year averaging 38 percent. “I am deeply disappointed and frustrated to share these rates,” Cameron said in a news release; you can read it here. “I understand how difficult it will be for Idahoans to afford reasonable coverage, especially those without a subsidy.”

The rates, which also cover plans offered outside the exchange, aren’t final; while Cameron’s department doesn’t have authority to regulate rates, it can declare proposed rates “unreasonable,” and it has successfully negotiated lower rate increases with carriers in the past to avoid labeling them as unreasonable. Final rates will be announced in about two months.

Idaho Statesman reporter Audrey Dutton reports that the largest increases are proposed in the “silver” plans, which are the most popular ones on the exchange, falling mid-range in pricing and benefits between the lower-level “bronze” plans and the high-end “gold” plans. Silver plans are showing average increases of 50 percent in premiums; they range from a low of 40 percent at Blue Cross to 69 percent at SelectHealth. Dutton writes that because subsidies that help Idahoans purchase plans on the exchange are based on the silver plan rates, that could mean that Idahoans actually end up paying less, but the federal government has to pay more, depending on their plans. You can read her full report here.

Cameron, in the release, said the big rate increases for silver plans are being driven by the federal government’s potential refusal to fund something called the “cost share reduction” mechanism, or SCR, which lowers deductibles and out-of-pocket expenses for lower-income enrollees. If it’s not funded, insurers still have to offer the benefit. “I call on Congress to either repeal the CSR requirement or fund the program,” Cameron said. “That action alone would reduce the proposed increase by at least 20 percent on the silver plans.”

Idaho continues to have much higher numbers of insurers participating in its exchange, the department reported. "While some states grapple to find a single carrier, Idaho has had five carriers participating on the exchange and five carriers participating nationwide," according to the release. In 2018, it reported, one carrier, Bridgespan, is withdrawing, and SelectHealth will reduce the number of counties it serves in eastern Idaho, but Idahoans still will have a choice from among three or more insurers in each of the state's 44 counties.