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People newly insured under the Affordable Care Act were sicker, used more medical care and had higher medical costs than those who already had coverage, the Blue Cross and Blue Shield Association said Tuesday in a new study of its policyholders. Because insurers’ premiums have to cover their medical expenses, the new report helps explain why Blue Cross plans have sought, and insurance commissioners have approved, substantial rate increases in many states. (Pear, 3/30)

Health insurers gained a sicker, more expensive patient population after the Affordable Care Act expanded coverage in 2014, according to an early look at medical claims from the Blue Cross Blue Shield Association, which represents the most common brand of insurance. Newer customers had higher rates of diabetes, depression and high blood pressure, among other conditions, the association said in a report released Wednesday. (3/30)

Medical costs for individuals who obtained coverage through the ACA’s insurance exchanges were, on average, 22 percent higher than those with employer-based coverage in 2015, according to the association. Average monthly medical spending per member was $559 for individual enrollees in 2015, for example, versus $457 for group members. ... Under the law, no one can be denied coverage because of a pre-existing medical condition. Researchers and policy experts have always predicted that new enrollees during the first few years would include many older, sicker consumers who previously lacked insurance. (Sun, 3/30)

"What we don't know is where we go from here," said Alissa Fox, senior vice president at the Blue Cross association, which represents 36 independent Blue Cross Blue Shield insurers. (Luhby, 3/30)

The report was released by the Blue Cross Blue Shield Association, which represents the Blue insurers, most of which are not-for-profit. The group may be airing an early defense for further premium increases, said Sam Glick, a partner with consulting firm Oliver Wyman, a unit of Marsh & McLennan Cos. “It’s making it clear the populations they are serving may be higher cost, and trying to lay some of the groundwork for rate increases and defending their tax-exempt status,” he said. A spokesman for the Department of Health and Human Services said it was “no surprise that people who newly gained access to coverage under the Affordable Care Act needed health care,” noting that people with pre-existing health conditions often couldn’t buy plans before ACA changes in 2014. (Wilde Mathews, 3/30)