Alabama Insurance Rates Up In Exchanges
By Brian Lyman, Montgomery Advertiser, Ala. |
Analysis of the individual insurance plans being offered in
In
The increases are coming despite the entry of UnitedHealthcare into marketplace, which is offering plans in all 67 counties in the state, providing
Nationally, the increases are below what was traditionally seen in the individual marketplace, which prior to the Affordable Care Act was notable for its instability and churn. Experts said a major issue with the increases is lack of providers, or the large number of areas in the state serviced by single providers.
The changes to the health care plans are because of prices charged by doctors and hospitals to the providers, said
"When there is competition, insurers then may be able to compete against each other, but provider competition really matters" she said.
The increases in
Other studies have cited the relative lack of competition among providers as a problem. A report released last August by the
"Given its market dominance, BCBS has considerable power in negotiating rates with providers," the report said. "However, the large number of one-hospital cities or counties throughout the state makes it difficult to negotiate in many areas."
"You need to have those particular hospitals and most of the physicians in the area in your network," he said. "Otherwise, it's pretty hard to sell a plan. When you get into
The system is only slowly catching up to the new numbers of insured, but Holahan said some hospitals are purchasing private practices and ambulatory clinics, where nurse practitioners and physician assistants can be better utilized.
"Because people have insurance cards, there are really a lot of interesting things happening," Holahan said. "When you're not seeing the expansion of
Gov.
Advocates for expansion have argued the expansion could bring both public health benefits and economic benefits to the state.
About 97,000 Alabamians signed up for health insurance through the federal exchange in the open enrollment period that ended
However, those getting plans through the exchange, particularly in the
Last year, the cheapest Silver plan offered in the exchange was
"This is still a market that is still going through change, and new insurers are going in," Cox said. "Even if nothing's changed with your family, it still can be important go back onto to marketplace and see your options."
Some people may not see their out-of-pocket costs change a great deal. A
However, with the subsidies available to that individual, the actual out-of-pocket cost would decline slightly, from
An individual in
Plans
Under the Affordable Care Act, insurance plans are broken into four categories:
--Platinum plans cover 90 percent of health care costs after the deductible, and usually have the lowest deductibles and highest monthly premium costs.
--Gold plans cover 80 percent of health care costs, with higher deductibles than Platinum plans but lower monthly premiums.
--Silver plans cover 70 percent of health care costs. These are usually the most popular plans in the exchanges, and subsidies to help pay the costs of the plans are tied to these. Silver plans also have cost-sharing assistance for those who qualify for premium tax credits, reducing out-of-pocket costs.
--Bronze plans cover 60 percent of health care costs. They have the lowest monthly premiums but usually high deductibles.
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