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Health insurance premiums in Utah are expected to rise by at least 15 percent across the board in 2018 if a system of subsidies for lower-income residents is not funded, state insurance officials said Thursday.

Although the state Department of Insurance won't have hard estimates on those rate increases until July or August, officials told the Legislature's Health Reform Task Force Committee that rates could climb by 20 percent or more for 2018, not including rising health care costs and other factors.

"It's a lot of skepticism today," Tanji Northrup, assistant commission at the Insurance Department, said after the meeting.

"With the unknown of cost-sharing-reductions funding and the [U.S. Senate's pending] decision on the health reform bill," Northrup said, "we have great uncertainty for what insurers will be participating in the market and where rates could land for 2018."

Made available through the Affordable Care Act (ACA) passed under President Barack Obama, "cost-sharing reductions" are benefits offered to low- and moderate-income residents to help offset their deductible and copay costs.

In 2016, about 109,000 Utahns received such benefits, according to Centers for Medicare and Medicaid Services data, and more than $100 million in subsidy payments were made to Utah consumers.

Cost-sharing subsidies have been up for debate since late 2014, when the U.S. House of Representatives sued the Obama administration on the grounds that the ACA, also known as Obamacare, never legally funded the program.

President Donald Trump's administration has left the lawsuit's appeal in limbo, Northrup said, creating uncertainty on whether insurers will continue to participate in the ACA's insurance marketplaces without the subsidies.

Premiums increased about 30 percent in 2017 for people who buy their own insurance plans, according to state insurance officials.

If cost-sharing funding is cut, an official with the nonprofit Utah Health Policy Project said, individuals eligible for the subsidy will find health care even less accessible.

"The ability to use insurance is based on deductibles and copays, and this program has been reducing those for tens of thousands of Utah families," said Jason Stevenson, the Utah Health Policy Project education and communication director.

"Now, based on uncertainty from the Trump administration," he said, "insurers and families don't know if [those subsidies] are going to be there, making the market unstable."

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