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Tuesday, Oct 27 2015

Full Issue

Health Law Marketplace Plan Costs To Go Up An Average Of 7.5 Percent

This estimate, offered Monday by Health and Human Services officials, is based on the benchmark second-lowest silver-level plan.

The Obama administration said many consumers will see noticeable premium increases when buying health coverage on insurance exchanges in 2016, acknowledging for the first time what many health-care experts had predicted. ... The higher premiums are likely to intensify Republican’s claims that the health law isn’t holding down costs. The Obama administration is urging customers to go back online during open enrollment, which begins Nov. 1, and shop around to see if they can limit the impact of the cost increases. (Armour, 10/26)

Consumers on Monday began shopping online for health insurance through the Affordable Care Act on a newly remodeled version of HealthCare.gov that worked more or less as promised by the government. When a consumer searches for health plans on the federal website, the results are listed in order of price — the premium — from the cheapest to the most expensive. But consumers can also see plans ranked by deductible, or the amount they must pay up front before the insurance begins to pay. (Pear, 26)

The HHS report, released late Monday, focuses on the monthly premiums for the second-lowest silver plan, also called the benchmark, which is used by the Internal Revenue Service to calculate tax credits to help pay for the premiums. The credits are available to people with incomes between 100 percent and 400 percent of the federal poverty line ($11,770 to $47,080 for an individual) who purchase coverage on the federal or state-based online marketplaces, or exchanges. (Carey and Rau, 10/27)

The federal government says the cost of a benchmark plan on HealthCare.gov will increase 7.5 percent for 2016 coverage, but most people will still be able to buy a plan for less than $100 a month, after tax credits. ... Insurers in many states had underpriced their plans and are raising rates because of medical inflation and higher claims than expected. Insurers are trying to find the right prices in the new marketplace. (10/26)

About 70% of those who return to the federal insurance exchange when open enrollment starts Nov. 1 will pay less than $75 a month after they receive tax credits, a government analysis released Monday shows. ... The new report did not address the important issue of total out-of-pocket costs, which include deductibles, co-payments and other cost sharing. Many people who shop based on premium costs alone can be alarmed when they see how much they have to contribute to their health care on top of their monthly premiums. (O'Donnell, 10/26)

But the average rate hikes will vary dramatically from state to state — skyrocketing more than 30 percent in Alaska, Montana and Oklahoma while dropping 12.6 percent in Indiana. ... Those benchmark plans, which are among the most popular sold on the law's health insurance exchanges, are important because they're used to calculate how much federal support low- and middle-income exchange customers will receive toward their monthly premiums. (Demko, 10/26)

The analysis is based on hundreds of health plans sold in local markets within 37 states that use HealthCare.gov, the federal online insurance marketplace. It excludes plans in other states that have created separate ACA insurance marketplaces. The rates reflect the prices of the second-least expensive health plan in each market for 2016 in a tier of coverage known as silver. ACA health plans are divided into four tiers, all named for metals, depending on the amount of customers’ care that they cover. Silver plans have proven by far the most popular. Officials at HHS issued the analysis as less than a week remains before the start on Nov. 1 of a third open-enrollment season for Americans eligible to sign up for health plans under the insurance marketplaces created by the 2010 health-care law. (Goldstein, 10/26)

The Obama administration has been seeking to make sure affordable options are available as part of its goal of getting more people signed up for insurance in the 2016 enrollment period, which starts Sunday. Those who remain uninsured tend to be younger and poorer than people who’ve already signed up, HHS Secretary Sylvia Mathews Burwell has said. Some insurers had sought rate increases of 10 percent or more for 2016, raising concerns that cheap options would dwindle. (Tracer, 10/26)

The increase for next year does not take into account the billions of dollars in government subsidies that are given to people on the exchanges. It also doesn’t include the dozen state marketplaces that set their own rates and determine their own benchmark plans. The data released Monday afternoon shows that the change in premium prices varies widely among the 34 states. (Ferris, 10/26)

When the health insurance marketplaces open on Sunday, consumers shopping for 2016 coverage may encounter steeper premium increases than last year and more plans that offer no out-of-network coverage. ... Although most consumers zero in on premiums when comparing plans, next year it could be especially important to pay attention to the network of doctors and hospitals that are part of the plans that they’re considering. There will likely be fewer plans that cover broad networks of providers, says Kathy Hempstead, who directs health insurance coverage issues for the Robert Wood Johnson Foundation. In addition, a growing number of marketplace plans will cover only doctors or hospitals in their provider networks. (Andrews, 10/27)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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