I think we all knew this was coming, and this is the opening salvo, but some of these numbers have permanently lodged my eyebrows in my hair. From the WSJ:
Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans.
The projections, made in sessions with brokers and agents, provide some of the most concrete evidence yet of how much insurance companies might increase prices when major provisions of the law kick in next year—a subject of rigorous debate.
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The projected increases are at odds with what the Obama Administration says consumers should be expecting overall in terms of cost. The Department of Health and Human Services says that the law will "make health-care coverage more affordable and accessible," pointing to a 2009 analysis by the Congressional Budget Office that says average individual premiums, on an apples-to-apples basis, would be lower.
The gulf between the pricing talk from some insurers and the government projections suggests how complicated the law's effects will be. Carriers will be filing proposed prices with regulators over the next few months.
Part of the murkiness stems from the role of government subsidies. Federal subsidies under the health law will help lower-income consumers defray costs, but they are generally not included in insurers' premium projections. Many consumers will be getting more generous plans because of new requirements in the law. The effects of the law will vary widely, and insurers and other analysts agree that some consumers and small businesses will likely see premiums go down.
Starting next year, the law will block insurers from refusing to sell coverage or setting premiums based on people's health histories, and will reduce their ability to set rates based on age. That can raise coverage prices for younger, healthier consumers, while reining them in for older, sicker ones. The rules can also affect small businesses, which sometimes pay premiums tied to employees' health status and claims history.
The law's 2014 effect on larger companies is likely to be more limited. Many of the big changes coming next year won't touch them as directly as individual consumers and small businesses, though some will have to grapple with the cost of covering more workers or paying a penalty.
The possibility of higher premiums has become the latest focal point of the political tussle over the health law, which marks its third anniversary Saturday. Republican lawmakers have held hearings on the issue, and six GOP members of the House Energy and Commerce committee wrote last week to more than a dozen insurers asking them to turn over internal analyses on the law's impact on premiums and costs.
The insurance industry has also been talking publicly about big potential premium increases in lobbying for tweaks to the law.
The individual market includes about 15 million people, and around 18% of the roughly 149 million with employer coverage were at small companies, according to 2011 figures from the Kaiser Family Foundation. The individual market is expected to grow to around 35 million people by 2016 as a result of the law.
In a private presentation to brokers late last month, UnitedHealth Group Inc., the nation's largest carrier, said premiums for some consumers buying their own plans could go up as much as 116%, and small-business rates as much as 25% to 50%. The company said the estimates were driven in part by growing medical costs not directly tied to the law. It also cited the law's requirements that health status not affect rates and that plans include certain minimum benefits and limits to out-of-pocket charges, among other things.
Jeff Alter, who leads UnitedHealth's employer and individual insurance business, said the numbers represented a "high-end scenario," not an average. "There are some scenarios in which a member could see as much as a 116% increase or over," he said, though others, such as some older consumers, could see decreases. He said the company dwelled on the possible increases because it was trying to prepare brokers to speak with clients facing big jumps.
Other carriers have also projected steep rate increases during private meetings and conversations with brokers. Brokers say they are being told to prepare the marketplace for small-business and individual rate increases as carriers get ready to file specific rate proposals and plan designs with regulators.
Insurers are "not being shy that premiums are going to increase in 2014," and are urging brokers to "brace our clients," said John Lacy, vice president of group benefits at Bouchard Insurance, a brokerage in Clearwater, Fla. His firm has been hearing from carrier representatives that individual premiums in Florida could go up 35% to 50%, on average, and small-business rates around 30%, though it hopes to find strategies to blunt the impact.
Aetna Inc., in a presentation last fall to its national broker advisory council, suggested rates on individual plans not being grandfathered under the law could go up 55%, on average, and gave a figure of 29% for small business rates. Both numbers included 10 percentage points tied to medical-cost inflation, not the law. An Aetna spokesman said the numbers are "still generally in line with what we've been estimating," and represented the average impact in a typical state.
