[M]VP Health Care has asked to raise prices on the health exchange by more than it should be allowed next year, according to a report given to the Green Mountain Care Board on Monday, while Blue Cross Blue Shield of Vermont requested roughly the right amount.
MVP requested an 8.8 percent increase in what it charges customers on Vermont Health Connect starting Jan. 1. Blue Cross Blue Shield of Vermont requested an 8.18 percent increase.
The board’s actuaries analyzed the requests and came out with an opinion Monday. The actuaries said MVP should be able to raise its prices only 3.7 percent and that Blue Cross’s prices should go up 8.24 percent instead of 8.18 percent.
The Green Mountain Care Board will decide how much the insurers will be allowed to charge. Board Chairman Al Gobeille declined to comment on the report because the rate case is still open.
A lobbyist for MVP was out of the office Monday.
The MVP rates take several factors into account, but one of the largest is an 11.6 percent increase in costs for prescription drugs. The insurer estimates that costs of generic drugs will go down but brand name drugs will go up 11.7 percent and specialty drugs, 20.5 percent.
The insurer is assuming the cost of medical care will go up 2.5 percent, which actuaries say is reasonable. Administrative costs of MVP’s health insurance plans will remain the same as in 2016, but the amount of premiums going into MVP’s cash reserves will go up.
The Green Mountain Care Board has broad authority to accept the actuaries’ recommendations or choose another path. In December, the board went against the actuaries’ recommendations to decline a price increase, and MVP decided to sue, accusing the board of overreaching its power.
If the board approved MVP’s original request, the prices would go up by the following amounts for each plan: 9 percent for catastrophic plans, 10.4 percent for bronze-level plans, 8 percent for silver plans, 8.3 percent for gold plans and 7 percent for platinum plans.
The actuaries are recommending the following: a 4.3 percent increase for catastrophic plans, a 5.4 percent increase for bronze plans, a 3 percent increase for silver plans, a 3.3 percent increase for gold plans and a 1.9 percent increase for platinum plans.
MVP insures about 10 percent of customers who use Vermont Health Connect. Among people using the exchange, about two-thirds get financial help through the state or federal government, and the rest pay the full price.
Hearings on the insurance prices for Vermont Health Connect customers will be held in Montpelier at 9 a.m. July 20 for Blue Cross and 9 a.m. July 21 for MVP at the Green Mountain Care Board offices in City Center. Health care advocates at Vermont Legal Aid will testify on behalf of consumers.