2015 ACA Premium Increases

[ERhoosier]

Over three decades, health care costs in the US rose from 7% of GDP to 17%. A clearer trend could not exist. The rate of increase appears to have slowed, probably because it reached the level of general unaffordability.

Health care reform is not about cost and is best described by the concept of "Triple Aim", which is The PPACA is one step in that direction, not yet fully implemented, and probably too early to measure the impact.

The upward trend in US HC costs has not been a straight line, but has had periods of slowing followed by reinflation (e.g. 61-65, 72-73, 96-98).
IMHO- It's too early to call recent lull in HC inflation a change in the overall upward trend, although I sure hope it is.
FWIW- US gov't's historical HC inflation data is available here (searchable by various annual periods)-
Bureau of Labor Statistics Data

I agree that cost is not the only aim of HC reform, but it is a major one. It was touted as such from the beginnings of the ACA debate. Ultimately cost containment is critical to the sustainability of any HC system (private insurance, single-payer, or socialized). It is axiomatic that if costs rise beyond point of "unaffordability", population health & experience will be adversely affected by the decline in real access to HC services. Only time will tell if ACA was indeed a meaningful step in cost containment. I personally doubt it. Most major CC features of ACA have already been implemented. I discount FY 2014 data as a blip as all parties absorbed the complex roll-out of the new system. But IMHO FY 2015 should have brought a meaningful decline in HI premiums across the US. The prelim data suggests this is not the case. I hope history proves me wrong, but I feel unsubsidized FIRE's should be prepared for a resumption of significant rate hikes in 2016 and beyond.

 

[brewer12345]

There is a really, really simple way to control healthcare costs: monopsony. Our elected leaders chose not to do this when the changes were made to the system a few years ago. So we swim through the murky seas as best as we are able. Fun, eh?

 

[ERhoosier]

There is a really, really simple way to control healthcare costs: monopsony....

HC costs are a growing problem across ALL nations' HC systems regardless of who pays the bills. Interestingly, future national HC spending growth projected by OECD (2013 report below) is expected to be lowest in US, UK, and Nordic states, 3 states with very different ways of funding HC.
http://www.oecd.org/eco/growth/aaaaaawhatfuture.pdf

And a report released just yesterday by CMS tends to support that OECD prediction of HC cost acceleration. The CMS report projects US HC spending to pick up significantly in both gov't and private HI programs.
http://www.cms.gov/Research-Statist...tionalHealthExpendData/Downloads/Proj2013.pdf

 

[Brat]

My DIL just got back from a meeting with their business insurance agent (small employer), she said that rates went up 25% as a result of complying with ACA, that the insured would have a lot less at risk but it is costing them a bundle.

 

[Htown Harry]

There is another newly-released set of data derived from analyzing rate filings, this time from the Kaiser family Foundation:

Link to summary here (a link to the full report is at the upper right): Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation

The analysis examines premium changes for the lowest-cost bronze plan and the two lowest-cost silver plans in 16 major cities. The second-lowest cost silver plan in each state is of particular interest as it acts as a benchmark that helps determine how much assistance eligible individuals can receive in the form of federal tax credits. The findings show that in general, individuals will pay slightly less to enroll in the second-lowest cost plan in 2015 than they did in 2014, prior to the application of tax credits.

Analysis of the report from former Washington Post reporter Sarah Kliff:
Some big Obamacare news: premiums will fall in seven big cities - Vox

Once again, it appears the early speculation of significantly jacked-up Year Two individual policy premiums was off the mark.

 

[MichaelB]

There is another newly-released set of data derived from analyzing rate filings, this time from the Kaiser family Foundation:

Link to summary here (a link to the full report is at the upper right): Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation
Analysis of the report from former Washington Post reporter Sarah Kliff:
Some big Obamacare news: premiums will fall in seven big cities - Vox

Nice links, Harry.

 

[scrabbler1]

A few weeks ago, I posted in this thread about how my insurance preovider, Empire BCBS of New York, had filed a rate increase of about 18%. After some research, I discovered that their filed increase was reduced to about 7%, some good news. The 18% increase reminded me of the 2 huge increases I got hit with in 2010 and 2011 when my pre-ACA individual policy jumped 20% then another 25%, or 50% when taken together compared to what I was paying in 2009.

For those of you who live in New York, here is a link to the press release by the state's Department of Financial Services (DFS):

Press Release - September 4, 2014: Superintendent Lawsky Announces Setting Of 2015 Health Insurance Rates For New York, Including Rates For Health Benefits Exchange

And below is a summary chart of rate changes for the individual market: (Sorry, I don't know how to format it in the table form it appears in the link, but it is still readable.)

