The roughly 88,000 Nebraskans who purchase health insurance on the federal marketplace could see a bit of a break in premium prices next year — and a new player in the market.

Medica has proposed rates for three individual plans for 2020 with an average decrease of 5.3%. The Minnesota-based group has been the only insurer offering plans in the state compliant with the Affordable Care Act for the past two years.

“We’re very happy that the rates are going down for Nebraskans,” said Martin Swanson, the Nebraska Department of Insurance’s health policy administrator.

He cautioned, however, that not all consumers will see a rate decrease. Actual premiums can depend on a number of factors, such as age and smoking status.

Nebraskans also will have another option next year. Bright Health, an insurance startup also based in Minnesota, announced in July that it would offer plans in Nebraska in 2020, including individual plans compliant with the ACA. Omaha and Nebraska statewide are among 22 new markets in 12 states for the company.

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Swanson said the company has filed proposed rates with the state. However, they won’t be public until all proposed rates are finalized in November.

“We welcome the competition into the Nebraska market,” he said. Competition in a market typically brings prices down.

Iowa’s rates are shaping up to be more of a mixed bag. Medica has proposed rates for four individual plans in 2020 with an average decrease of 11.3%, according to the federal HealthCare.gov website. Wellmark Health Plan of Iowa and Wellmark Health Value Plan proposed increases of 4.7% and 4.75%, respectively.

This year, Nebraska and Iowa residents saw single-digit increases or slightly lower rates in individual insurance premiums. That was seen as a sign of stability in health plans after four years of double-digit increases and insurance company losses that drove some insurance companies out of the market.

Monthly premiums were still high enough, however, that more than 80% of people who bought coverage through the exchanges last year were expected to receive federal subsidies to help cover the cost.

Geoff Bartsh, vice president and general manager of Medica’s individual and family business unit, said those who face the biggest challenges are ones who narrowly miss qualifying for a premium subsidy because their incomes are too high.

“We still have a lot of work to do to make premiums, and health care costs in general, more affordable,” he said.

Medica’s proposed rates for next year reflect its experience with claims in 2018, which was better than expected. The company filed proposed decreases or low increases across its entire service area, officials said, which seems consistent with the rest of the country.

“We think this is a good sign for market stability,” said Greg Bury, a company spokesman.

Jon Watson, Bright Health’s president of individual and family plans, said he expects the company’s rates to be competitive.

Bright Health, when it enters a market, typically establishes a relationship with a major health system and builds a network of services around that provider.

In Nebraska, the company is partnering with the Nebraska Health Network, which is made up largely of Nebraska Medicine and Methodist Health System providers and hospitals, as well as some independent physicians.

Medica has plans with both the Nebraska Health Network and CHI Health.

Lee Handke, the Nebraska Health Network’s chief executive officer, said he expects consumers to have good choices in terms of price, plan design and benefit options.

“Both Medica and Bright Health are strong choices,” he said. “We’re happy that we’re partnering with both of those plans.”

Consumers will be able to “window shop” individual plans shortly before next year’s exchange opens. Open enrollment for 2020 plans will be Nov. 1 to Dec. 15.

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Julie Anderson is a medical reporter for The World-Herald. She covers health care and health care trends and developments, including hospitals, research and treatments. Follow her on Twitter @JulieAnderson41. Phone: 402-444-1066.

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