BUFFALO, NY - Western New Yorkers who purchase health insurance through the New York State of Health Marketplace may hope that their coverage includes treatment for sticker shock, when they receive letters from their insurance carriers, advising them that providers are seeking approval for higher rates amid climbing health care costs.

Buffalo-based HealthNow New York, which operates locally as BlueCross BlueShield of Western New York: is seeking an average 49% increase for its individual plans, and an 8% increase for small groups.

Some customers of its Bronze plan have advised WGRZ-TV that they have been notified their proposed rate hike will be 58 percent.

In a statement BlueCoss BlueShield of WNY said their rate hike requests “directly reflect the cost of care and the cost to administer health insurance benefits in New York State.”

Meanwhile, Independent Health seeks to hike rates 26% for individual plans, and 13% for small groups.

Fidelis Care wants an 8% hike for individual plans, and Univera is proposing a 4.4% increase.

Only in New York

In its statement, BlueCross BlueShield claims that “unnecessary changes made in Albany to a federal program known as ‘risk adjustment’ are driving almost half of our requested rate increase. By making these changes, Albany has essentially ‘tipped the scale’ and transferred funding from upstate to downstate health plans who historically, have served healthier members.”

The company claims the state’s actions have “driven over $7 million in losses”, and its statement concludes by saying, “As a not-for-profit health plan we’d be happy with just breaking even. In order to do that, and ensure the sustainability of these offerings, we must unfortunately ask New York State to approve our rate request to appropriately reflect the true cost of care.”
“Plans have been losing money in recent years,” said Leslie Moran, Vice President of the New York Health Plan Association (NYHPA), a trade group representing insurers in the state.

What about ObamaCare?

“What happened under the Affordable Care Act is that we made health insurance accessible for people, but because we haven’t gotten at the underlying cost of care, we haven't really gotten at the affordable aspect of it," said Moran.

And it's those underlying costs, according to Moran, and additional ones for residents of New York in particular, which are driving higher premiums.

"Things like prescription drug costs keep growing, as do doctor and hospital costs…and New York has done little to control them,” she said. “And then we have things like health care taxes in New York that drive up the cost of insurance as well."

Those taxes add about $5 Billion annually to the health care costs of New York residents according to NYHPA.

Meanwhile, Rep. Chris Collins (R-NY 27th), a longtime critic of Obamacare, was quick to pounce.

“Not only has Obamacare been a failure for most of America, it is now failing the people of Western New York by making basic healthcare completely unaffordable and inaccessible,” said Collins. “I am absolutely appalled a BlueCross BlueShield plan in Western New York would increase by almost fifty percent in the marketplace…Obamacare’s chief cheerleader in our state, Governor Andrew Cuomo, owes our community an apology,” Collins said.

State Has Final Say.

However, just because the Insurance companies are requesting these rate hikes, it doesn't mean the State Department of Financial Services (DFS) will approve them.

“Historically, at least looking at the last three years, they have reduced them (rate hike requests) significantly," said Moran, who says some of the citizen outcry that might be forthcoming should be directed to DFS.

The agency was supposed to have put all the plans submitted by the insurers, along with their reasoning for the rate hikes, on its website the first of this month. But it still hasn’t, a full week after it was expected to.

“Then you would have the ability to read the application in detail, and the ability to then comment on it,” said Moran. “But right now consumers don’t have that ability and the clock is ticking because the comment period is only for 30 days, and we’re already seven days into that 30 day clock," she said.

As of Wednesday evening the DFS press office did not respond to our e-mailed inquiry as to why it has failed to post the information, or when it plans to do so.