An official with Blue Cross & Blue Shield of North Carolina told a gathering of brokers last week that individual premiums could go up by as much as 40% to 50%, according to brokers who were present. A spokeswoman for the insurer said "we don't have final numbers" yet on premiums.
There has long been debate, even among insurance experts, over how the law will affect premiums. Because the effect is likely to vary, different measurements can arrive at different conclusions. The CBO analysis cited by the administration determined that average premiums for consumers who buy their own coverage would be 14% to 20% lower because of the law—if the law didn't change the types of plans they purchased.
But the CBO also suggested the law would lead to consumers buying more expensive plans, largely because it requires coverage to include certain benefits and limit charges such as deductibles. When this effect was taken into account, the average premiums would go up 10% to 13%, the agency said, though subsidies would ease the bite for most people. The agency also said small-business policies were likely to cost within a few percentage points of the amount they would have without the law.
Health and Human Services officials say competition among insurers, as well as provisions to limit their financial risk from attracting high-cost consumers, will exert downward pressure on premiums, and point to the tax subsidies that will limit many consumers' costs.
Subsidies will be available on a sliding scale for people with incomes of up to four times the federal poverty level—currently $45,960 for a single person and $94,200 a year for a family of four. More than half of the 35 million people expected to be in the individual market by 2016 are likely to qualify for credits. People whose incomes are around the poverty level could see almost all of the cost of their insurance subsidized, while people at the upper end will get only a small discount toward their premiums.
Post by EloiseWeenie on Mar 23, 2013 8:04:48 GMT -5
An official with Blue Cross & Blue Shield of North Carolina told a gathering of brokers last week that individual premiums could go up by as much as 40% to 50%, according to brokers who were present. A spokeswoman for the insurer said "we don't have final numbers" yet on premiums.
I already pay close to $400/mo for me and Amelia through BCBSNC, which for my H's salary is a large percentage. I guess I'll be GBCNing from the poor house next year.
I'm convinced that the health insurance model is ultimately unsustainable. The median household income in this country is ~$55,000 per year. A monthly premium of $458.33 would be 10% of that household's income. And that's before any OOP costs for services. What percentage of income can we realistically expect the average household to spend on healthcare?
Has there been anything about the tax on Cadillac plans? I know I read some things several months ago, but if our premiums go up much at all we will easily be in that position of being taxed. It was a very thin margin if I am remembering the numbers correctly.
And then I will light shit on fire because our premiums cost a fuckton already. Like way more than we spend on healthcare for a year but it is the only option. They added an HSA plan this year for the first time but the cost difference was only $1600 in premiums which didn't make sense because we would easily spend that much in a year and with the traditional plan we have no deductible or 80/20 stuff but the HSA plan had those things, obviously. It was a no brainer.
I'm convinced that the health insurance model is ultimately unsustainable. The median household income in this country is ~$55,000 per year. A monthly premium of $458.33 would be 10% of that household's income. And that's before any OOP costs for services. What percentage of income can we realistically expect the average household to spend on healthcare?
How much would it cost in taxes if we switched to UHC?
I'm convinced that the health insurance model is ultimately unsustainable. The median household income in this country is ~$55,000 per year. A monthly premium of $458.33 would be 10% of that household's income. And that's before any OOP costs for services. What percentage of income can we realistically expect the average household to spend on healthcare?
How much would it cost in taxes if we switched to UHC?
i don't have an answer. I have no clue.
I don't know, but I really just don't see another way.
The market does a shit job of dealing with healthcare.
I'm convinced that the health insurance model is ultimately unsustainable. The median household income in this country is ~$55,000 per year. A monthly premium of $458.33 would be 10% of that household's income. And that's before any OOP costs for services. What percentage of income can we realistically expect the average household to spend on healthcare?
That might be the ultimate purpose: to make the current model unsustainable so that the masses will begin clamoring for the "public option" and ultimately "single payer." I do not know why it is a surprise to many that with 30 million people entering the system, the costs will increase.
There's an interesting piece in Politico about how the health care reform remains unpopular, even though proponents said it would gain popularity with time.