2015 INDIVIDUAL MARKET RATE ACTIONS - OVERALL SUMMARY

Company
Requested
Approved
Reduction
Aetna Life Insurance Co.
19.96%
5.32%
-14.64%
Affinity Health Plan*
-12.58%
-15.21%
-2.63%
CDPHP*
6.69%
0.15%
-6.54%
Emblem-HIP*
9.81%
6.72%
-3.09%
Empire BlueCross BlueShield HMO*
18.40%
7.37%
-11.03%
Excellus*
19.59%
9.23%
-10.36%
Fidelis*
7.14%
3.23%
-3.91%
Health Republic Insurance of New York*
15.35%
13.04%
-2.31%
Healthfirst*
-9.67%
-11.95%
-2.28%
HealthNow*
7.24%
1.41%
-5.83%
Independent Health Benefits Corp.*
5.44%
-2.01%
-7.45%
MetroPlus Health Plan*
17.78%
6.90%
-10.88%
MVP Health Care*
18.31%
9.97%
-8.34%
Care Connect (North Shore LIJ)*
-1.24%
-3.22%
-1.98%
Oscar*
6.28%
6.28%
0.00%
Oxford Health Plan
1.08%
-9.41%
-10.49%
UnitedHealthcare of NY*
-5.85%
-15.32%
-9.47%
All companies
12.50%
5.70%
-6.80%

* Companies that offer individual coverage on the NY State of Health Individual Marketplace
(Note: Freelancers Insurance Company, Crystal Run Health Plan, Montefiore Insurance Company and Wellcare of NY* are new entrants to the market and are selling new products with new premium rates, and therefore did not request rate increases. Accordingly, their premium rates are not shown in the above chart.)

 

[Mulligan]

I live in a state (MO) that has zero regulatory control over prices. And there is still zero info coming out for coming years rates. I'm getting kicked into this process at the end of the year, so I have added interest in the rates this year. Last years ACA rates in comparison to other states were quite reasonable though despite any regulatory control. I wonder if some regulated states are playing cat and mouse games. Meaning the companies throw out high increases knowing they will get pared back.


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[travelover]

........... I wonder if some regulated states are playing cat and mouse games. Meaning the companies throw out high increases knowing they will get pared back.................

I'm sure that they never even thought of that..........

 

[pb4uski]

I live in a state (MO) that has zero regulatory control over prices. And there is still zero info coming out for coming years rates. ....

Are you sure about that? Surely there must be product filings and reviews of them by the insurance department - I have never heard of a state where there is not some sort of process.

 

[Mulligan]

Are you sure about that? Surely there must be product filings and reviews of them by the insurance department - I have never heard of a state where there is not some sort of process.

PB, let me clarify...they have no control over the prices carriers charge. They do have to submit them though. So it's kinda of like a procedure of my dad by law would have had to warn me he was going to beat me hard for misbehavior before he could actually do it. There are procedures and such but not on the only thing that concerns me which is price.


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[scrabbler1]

Are you sure about that? Surely there must be product filings and reviews of them by the insurance department - I have never heard of a state where there is not some sort of process.

I don't know about health insurance, but in my 23 years working in personal auto insurance there were many "File and Use" states in which the insurers simply filed their rate changes and put them into effect. I never worked on Missouri so I don't know if that was one of the File & Use states for personal auto.

 

[ERhoosier]

There is another newly-released set of data derived from analyzing rate filings, this time from the Kaiser family Foundation:

Link to summary here (a link to the full report is at the upper right): Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation
Analysis of the report from former Washington Post reporter Sarah Kliff:
Some big Obamacare news: premiums will fall in seven big cities - Vox

The Kliff article title is misleading. The KFF analysis found ave Silver premiums were decreasing slightly, but ave Bronze premiums were INcreasing 3.3%. And these were "final" rates for some of the cities but only "preliminary" for others.
http://kaiserfamilyfoundation.files.wordpress.com/2014/09/8627-analysis-of-2015-premium-changes.pdf
As the KFF press release itself puts it-
"... it is important to bear in mind that the overall picture may change as comprehensive data across all fifty states becomes available."
Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation

Will indeed be interesting to see if KFF or PWC's estimates turn out to be closer to actual 2015 rates.

 

[brewer12345]

The Kliff article title is misleading. The KFF analysis found ave Silver premiums were decreasing slightly, but ave Bronze premiums were INcreasing 3.3%. And these were "final" rates for some of the cities but only "preliminary" for others.
http://kaiserfamilyfoundation.files.wordpress.com/2014/09/8627-analysis-of-2015-premium-changes.pdf
As the KFF press release itself puts it-
"... it is important to bear in mind that the overall picture may change as comprehensive data across all fifty states becomes available."
Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation

Will indeed be interesting to see if KFF or PWC's estimates turn out to be closer to actual 2015 rates.

And here we are jumping up and down trying to figure all this out now when in a couple months or so it will be known to one and all. Silly.

 

[ERhoosier]

And here we are jumping up and down trying to figure all this out now when in a couple months or so it will be known to one and all. Silly.

