“Don’t Expect Premiums to go Down With Health Care Reform – Some Customers Might See Increases of 50 to 70 Percent”
“Reasons for the increases are all a bit technical, as is seemingly everything associated with the new law. A key point is that right now, most people who buy their own insurance policies, rather than obtaining them through their employers, try to minimize premium costs by buying policies with larger deductibles and copayments. But under health care reform, insurance policies will have to provide a richer level of benefits. The typical LifeWise customer purchases a policy with an actuarial value of 0.4 – meaning that the aggregate percentage of medical costs that are paid by the health plan rather than the customer is 40 percent. Under health care reform, plans that are sold on exchanges must have a value of at least 60 percent. So that means the benefits package has to be 50 percent richer.
Under the federal law, insurance companies can offer policies outside the exchange as well. But the Washington Legislature passed a law this year that essentially says insurance companies must provide the same policies outside the exchange as they do within it – because without the rule, state regulators argued that customers would flee and buy less-expensive insurance on the open market.
Add the effect of the mandates and taxes that are embedded in the act, and the fact that insurance companies will not be able to deny coverage to those with a pre-existing condition. Then add the fact that customers now served by the state’s program for high-risk customers will be entering the general insurance population. It becomes clear that the cost of the typical insurance policy will go higher, Roe said.
And the law doesn’t provide much relief. The law will offer subsidies in the form of tax credits to those who make less than 400 percent of the federal poverty level. But most current purchasers of insurance policies will not qualify, and for those who do, the subsidies may not be enough to offset the cost. That’s because the subsidies will be set on a sliding scale based on income.
“I think it is staggering that in fact the Affordable Care Act increases the per-person cost of health care from $9,000 to $14,000,” he said. “I find that just staggering. To focus in on two costs, though, I think really drives home that point.”
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