Feds, Foes Clash Over ACA In Florida
Aug. 26--Welcome to a big fight to control the narrative after big insurers including Aetna jumped ship in the Affordable Care Act marketplace in Florida and other states.
Even if 2017 health insurance rates go up 25 percent, 86 percent of Florida consumers buying plans from healthcare.gov will see premiums remain below $100 per month after tax credits, U.S. officials said. In fact, 82 percent will pay $75 or less, they said.
Obamacare opponents see a "desperate" attempt to distract attention away from the health law's problems, but administration officials said they are the ones trying to clear up misleading spin.
"Headline rate increases do not reflect what consumers actually pay," said Kathryn Martin, acting assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services. "Our study shows that, even in a scenario where all plans saw double digit rate increases, the vast majority of consumers would continue to have affordable options."
That is because subsidies -- government help in the form of tax credits -- go up along with rates, they said. Consumers' ability to shop around also helps keep costs down, and whatever its challenges, the Affordable Care Act has helped bring the uninsured rate to a record low, their message goes.
But FreedomWorks, a Washington, D.C. group critical of the health law, says the administration's storyline throws a smokescreen over the true costs taxpayers pick up. It also downplays risks to the whole enterprise from the exit of big insurers like Aetna, Humana and UnitedHealthcare from public exchanges, the group maintains.
"The Department of Health and Human Services is desperate to change the narrative about Obamacare," said Jason Pye, director of communications for FreedomWorks. "Try as they may to distract Americans from the failures of ObamaCare as insurers exit the exchanges, the law is leading the individual markets and some states into a slow and painful death spiral that will drive up premiums and leave taxpayers with the tab."
In Florida, 15 health insurers want an average 17.7 percent increase in 2017 premiums for Affordable Care Act individual plans, state officials said in May -- higher than an approved average increase under 10 percent a year ago. Regulators are expected to rule on those requests in coming weeks.
Aetna said this month it was pulling out because losses were too high. Aetna officials had previously expressed confidence in the public exchanges, but a letter from an Aetna executive warned of a possible marketplace retreat if regulators did not approve a proposed merger with Humana.
The U.S. Department of Justice has opposed the merger on the grounds it could hurt consumers by reducing competition.
In Palm Beach County, it appears consumers will be able to choose from plans offered by five companies in 2017, down from seven this year, according to data compiled by the online news site Vox.
To be clear, not every major insurer is bailing out. One of the state's largest, Florida Blue, reported a $471 million gross profit on ACA-compliant individual plans in 2015, up from $124 million in 2014. A spokesman said the company "remains committed to the Affordable Care Act and the Florida marketplace."
Consumers in Florida who receive subsidies through the exchange pay an average of about $84 per month now, U.S. officials have said. About 9 out of 10 signing up through healthcare.gov in Florida get subsidies, officials said.
"But the reality of the law is that the subsidies aren't free money," Pye said. "Taxpayers are picking up an average of $302 per plan each month. The Congressional Budget Office projects that the federal government -- that is, taxpayers -- will spend more than $600 billion on these subsidies over the next ten years."
Federal officials said independent researchers calculated that 2016 marketplace rates are between 12 percent and 20 percent below what the Congressional Budget Office initially predicted. Meanwhile, more people than ever, including more than 1.5 million signing up through healthcare.gov in Florida, are getting coverage. Don't forget, they say, what the landscape was like before the law: For example, people are no longer being denied coverage for having pre-existing conditions.
The administration's analysis released Wednesday placed little attention on deductibles, though these can pose a considerable cost to consumers in many of today's marketplace as well as employer plans.
On Thursday, federal officials released another report saying expanding Medicaid reduces marketplace premiums about 7 percent in states that choose to do it. Florida, which led opposition to the health law in court, has declined to expand Medicaid to cover more low-income people.
Administration officials also say look at the bigger picture: Since the Affordable Care Act became law, overall health care prices have climbed "at the lowest rate in 50 years." They also say premiums at employer-sponsored health plans have grown "at some of the slowest rates on record," citing research from the Kaiser Family Foundation and partners.
While big employers are generally holding steady in offering health plans, some smaller ones are cutting back, leaving workers to find coverage on their own, research shows.
More than 95 percent of companies with more than 100 employees continue to offer health coverage since the Affordable Care Act passed, according to a July report by the nonprofit Employee Benefit Research Institute of Washington, D.C. At firms with 1,000 or more employees, the offer rate is 99 percent.
Despite some predictions even big employers would bail out of coverage, studies are finding most of them are keeping health plans as a key tool to recruit and retain workers.
Still, it can a different story at smaller firms, researchers found.
About 36 percent of employers with fewer than 10 workers offered health coverage in 2008, but that dropped to 22.7 percent in 2015, Employee Benefit Research Institute found
About two in three employers with 10 to 24 workers offered coverage in 2008 but less than half did last year, the institute said. Firms with 25 to 99 workers slid from 81 percent offering health plans to 74 percent in that span, the report said.
In part, this is influenced by legal requirements. The Affordable Care Act requires individuals to have health coverage or pay a penalty, and also says employers with 50 or more employees must offer health insurance coverage or face a penalty. Employers with fewer than 50 employees are exempt.
The Congressional Budget Office estimated in March about 155 million people, or about 57 percent of the population under age 65, have employer-based coverage. This number is projected to decline to 152 million in 2019 but stabilize and stay at that level through 2026, officials said.
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