Older, Sicker ACA Patients Lead Insurers to Seek Big 2016 Rate Hikes

High medical costs from relatively small numbers of very ill enrollees to Obamacare are leading large insurance companies to ask regulators in some states to raise their rates by more than 50 percent next year.

In New Mexico, for instance, Health Care Service Corp. is seeking an average jump of 51.6 percent, The Wall Street Journal reports. BlueCross BlueShield of Tennessee has sought an average raise of 36.3 percent, while CareFirst BlueCross BlueShield in Maryland has asked for a 30.4 percent increase.

“This year, health plans have a full year of claims data to understand the health needs of the [health insurance] exchange population, and these enrollees are generally older and often managing multiple chronic conditions,” Clare Krusing, a spokeswoman for the Washington-based industry group America’s Health Insurance Plans, told the Journal.

“Premiums reflect the rising cost of providing care to individuals and families, and the explosion in prescription and specialty drug prices is a significant factor,” she said.

The requests confirm a general premise of the Affordable Care Act: Older, sicker patients were more likely to sign up for plans — and this was, in theory, to be balanced by heavy participation by younger adults.