ACA Federal Marketplace updates

[jflynn4]

As someone who is currently paying in excess of $1900 per month for a high deductible plan through Golden Rule (DW had breast cancer in 2003 and I have arthritis in my neck), even without subsidies, my premiums will drop by about $700 per month (at worst). This is not about politics for me but about being able to actually afford coverage of some kind.

 

[MichaelB]

Yes..need to consider a full work up and all preventive tests.

Are those rates in Maryland and DC, projected exchange rates for individual coverage.? Need to spend some time looking around. I feel I am on the internet hours a day as it is! LOL!

Here are Maryland rates Maryland Insurance Administration - Home Page
Here are DC rates http://disb.dc.gov/sites/default/fi...ion/attachments/FinalIndividualRates71913.pdf
Both are for 2014. We have no idea if they will be close to VA. Not much to go on, but some age breakdown.

 

[sheehs1]

Thanks for the links Mulligan and Michael. It helps and I have printed off a couple of them. Yes they are averages...but at least it is something to go on for now.
My current rate for 2014 from Anthem is falling in line with these averages. That makes me hopeful.

 

[sheehs1]

As someone who is currently paying in excess of $1900 per month for a high deductible plan through Golden Rule (DW had breast cancer in 2003 and I have arthritis in my neck), even without subsidies, my premiums will drop by about $700 per month (at worst). This is not about politics for me but about being able to actually afford coverage of some kind.

jflynn4, It is when I read or hear about premiums like this that I'm glad something is changing for the better for some.

And to be honest, for a few years now, I've been afraid of getting a serious diagnosis of any kind (knock on wood). ACA should eliminate that fear.

 

[brewer12345]

jflynn4, It is when I read or hear about premiums like this that I'm glad something is changing for the better for some.

And to be honest, for a few years now, I've been afraid of getting a serious diagnosis of any kind (knock on wood). ACA should eliminate that fear.

I have long thought that a serious diagnosis means no er for me, ever. Now that will be off the table.

 

[ERhoosier]

Another independent study of ACA's effects on individual "nongroup" market- this time using most recent info from 10 states.
The Affordable Care Act and Health Insurance Markets: Simulating the Effects of Regulation | RAND
From my prelim read, main points seem to be that over next 2 yrs ('14-'16 as ACA mandates kick-in)-
- There remains large window of uncertainty due to assumptions (e.g. actual enrollee population (by age, health, etc), specific implementation rules/delays, legislative tweaks, etc)
- Uninsured population will go down but remain a significant % of population
- Nongroup participation in individual market will rise
- Nationally little change in overall individual HI premiums due to ACA (assuming similar coverage features), but with marked variation by State from sl decrease (2) to basically unchanged (5) to 40+% increase (3). Net HI premium changes would, of course, vary depending on individual premium subsidy (if any).

IOW- After 77 pages of analysis, we're told that under ACA someone's individual HI premiums may decrease, not change, or increase.
Guess that about covers all the bases

 

[pb4uski]

Another independent study of ACA's effects on individual "nongroup" market....

IOW- After 77 pages of analysis, we're told that under ACA someone's individual HI premiums may decrease, not change, or increase. ....

Well if it was a government study rather than an independent study it would have taken 770 pages rather than 77 so be happy.

 

[Htown Harry]

Sarah Kliff of the Washington Post included an interesting graph in her blog post today. (Created by an entity called Deft Research)

First, there is a generic table of monthly premiums with 60 y.o.'s paying 3X the premiums of 21 Y.O.'s:

Then various variable were used to create this chart:

The subsidy "cliff" kicking in at 400% of poverty line couldn't be more clear.

Here's a link to the article, which is focused more on the blue line:
The bros might just sign up for Obamacare yet

 

[meierlde]

In an interesting post from the Insurance Journal : Premium Increases Under Obamacare Are Exaggerated, Rand Says, the Rand Corp compares premiums on the ACA to prior premiums and says they are going to on average be about the same. Note that this study did normalize for increased benefits, so that comparing an old bare bones policy to one under the ACA was apples to apples.

 

[golfnut]

Just waiting on the Illinois exchange premiums.

 

[Mulligan]

Just waiting on the Illinois exchange premiums.