And it is silly to be so focused on premium projections when changes in plan design features (inc networks) may be far more important. What good is a decrease in premiums to a heart patient if the only heart surgeons/hospitals left in network have historically worse outcomes

 

[Mulligan]

And it is silly to be so focused on premium projections when changes in plan design features (inc networks) may be far more important. What good is a decrease in premiums to a heart patient if the only heart surgeons/hospitals left in network have historically worse outcomes

Very true for many people I am sure. Until I have a health problem though I will get the cheapest one within reasonable driving distance even if the facility is a tent with no AC!


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[brewer12345]

And it is silly to be so focused on premium projections when changes in plan design features (inc networks) may be far more important. What good is a decrease in premiums to a heart patient if the only heart surgeons/hospitals left in network have historically worse outcomes

Very true. Had we simply gone to single payer that problem would have been eliminated.

 

[ERhoosier]

Very true. Had we simply gone to single payer that problem would have been eliminated.

The specifics would change, but the core patient issue would still be there. Difficulties seeking the best available care are certainly not eliminated by single payer.

Ask too many US vets struggling with the VA.

Or the recent case in UK in which the parents of a child with a brain tumor were arrested under Interpol warrant when they fled to Spain to arrange an expensive treatment for him (proton beam therapy, which is routinely approved by all major US HI carriers).
Ashya King: 'Cruel NHS has not given us the treatment we need', says father of five-year-old with brain tumour who fled to Spain - Home News - UK - The Independent

Or the Newfoundland Premier pursuing cardiac surgery in the US vs Canada-
Canadian official seeks heart surgery in US | UTSanDiego.com

There just ain't no single perfect HC system.

 

[ziggy29]

Very true. Had we simply gone to single payer that problem would have been eliminated.

Not the network issue, not entirely. In single payer, presumably providers would be permitted to opt out and develop a cash-only practice. If some of the best doctors and facilities went that way, you'd have the same problem.

 

[brewer12345]

The specifics would change, but the core patient issue would still be there. Difficulties seeking the best available care are certainly not eliminated by single payer.

Ask too many US vets struggling with the VA.

Or the recent case in UK in which the parents of a child with a brain tumor were arrested under Interpol warrant when they fled to Spain to arrange an expensive treatment for him (proton beam therapy, which is routinely approved by all major US HI carriers).
Ashya King: 'Cruel NHS has not given us the treatment we need', says father of five-year-old with brain tumour who fled to Spain - Home News - UK - The Independent

Or the Newfoundland Premier pursuing cardiac surgery in the US vs Canada-
Canadian official seeks heart surgery in US | UTSanDiego.com

There just ain't no single perfect HC system.

Did you cut and paste those from Fox News?

Yes, there is no perfect system, especially in a world where there isn't enough money to go around. The hash we had before ACA was embarrassing. The hash we have now is still somewhat embarrassing, but at least it is a bit more fair. Its clear to me that changing the healthcare system is not done yet in the US. The question is whether we change before or after the boomer pig goes through the healthcare snake.

 

[brewer12345]

Not the network issue, not entirely. In single payer, presumably providers would be permitted to opt out and develop a cash-only practice. If some of the best doctors and facilities went that way, you'd have the same problem.

There is a real easy solution to that one: thou shalt have no other God than Jahweh. Thou shalt have no other payers than Sam (Uncle).

 

[ERhoosier]

Did you cut and paste those from Fox News?

No.
Those stories have been widely reported by a variety of independent news services.

 

[brewer12345]

No.
Those stories have been widely reported by a variety of independent news services.

I can guess which ones.

Meanwhile, we are throwing anecdotes against the wall to see which ones emotionally stick rather than looking at statistics. Nice.

Back on topic:

I will be shopping for a new plan next year based on a change in income that will likely boost me out of subsidy range. If at all possible, I will be looking for a Bronze HSA eligible policy with the same insurer (Kaiser). It will be interesting to see both what the premium change on my existing policy is and how that price compares with whatever alternatives I may be presented with.

 

[MichaelB]

Yes, back on topic. We don't know yet what premiums will be for 2015. Hope for the best but prepare for the worst, so I'm doing some of the leg work now.

During the last enrollment period it was very difficult to get any kind of meaningful information on the insurers networks, their websites were overloaded. Now is a good time to do that and get ahead of the game. It's also a good time to look for the policy documents and call with questions. Despite the efforts to standardize coverage I found some big differences among the insurers. For example, one policy doesn't cover "elective surgery", which I find confusing because inpatient hospital care is one of the 10 essential health benefits,and the policy claims to be ACA compliant.

There will also be new insurers in many markets across the country. As before, price alone won't be the deciding factor.

 

[brewer12345]

I take it they do not define "elective surgery?" Does this mean they won't pay for a nose job, or they won't pay for, say, gall bladder removal?