I'm convinced that the health insurance model is ultimately unsustainable. The median household income in this country is ~$55,000 per year. A monthly premium of $458.33 would be 10% of that household's income. And that's before any OOP costs for services. What percentage of income can we realistically expect the average household to spend on healthcare?
That might be the ultimate purpose: to make the current model unsustainable so that the masses will begin clamoring for the "public option" and ultimately "single payer." I do not know why it is a surprise to many that with 30 million people entering the system, the costs will increase.
There's an interesting piece in Politico about how the health care reform remains unpopular, even though proponents said it would gain popularity with time.
This is actually a pretty popular theory floating around.
I'm with angry. I just don't see how this is sustainable in the long term and something is going to have to give.
Right, I'm just curious if it will also be as high of a cost, because then either way cost can't be argued as the issue.
I say that as someone who adored UHC in the UK, so I'm not trying to argue against it.
I would think it would be lower. If everyone in the nation is covered, then it's the same cost if you add up the total of their premiums, minus the billions of dollars siphoned away by insurance company profits, marketing costs, administrative costs, and other middleman costs. It has to be cheaper.
Post by druidprincess on Mar 23, 2013 10:25:07 GMT -5
Kudos to the first of us who can pull up the threads where many of us were predicting this from the start. Look how quickly UHC got on the table. I'm sorry, but anyone will have an extremely high difficult time removing my tinfoil hat from this wardrobe.
Kudos to the first of us who can pull up the threads where many of us were predicting this from the start. Look how quickly UHC got on the table. I'm sorry, but anyone will have an extremely high difficult time removing my tinfoil hat from this wardrobe.
im right there with you crying that we didn't even need a "public option" to get to this point. I love how this is all a "market" failure. As if this industry looks anything like a free market. The only optimistic thing I can say is MAYBE this would cause our brilliant leaders in DC to care about the cost of care and insurance instead of ignoring it and pretending that isn't the main problem we have.
I don't believe for one second that all of this is tied to ACA. The article itself states that up to 10% is because of increases in costs NOT associated with ACA (which is a seperate conversation we do need to have), and that's insurance lobbyists (fuckers) are using threats of increased premiums to lobby for tweaks in the bill.
Does the ACA have a provision that rates have to be approved? I can't remember, but lots of states do have that (including mine) and threats of higher premiums often cannot be justified based on the actuary data. I think there's still a lot more to this story.
Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans.
I wish I could remember one year, just one, where they didn't go up sharply. It seems like it doesn't matter the circumstances, your health insurer is going to raise your premiums, a lot, every year.
Considering that they're now going to insure lots of healthy 20 year olds who typically didn't bother with health insurance and don't typically need doctors, that should be a windfall for them that should offset whatever is driving costs the other way.
I would have much preferred government run health care to one that left insurers involved.
I don't believe for one second that all of this is tied to ACA. The article itself states that up to 10% is because of increases in costs NOT associated with ACA (which is a seperate conversation we do need to have), and that's insurance lobbyists (fuckers) are using threats of increased premiums to lobby for tweaks in the bill.
Does the ACA have a provision that rates have to be approved? I can't remember, but lots of states do have that (including mine) and threats of higher premiums often cannot be justified based on the actuary data. I think there's still a lot more to this story.
This was my thought, as well. The article was written in such a scare-tactic manner.
And even if the entire increase was directly tied to the ACA, the fact is that it is completely unacceptable for us to have so many people uninsured and underinsured. There are major problems with our health insurance and health care system, but we cannot expect to move forward as a nation if we bury such large portions of our populace in a hole in which they cannot even get basic health care.
Post by druidprincess on Mar 23, 2013 12:22:38 GMT -5
Base point being the insurers (who are hateful, let's be clear) still have the power and motivation to do this. Which gets back to the root cause that HCR did not in fact get to the root cause of our fucked up health insurance/care system. Which gets back to the part where I'm not one whit surprised at this outcome and progression.