After all of the states premiums get released we will have to run a poll to see who got rate relief, and who got bent over the barrel. I will make a guess and say due to the ages of people here and some thrifty people on this forum who can and will manage their AGI, there probably will be more winners than losers, which unfortunately will not include me.

 

[golfnut]

After all of the states premiums get released we will have to run a poll to see who got rate relief, and who got bent over the barrel. I will make a guess and say due to the ages of people here and some thrifty people on this forum who can and will manage their AGI, there probably will be more winners than losers, which unfortunately will not include me.

It's difficult to be a winner living in Illinois when you are counting on state run (in the ground) programs.

 

[Htown Harry]

The Wall Street Journal has posted a calculator for those age 49 and above, based on Toledo Ohio rates:
Senior Discounts - WSJ.com

Here's a link to the article for those that have access behind the paywall:

Subsidies for Older Buyers Give Health Insurers a Headache - WSJ.com

There's a similar WSJ calculator for young people in Oregon here:
The Young and the Healthy - WSJ.com

 

[ERhoosier]

In an interesting post from the Insurance Journal : Premium Increases Under Obamacare Are Exaggerated, Rand Says, the Rand Corp compares premiums on the ACA to prior premiums and says they are going to on average be about the same. Note that this study did normalize for increased benefits, so that comparing an old bare bones policy to one under the ACA was apples to apples.

I prev linked to the actual RAND study this article purports to summarize. This IJ article is rather disingenuous in focusing on hypothetical "average" and ignoring the wide variation RAND predicts between states (p vii of RAND study). Financial impact will be quite different for those poor folks in 3 states RAND predicts will see HI premium increases up to 40% vs those fortunate residents of 2 state who may see DEcrases in HI premiums. Also- RAND study only looked at 10 states. There are 40 still to be considered. And both parties (as well as some major labor unions) appear to agree that ACA needs at least some changes.
Bottom line - There is still much uncertainty, inc the likelihood that the economic differences between winners & losers under ACA may be rather large. Looks like budgeting for HI will remain problematic for most under ACA- at least for the 1st few yrs. Particularly for those near the "cliff", as Harry's nice chart showed.

 

[Mulligan]

The Wall Street Journal has posted a calculator for those age 49 and above, based on Toledo Ohio rates:
Senior Discounts - WSJ.com

Here's a link to the article for those that have access behind the paywall:

Subsidies for Older Buyers Give Health Insurers a Headache - WSJ.com

There's a similar WSJ calculator for young people in Oregon here:
The Young and the Healthy - WSJ.com

Nice link Harry. I sent it to my thick headed friend who continues to believe Obamacare will be cheaper than his retired group plan he is presently on. About 40% higher for the similar plan he has, plus it got worse each year he gets older. As for me, this was the best comparison yet. For a bronze that has a $500 higher deductible than I presently have I would only have to pay THREE TIMES what I presently pay. Can't wait for 2015!

 

[joe8012]

Nice link Harry. I sent it to my thick headed friend who continues to believe Obamacare will be cheaper than his retired group plan he is presently on. About 40% higher for the similar plan he has, plus it got worse each year he gets older. As for me, this was the best comparison yet. For a bronze that has a $500 higher deductible than I presently have I would only have to pay THREE TIMES what I presently pay. Can't wait for 2015!

This is a lot worse than I thought. After reading the Covered Ca. site, I thought a silver plan had a zero copay and a 2500 ded. The wall street link to the Toledo Ohio Calculator shows a silver plan having a 3500 ded. with a 30% copy at 6000 additional. Ok lets do the math for a 60 yr old couple. 12k in premiums, 7k in ded, 12k in copy pays. 31k a year. That would be double the cost of what I can buy today. I hope I made a mistake somewhere.

 

[MRG]

So little time and so many questions.

Whatever my rate turns out to be it will be better than what happens when my COBRA runs out.

MRG

 

[Mulligan]

This is a lot worse than I thought. After reading the Covered Ca. site, I thought a silver plan had a zero copay and a 2500 ded. The wall street link to the Toledo Ohio Calculator shows a silver plan having a 3500 ded. with a 30% copy at 6000 additional. Ok lets do the math for a 60 yr old couple. 12k in premiums, 7k in ded, 12k in copy pays. 31k a year. That would be double the cost of what I can buy today. I hope I made a mistake somewhere.

