The Oregon Division of Financial Regulation said last week it reviewed rate proposals from major health insurers and approved an average 16% increase for individual plans sold through the Oregon Health Insurance Marketplace. Small-business plans covering companies with up to 50 employees face an average 15.5% increase.
Oregonians who run small businesses or buy individual health coverage through the state health insurance marketplace face steep premium increases next year.
State insurance regulators are expected to finalize the rates in early September. Estimates from financial regulators show a 40-year-old in Portland seeking a middle-tier silver plan would pay between $571 and $689 per month in premiums.
For small-group coverage using the same parameters, the monthly cost per person would range from $509 to $754, depending on the insurer.
Marketplace insurers, including Moda Health Plan and BridgeSpan Health Company, had pushed for rate increases closer to 17%.
They cited higher medical costs, fewer insurers participating in the marketplace and tariffs raising the price of medical equipment and pharmaceuticals.
Oregon regulators presented the lower approved increases as a consumer savings measure. The Division of Financial Regulation said its review would save consumers about $30 mn in premiums next year.
Regulators also pointed to uncertainty after Congress declined last year to extend enhanced Affordable Care Act tax credits. Those credits helped make health insurance more affordable for nearly 120,000 Oregonians, according to state officials.
People earning more than 400% of the federal poverty level no longer qualify for those subsidies. That threshold equals $63,840 in annual income for an individual and $132,000 for a household of four. Congress passed the enhanced subsidies in 2021 to address the economic fallout from the COVID-19 pandemic.
Oregon Insurance Commissioner TK Keen said rising insurance rates form part of the higher cost of living facing many residents. He said the Division of Financial Regulation team scrutinized the proposed increases and reduced them to protect consumers’ budgets.
The proposed rate increases come as Oregon pushes back against federal health policy changes. Attorney General Dan Rayfield last week joined 20 other states in suing the Trump administration over a new federal rule affecting health coverage.
The rule would reduce access to caps on out-of-pocket costs, bring back income-verification requirements and expand last-resort health plans designed for emergency use.
Rayfield said the administration keeps stripping away health coverage, food assistance and basic protections for working families while favoring a select few. He said Oregon is challenging federal actions he argues would make Americans sicker, poorer and less free.
