"We still would have seen premium increases in many of these states even without the political uncertainty", Cynthia Cox, a co-author of the analysis and associate director for Kaiser's Program for the Study of Health Reform and Private Insurance, told The Hill.
The analysis out Thursday from the Kaiser Family Foundation finds that mixed signals from President Donald Trump have created uncertainty "far outside the norm", leading insurers to seek higher premium increases for 2018 than would otherwise have been the case.
Insurers have until September 27 to commit to participating in the exchanges next year.
Researchers from the Kaiser organization looked at proposed premiums for a benchmark silver plan across major metropolitan areas in 20 states and Washington, D.C.
Trump has recently threatened to cut off the payments for the cost-sharing subsidies, which reduce deductibles and co-pays for lower-income enrollees. The payments are now the subject of a lawsuit filed by House Republicans that was appealed by the Obama administration, and if Trump drops the appeal the payments will stop. Where these factors are addressed explicitly in rate filings, insurers that have assumed that the individual mandate will not be enforced have factored in additional rate increases of 1.2 to 20 percent, while those that have assumed the cost-sharing reduction payments (CSRs) will not be paid have factored in an additional 2 to 23 percent.
The report suggests that uncertainty over threats of repeal and replace by Republicans in the House and Senate, and the Trump Administration, have had a varying impact on potential premium increases.
KFF found that the highest proposed premium rate increases were in Wilmington, up 49 percent from $423 to $631 a month, up 34 percent from $258 to $346 in Albuquerque, N.M., and up 33 percent from $296 to $394 in Richmond, Va. Both figures don't factor in tax credits, which shield many enrollees from steep rate hikes. "This year, because of the uncertainty insurers face over whether the individual mandate will be enforced or cost-sharing subsidy payments will be made, some companies have included an additional rate increase in their initial rate requests, while other companies have said they may revise their premiums late in the process".
Insurers filed their preliminary premium rates on August 1.
About 6.7 million people buy coverage on the non-group market and do not receive subsidies.