For your wallet's sake Joe, I hope you did! But they have been saying all along (minus government subsidies) that people with underwritten plans with excellent health were going to get hammered in Ohio, Missouri, Texas, and a few others. Somehow it doesn't make it feel better when everything considered it all "evens out" cost wise... I am certainly happy for the people who have previously been excluded who now can get much needed insurance. And I would have gladly paid the reported 25% increase in premiums to allow these people affordable insurance. What gets my goad is the other 75% or so...paying for deductibles I don't want or the "necessary components" I do not need or want. Sorry, end of rant. I promise I won't do it again.....until I see my states officially posted premiums.

 

[killingme]

Nice link Harry. I sent it to my thick headed friend who continues to believe Obamacare will be cheaper than his retired group plan he is presently on. About 40% higher for the similar plan he has, plus it got worse each year he gets older. As for me, this was the best comparison yet. For a bronze that has a $500 higher deductible than I presently have I would only have to pay THREE TIMES what I presently pay. Can't wait for 2015!

Same boat here, so was hammered when I was working with taxes and get hammered again. Hey at least I have my health

 

[grasshopper]

Well I received my renewal letter from AZ BCBS, my letter states that I am grandfathered, and I can continue with my existing policy indefinitely. Rates jumped 12% with no age creep, so for the two of us with 80% coverage PPO, $2500 each deductibles, $861 a month. I have made adjustments to our income to stay under 400%, but at least the existing plan isn't a deal breaker. I can live with the extra $100 a month.

Any thoughts about staying with a underwritten group(plan) and increases vs whatever the cat dragged in group, and future rate increases. My guess is that the UW group would be healthier, and keep costs down.

 

[sheehs1]

Well I received my renewal letter from AZ BCBS, my letter states that I am grandfathered, and I can continue with my existing policy indefinitely. Rates jumped 12% with no age creep, so for the two of us with 80% coverage PPO, $2500 each deductibles, $861 a month. I have made adjustments to our income to stay under 400%, but at least the existing plan isn't a deal breaker. I can live with the extra $100 a month.

Any thoughts about staying with a underwritten group(plan) and increases vs whatever the cat dragged in group, and future rate increases. My guess is that the UW group would be healthier, and keep costs down.

grasshopper, I think it's too early to know what will happen with the grandfathered plans. Not sure if they will look at the grandfathered plans independent of the ACA plans or not but my guess is they will increase all plans every year.

Think of it this way. Even with the underwriting requirements they had, the ability to deny coverage and considering the premium increases on those plans the last 5 years I would not expect much to change. If they find their cost are better for those on the exchange due to volume or for any other reason, they will increase premiums on those grandfathered plans to force people out of them. On the flip side, if the grandfathered plans are more advantageous to them, they may do what they can to keep people on them. However they did not do that two years ago. They increased the underwritten plans so much a lot of us had to jump to another plan just to afford the ongoing premium increases, giving up our grandfathered status.

Congratulations on having a safety net of choices. You can play it year by year.

 

[MooreBonds]

Well I received my renewal letter from AZ BCBS, my letter states that I am grandfathered, and I can continue with my existing policy indefinitely. Rates jumped 12% with no age creep, so for the two of us with 80% coverage PPO, $2500 each deductibles, $861 a month. I have made adjustments to our income to stay under 400%, but at least the existing plan isn't a deal breaker. I can live with the extra $100 a month.

Any thoughts about staying with a underwritten group(plan) and increases vs whatever the cat dragged in group, and future rate increases. My guess is that the UW group would be healthier, and keep costs down.

Grasshopper, it sounds like you're with a group plan, but I can't quite tell (can you get subsidies with group plans by staying under 400% PL? I thought that was only for individual plans on the exchanges?) If you do have your own individual plan w/ your spouse, tread carefully with this.

Both Mulligan and I are in MO, and have Anthem high deductible HSA plans (the "Lumenos" policy). Anthem has refused to offer clarity on the future status of our HSA HDHP policy.

