ACA Federal Marketplace updates

[M Paquette]

See

UnitedHealth to exit individual insurance market in California - latimes.com

"The nation's largest health insurer, UnitedHealth Group Inc., is leaving California's individual health insurance market, the second major company to exit in advance of major changes under the Affordable Care Act."

UHC is only exiting the INDIVIDUAL health insurance market in California, where they were a very small player, covering some 8,000 people, or about 2% of the individual market. They will continue to offer their group plans as well as selling administrative services to larger 'self-insured' businesses.

Anthem Blue Cross, Kaiser Permanente and Blue Shield of California are the largest individual health insurers in California, with a total combined market share of 87%. (2011 Citigroup survey data)

 

[ERhoosier]

Reassuring article on prelim Exchange rates in Ohio-

http://news.cincinnati.com/article/...osts-health-exchange-may-lower-than-predicted

 

[Brat]

Video calling attention to Oregon's program: "Live Long In Oregon" - :60 - YouTube

Another video, not as cute as the above:

 

[MichaelB]

Thanks for posting those. seeing how the states do their outreach is going to be interesting, and entertaining.

 

[Bestwifeever]

Holy moley, something in New York is going down in cost:

State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.

http://www.nytimes.com/2013/07/17/h...rkers-set-to-fall-50.html?exprod=myyahoo&_r=0

 

[samclem]

Holy moley, something in New York is going down in cost:


http://www.nytimes.com/2013/07/17/h...rkers-set-to-fall-50.html?exprod=myyahoo&_r=0

From the article:

For years, New York has represented much that can go wrong with insurance markets. The state required insurers to cover everyone regardless of pre-existing conditions, but did not require everyone to purchase insurance — a feature of the new health care law — and did not offer generous subsidies so people could afford coverage.
With no ability to persuade the young and the healthy to buy policies, the state’s premiums have long been among the highest in the nation. “If there was any state that the A.C.A. could bring rates down, it was New York,” said Timothy Jost, a law professor at Washington and Lee University who closely follows the federal law.

The previous rates for individual policies were high for everyone because of the intervention of NY State. If not for this intervention, insurance would have been priced according to risk (i.e. using underwriting) and most people would have been able to get affordable policies--possibly for less than the ACA approved ones they'll now be forced to buy. (For other people--market-based insurance would have been more expensive or not available, forcing them into a high-risk pool or other arrangement). The ACA may have addressed one ill-advised government policy. It's not too early to start looking at how we'll implement the next batch of needed fixes.

Some will celebrate the ACA, others will see the issue as NY's original program that created the mispricing.

 

[Mulligan]

Holy moley, something in New York is going down in cost:

http://www.nytimes.com/2013/07/17/health/health-plan-cost-for-new-yorkers-set-to-fall-50.html?exprod=myyahoo&_r=0

The statistic I found stunning was only 17,000 people in the entire state of NY purchased through the individual market. Of course if I had to pay those crazy rates, I probably would have been one of those 2 million plus who do not carry insurance.

 

[MichaelB]

The previous rates for individual policies were high for everyone because of the intervention of NY State.

They weren't high for everyone. They were 2 or 3 times higher for individuals than for people in group policies, the networks were restricted, the coverage limited, and the lifeitme limits a joke. This was truly a choice between lousy coverage or none at all.

If not for this intervention, insurance would have been priced according to risk (i.e. using underwriting) and most people would have been able to get affordable policies--possibly for less than the ACA approved ones they'll now be forced to buy. (For other people--market-based insurance would have been more expensive or not
available, forcing them into a high-risk pool or other arrangement).

If not for this regulation, the only people able to get individual health care insurance in New York would be those without any risk at all. Those needing the insurance would have been excluded by design.

The ACA may have addressed one ill-advised government policy. It's not too early to start looking at how we'll implement the next batch of needed fixes.

Some will celebrate the ACA, others will see the issue as NY's original program that created the mispricing.

The PPACA has addressed many needs shared by everyone. No one in New York that needed or needs individual health care coverage will be sorry to see that poor excuse for insurance be replaced by PPACA enacted reforms and policies.

 

[kmt1972]

http://s3.documentcloud.org/documents/727416/approved-individual-premium-rates-2014.pdf

Are the rates for NY. While they are lower than the existing disastrous rates in NY state, they seem pretty high compared to the rest of the country. I also suspect the real numbers might be different over time because this assumes a certain rate of participation which might be lower due to some people opting to pay the penalty (or tax or whatever it is that supreme count decided it was.)

 

[Brat]

NY has always been costly, at least it is less costly than it once was. It will be interesting to see NJ $.

Yes, there may be a 'donut hole' where some people choose to pay the penalty because they earn too much for a substantial subsidy.

 

[Mulligan]

NY has always been costly, at least it is less costly than it once was. It will be interesting to see NJ $.

Yes, there may be a 'donut hole' where some people choose to pay the penalty because they earn too much for a substantial subsidy.

I imagine that will be correct. But, I think there will be a significant part of that donut hole constituted with people either too dumb, lazy, or oblivious to the law to bother to sign up. I imagine it will take the entire 2014 year, just to get a significant amount of these people aware and signed up even if they are "freebie's".