Base point being the insurers (who are hateful, let's be clear) still have the power and motivation to do this. Which gets back to the root cause that HCR did not in fact get to the root cause of our fucked up health insurance/care system. Which gets back to the part where I'm not one whit surprised at this outcome and progression.
The ACA is probably the best thing that could have ever happened to insurance companies.
To tie together ttt and asdfjkl's points, ACA IS the best thing to happen to health insurers, and yet those greedy, greedy fuckers are so fuckimg greedy they're going to destroy it for themselves. Greedy fuckers.
Well I remember saying back when the ACA was passed that I knew it was a complete shit sandwich since the people happiest about it were the insurance companies.
Whats the alternative? How do we make health care affordable for that family making $55,000 per year? How do we make sure that family can get care without going bankrupt?
Congress has been more interested in keeping/growing their contributions to get reelected than working on solving our jobs/economic problems or any other problems.
Whats the alternative? How do we make health care affordable for that family making $55,000 per year? How do we make sure that family can get care without going bankrupt?
Death panels.
i am 100% pro-death panel.
Also, enforce stuff like evidence based guidelines for mammograms, colonoscopies, etc. no, you don't need one every year (unless you are special, and have the bad genetics).
Idk, I know some will make a snide comment to me over this, but I just keep thinking about corporate welfare, citizens united, not taxing rich people enough, taxes made to hurt the poor specifically, etc. Say we did fix all of those - just say- how much would all that $$ in the system now get us to a great UHC program? I mean, we keep coming back to "we can't afford that" but that doesn't mean we could NEVER afford it under any circumstance. Obviously other 1st worlds are affording it and still have things like rich people and corporations and UHC. It's just a rhetorical question, really. I guess I just hate the conversation ender of "we can't afford that idea" as if the budget doesn't have the ability to change.
I'm not anti UHC, but what scares me is we would probably just implement it without actually having a funding plan (other than debt) established. Congress is idiotic like that.
Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans.
I wish I could remember one year, just one, where they didn't go up sharply. It seems like it doesn't matter the circumstances, your health insurer is going to raise your premiums, a lot, every year.
I can! My H's insurance did not go up AT ALL in 2012. His employer is self-insured. The premiums remained the same - or at least the employee portion remained the same. His insurance year is Jan 1 - Dec 31. The increase for 2013 was something like 3% - not bad.
At my job, my school pools together with other schools to broaden our group. Our premiums are also remaining fairly stable for this year (our year renews on June 1). Our premiums are going up something like 1% this year.
Both of us have insurance companies based in Massachusetts and insurance out of Mass.
I wish I could remember one year, just one, where they didn't go up sharply. It seems like it doesn't matter the circumstances, your health insurer is going to raise your premiums, a lot, every year.
I can! My H's insurance did not go up AT ALL in 2012. His employer is self-insured. The premiums remained the same - or at least the employee portion remained the same. His insurance year is Jan 1 - Dec 31. The increase for 2013 was something like 3% - not bad.
At my job, my school pools together with other schools to broaden our group. Our premiums are also remaining fairly stable for this year (our year renews on June 1). Our premiums are going up something like 1% this year.
Both of us have insurance companies based in Massachusetts and insurance out of Mass.
That's awesome. I had the opposite experience in that my Blue Cross was going to up a bit in 2012 - but then I ended up working for another company and paying through the nose for a shittier Cigna policy.
The price of that plan was going to be a lot more this year, so now I'm on a high deductible plan where my employer contributes 1000 a year. And the odd thing is, that paying all my own medical bills until I reach my deductible (we both had pneumonia, so not a typical year so far!) makes me wonder if we ever needed medical insurance at all, beyond for major hospitalization. And how much are medical costs driven up by the fact that every doctor has to hire people to deal with (fight with) insurance companies? Bringing in a middle man probably wasn't the smartest thing we ever did...
On the other hand, the statements I get that indicate the amount charged versus the negotiated insurance cost are simply outrageous. I really hope to God no one is paying that much for the same service!