When you go to ehealthinsurance.com and get a current quote for the same policy we currently have, it comes up in the search for the current rates we're paying....but when you click on the policy for more info, under the "rate guarantee" part, it says "N/A"!!! Meanwhile, other plans, like a Coventry plan, at least say the rate guarantee is "11+ months".

This means that Anthem is not guaranteeing the policy premium in our state. And, technically, can cancel or close the policy at any point in time.

Please check your own policy for the fine print, and get something in writing from Anthem for the guarantee for that quote/policy you have. They can make things sound great by saying "just continue with your policy as-is" (as they recently said to me), but look for what they're NOT saying: they're NOT saying "your current premium/plan will remain in effect for the future".

 

[grasshopper]

Grasshopper, it sounds like you're with a group plan, but I can't quite tell (can you get subsidies with group plans by staying under 400% PL? I thought that was only for individual plans on the exchanges?) If you do have your own individual plan w/ your spouse, tread carefully with this.

Both Mulligan and I are in MO, and have Anthem high deductible HSA plans (the "Lumenos" policy). Anthem has refused to offer clarity on the future status of our HSA HDHP policy.

When you go to ehealthinsurance.com and get a current quote for the same policy we currently have, it comes up in the search for the current rates we're paying....but when you click on the policy for more info, under the "rate guarantee" part, it says "N/A"!!! Meanwhile, other plans, like a Coventry plan, at least say the rate guarantee is "11+ months".

This means that Anthem is not guaranteeing the policy premium in our state. And, technically, can cancel or close the policy at any point in time.

Please check your own policy for the fine print, and get something in writing from Anthem for the guarantee for that quote/policy you have. They can make things sound great by saying "just continue with your policy as-is" (as they recently said to me), but look for what they're NOT saying: they're NOT saying "your current premium/plan will remain in effect for the future".

Yes it is an individual plan, I was referring to the group as underwritten PPO policies, it is considered a separate class of policy holders, from what I read. No one ever guarantees rates for a full term, wait until you hit 60 half way through the year. Besides I don't believe/trust insurance companies or anyone else to be 100% truthful

 

[Htown Harry]

The functionality of the Federal exchanges' shopping tools has been the source of some speculation.

A blog post I read today mentioned that the feds have released a manual for "navigators". It's 217 pages:
http://www.google.com/url?sa=t&rct=...o3iRBK95JLQUcvPMZfO2-8g&bvm=bv.51495398,d.cWc

Browsing through it, I found the section starting at page 105 on shopping for a policy on the marketplace web site the most interesting.

There will be filtering functions, sorting functions and links to the official summary of benefits and the provider's web site (to research prescription formularies and provider networks, for instance.)

Nothing was remarkable or surprising, really. It's just further confirmation that the web-site programming objectives are consistent with high-function web shopping tools seen in other markets.

Filtering & Sorting

The Marketplace initially sorts plans from the lowest to the highest premium amount, although consumers may rearrange QHPs by other criteria, such as maximum out-of-pocket costs.

Consumers may also filter QHPs to narrow the results to only display plans that meet the additional criteria. Exhibit 82 specifies the various filtering options available to consumers for customizing their QHP lists.

[filter options: Health Plan Categories, Cost-Sharing Reduction Available, Premium Price Range, Annual Deductible, Out-of-Pocket Maximum, Dental Coverage, Doctor Choice/Plan Type, Insurance Provider, Medical Management Programs, Multistate Network Availability, Health Savings Account (HSA) Eligible]

Side-by-Side Comparison

Consumers may make direct plan to plan comparisons using the side-by-side function. Exhibit 83 lists the attributes available to consumers for side-by-side comparisons.

[The exhibit lists about 40 types of services in 9 comparison categories. One example category:

Prescription Drug Coverage
• Generic drug
• Preferred brand drug
• Specialty drugs
• Non-preferred brand
• List of covered drugs]

 

[sengsational]

Sorry, end of rant. I promise I won't do it again.....until I see my states officially posted premiums.

Your ACA posts are the ones I read a little more closely than others, so please don't stop writing them. I like that you fairly reflect on the overall situation, integrating the latest information, and then add how that affects your situation and your current thinking.