 

[pb4uski]

....While they are lower than the existing disastrous rates in NY state, they seem pretty high compared to the rest of the country. ....

They seem to be in the ballpark with the 2014 approved rates in Vermont.

 

[Mulligan]

They seem to be in the ballpark with the 2014 approved rates in Vermont.

I believe "the spread" between states will be significantly narrowed in the coming year. The states that already had a higher regulations and more mandatory type coverages
such as CA and NY are not barking, while states with more "al a carte" coverages will be howling at the increase (at least the healthy ones that have existing coverage).

 

[sheehs1]

Brat...I realized that after I posted so I deleted the post! At first I thought it would be based on individual use. THEN I realized it was a collective use thing. Not sure how this will work. I'm sure the insurers will work hard to use at least 81% of what they take in.
There is always a work around to laws and unintended consequences.

Should be getting something from Anthem soon. July is half way over.

 

[ERhoosier]

Still incomplete details, but indications from Indiana's Dept of Insurance of significant rate increases in that state (which will be using Federal Marketplace).

http://www.indystar.com/article/201...cent-increase-individual-insurance-plan-rates

 

[killingme]

The thing to note is the downstate and upstate farming/rural rates are being considered together in the NYT article. Downstate (the five Burroughs) the rates will fall, since they were exorbitant to begin with, upstate the rates will increase.

The farm belters often choose to forego insurance due to its cost, regardless of age, and now they would be forced to buy or pay the tax/penalty, but really you are looking at apples and oranges since the median income is so much higher downstate. (eg new york city $121k, five buroughs $54K, Ithaca $27k, Buffalo $29k, Watkins Glen $32K) Downstate rates go down if and only if upstaters pay into the system.

Similarly, as mentioned regarding the young workers, why would they pay prior to age 27 in I am covered by my parents until 26? At that age making low end wages,I would not have been so altruistic.

 

[MichaelB]

The thing to note is the downstate and upstate farming/rural rates are being considered together in the NYT article. Downstate (the five Burroughs) the rates will fall, since they were exorbitant to begin with, upstate the rates will increase.

Do you have a source for this? Based on the published rate tables, premiums decline across the board, for all regions. In addition, some insurers charge more for upstate regions than the NYC area.

 

[Mulligan]

Still incomplete details, but indications from Indiana's Dept of Insurance of significant rate increases in that state (which will be using Federal Marketplace).

http://www.indystar.com/article/20130718/BUSINESS/307180100/State-says-Obamacare-will-force-78-percent-increase-individual-insurance-plan-rates

What I thought was interesting from the article was the stark difference in the individual health insurance market. NY with a population base of approximately 19 million people has only 17,000 on individual plans. While Indiana with a population of around 6.5 million has 200,000 people had individual plans.

 

[bUU]

A lot of that difference will probably go away once the employer mandate takes hold.

 

[timo2]

A lot of that difference will probably go away once the employer mandate takes hold.

I don't see what the problem would be if most employers dropped their plans and most people went through an exchange for their health insurance. It would be more portable, for one, and the employer wouldn't have to mess with health insurance.

 

[bUU]

Whether it will be a problem or not, all I was saying is that the difference would go away.

I think it would be a problem though: Employers are simply not anywhere near worthy of trust that they'll pass along the money that previously they used to sponsor employer-provided health insurance to the employees. I think any such suggestion would just be viewed by most businesses as an excuse to bolster their profits and stick it to their employees, especially those that they can readily replace.

 

[timo2]

Whether it will be a problem or not, all I was saying is that the difference would go away.

I think it would be a problem though: Employers are simply not anywhere near worthy of trust that they'll pass along the money that previously they used to sponsor employer-provided health insurance to the employees. I think any such suggestion would just be viewed by most businesses as an excuse to bolster their profits and stick it to their employees, especially those that they can readily replace.

It probably would be too much to expect any savings to be passed down. But maybe the business would lower prices instead of increase executive pay.

 

[ziggy29]

I don't see what the problem would be if most employers dropped their plans and most people went through an exchange for their health insurance. It would be more portable, for one, and the employer wouldn't have to mess with health insurance.

In theory, this is fine if (a) the employer passed on all the saved health care costs to the employee to buy their own insurance, and (b) if the inequity in tax treatment between employer-provided insurance benefits and cash payments used to buy your own policy were eliminated.

If someone's coverage costs the employer $10,000 a year, I don't trust employers to give employees $10,000 a year to buy their own policy, or less than that net of the subsidy so it's a wash for the employee. Then again, that subsidy is another wrinkle. Do you give the same $10,000 (or whatever) to someone with $100K in household income as someone earning $40K in household income, knowing that the latter would also get a pretty hefty subsidy and would pay a lot less than $10K per year out of pocket for health insurance?

 

[bUU]

It probably would be too much to expect any savings to be passed down. But maybe the business would lower prices instead of increase executive pay.

That still leave employees directed toward the dying in the streets scenario, since they'll have to buy health insurance but they won't have to buy food or clothing or safe shelter (for example), or pay co-pays for necessary medical services and medicines.

 

[ERhoosier]

The more things get OT politically, the more the scent of bacon begins to fill the air
I still think it's useful to have a thread for updates related to the Exchanges/Marketplace as Oct 1 approaches.