A breakdown of healthcare cost increases for a previously underwritten policy

[Mulligan]

I found this and am still digging, but this came from WellPoint. It shows the current premium for a healthy 25 year old receiving now. It then shows the cost of all the additional requirements and taxes that change the premium. Notice how all the taxes get "passed through" to the consumer. I like the $29 add on due to people waiting to get sick to get paid for services. Keep in mind this is payment without any subsidies. So a 25 year old will see his premium go up from $60 to $178. I am in Mo with an $88 premium and almost 50. This basically confirms I am probably going to get smacked harder as I am a lot older.

Individual Market Case #1: Younger/Healthier 25-Year Old Male in St. Louis, MO
Product:
Contract Type, Gender and Subscriber Age: Underwriting Class:
Lumenos $3000 ded, 100% Coins Single Male Age 25 Preferred (Best)
Single Monthly Premium
% Increase
Current premium
$60
Impact of guaranteed issue and no effective individual mandate, resulting in many waiting to purchase until services are needed
$89
50%
Limiting age discount to 3:1; eliminating gender rating
$118
32%
Eliminating health status discount
$153
30%
Requiring higher benefit level (70% actuarial value and required new benefits)
$171
12%
Health insurer $6.7B annual tax
$176
3%
Pharmaceutical tax and medical device tax
$178
1%
Total Impact
$60 to $178
199%

Notes:
• Methodology for each element presented in the Appendix.
• Impact for guaranteed issue with no effective mandate expected to be in the range of 20% to 80%; the midpoint of
50% is shown.
• Display reflects costs for new sales; to the extent that pre-reform benefits and rating rules are grandfathered,
existing members will initially experience minimal impacts post-reform. However, new purchasers will face these
pricing changes.
• In the Senate Finance Committee legislation, those 25 and under are eligible to purchase a product with more
modest benefits, but this is not available in the Senate HELP or House bills. If this provision is incorporated into the final legislation, those 25 and under will not likely face higher premiums due to richer benefit requirements.

 

[Mulligan]

Added clarification. These were just projected numbers and not formal proposals of any type for MO. I get frustrated because this state has an absolute wall of silence except for the fact that they did release names of companies who will participate. But not a whisper about prices. Hopefully there will be some negotiations with the Feds or a company providing lower rates will cause others to drop theirs. It did also mention that an older unhealthy couple of 60 could see their premiums decrease about 10% from what they are currently paying.

 

[samclem]

Mulligan,
Thanks. That at least provides a glimpse as to the "why" of the premium differences some people will see.

Notes: . . . .

• In the Senate Finance Committee legislation, those 25 and under are eligible to purchase a product with more
modest benefits, but this is not available in the Senate HELP or House bills. If this provision is incorporated into the final legislation, those 25 and under will not likely face higher premiums due to richer benefit requirements.

This note indicates the estimate was done some time ago--before final passage of the law. It is possible that Wellpoint's illustration was designed to "influence as well as to inform."

 

[Mulligan]

Mulligan,
Thanks. That at least provides a glimpse as to the "why" of the premium differences some people will see.

This note indicates the estimate was done some time ago--before final passage of the law. It is possible that Wellpoint's illustration was designed to "influence as well as to inform."

Yes, good point. I knew it was in the past, but didn't know when that is why I tried add that I knew it wasn't the actual rate request. Of course none of this means anything if you cannot get the cheapest rate to begin with. I do love the breakdowns. It sure seems the percentages are coming through though pertaining to healthy people in underwriting states. There was also a chart I couldn't extract that should various percent increases in various states based on the reform legislation. It showed California and New York as not having increases from them, which turned out basically true, and mentioned others such as Ohio have nice increases which also has turned out true. The breakdowns were very interesting to me. And this is a small and meaningless point, but I hate this sideshow of taxes imposed on companies trying to trick people into thinking they are not paying for it when ultimately they will. Just put it out there front and center and be done with it.

 

[NW-Bound]

In Arizona, there was no health insurance with underwriting (state law?). Hence, we have always paid a higher premium although we had been healthy, and I was very much surprised when I learned you paid so little. I did not know there was another type of insurance. Here, the only requirement was continuity of coverage from another insurance, either COBRA or private.

But now, I have suddenly become one of those undesirables with a preexisting condition. You'll never know!

 

[fisherman]

Mulligan,

Open to moving to MO from TN for a rate like that. Our states have similar HC laws. Would you be willing to post the details of your policy? Out of pocket Max in and out of Network, co-pays if any, if it is a comprehensive policy or catastrophic only, Lifetime max, and annual max, etc.

I have not found a rate near that here in the last seven years and we have a fully underwritten policy with no riders and excellent health. The closest is a farm bureau policy with a 10K deductible then 80% copay up to 25K out of pocket with a 100K max annual and 1mill max lifetime caps. That policy is likely not available next year and I really do not see it fitting our needs.

 

[Mulligan]

Mulligan,

Open to moving to MO from TN for a rate like that. Our states have similar HC laws. Would you be willing to post the details of your policy? Out of pocket Max in and out of Network, co-pays if any, if it is a comprehensive policy or catastrophic only, Lifetime max, and annual max, etc.

I have not found a rate near that here in the last seven years and we have a fully underwritten policy with no riders and excellent health. The closest is a farm bureau policy with a 10K deductible then 80% copay up to 25K out of pocket with a 100K max annual and 1mill max lifetime caps. That policy is likely not available next year and I really do not see it fitting our needs.

Fisherman, sorry but the cheap rates for healthy people are over. After Dec. 31, the underwritten policies are gone. If you got a policy today, it would only be in effect through the end of the year. At the most until end of next year if the company allowed you to extend it through a technical loophole in the healthcare act. I think after all the 50 states rates are released, you are not going to see the wide ranges in rates throughout the states like it has been in the past. FWIW- it was a policy I was comfortable carrying until Medicare. $5500 deductible, after deductible it covered 100% everything including prescriptions, 7 million lifetime cap.

 

[fisherman]

Fisherman, sorry but the cheap rates for healthy people are over. After Dec. 31, the underwritten policies are gone. If you got a policy today, it would only be in effect through the end of the year. At the most until end of next year if the company allowed you to extend it through a technical loophole in the healthcare act. I think after all the 50 states rates are released, you are not going to see the wide ranges in rates throughout the states like it has been in the past. FWIW- it was a policy I was comfortable carrying until Medicare. $5500 deductible, after deductible it covered 100% everything including prescriptions, 7 million lifetime cap.

That was a great policy. You hit the jackpot on it. Similar to what I started with but was jacked up pretty quick by the insurer.