Insurance companies requested rate hikes almost unilaterally -- some more than 40 percent, according to a review of rate increase requests made to the state insurance department.
Starting in 2017, three providers will offer marketplace, or exchange, plans for consumers in northeastern and central
Insurance pros offer tips on buying insurance through online exchange
The review shows:
--Geisinger Quality Options requested a 40.68 percent increase.
--First Priority will join the exchange market in 2017.
The state calculated a weighted average on the proposed increases for each carrier's plans.
To compare the costs of the plans, the newspaper looked at what the lowest-rate silver-tier plan would cost a 40-year-old nonsmoker:
For that same low-rate silver plan, a 21-year-old nonsmoker would pay monthly:
These, however, are based only on requests. And, though consumers really won't know how much they will pay until
The rate hike requests follow dire predictions from insurance companies that they face hundreds of millions of dollars in losses.
"On average we had expected some of the low-cost silver plans to go up around 10 percent next year, but that's likely on the low side," said
In rural areas, rates likely will see even greater increases because consumers must rely on broader provider networks, she said.
Another reason insurers are reeling: they're dealing with an underestimated surge of heavy, first-time health care users inspired by their new coverage, said
"In three years from now, they're not going to be newly insured," he said. "That utilization rate's going to start going back down again, and the rates that they suggested for their plans is going to be more realistic."
The state will publish its final decision on the increase requests Monday.
Tax credits, offered to put the "affordable" in the Affordable Care Act, are to proportionally mirror any premium hikes for those who qualify. Credits may be applied monthly to reduce payments or claimed at one time during tax season.
According to the
The foundation also points out that higher-income enrollees pay more than employer-provided plans.
So, for example, a 40-year-old nonsmoker making
A self-employed artist, she bought a bronze-tier health insurance plan from the online marketplace, one with a low monthly premium but an "outrageous" deductible, around
"For me, I use health care as little possible," she said. "Unless it's an emergency."
That emergency came last summer.
"I chopped off the tip of my pinkie," she said. "I was making this raw sweet potato salad. I had this huge butcher knife, and all of the sudden ..." Her voice trailed off.
"I think I really needed a little love and attention so I went to the doctor," she said. "They cleaned me up."
Online marketplace plans want more customers like
Despite gains, online marketplace advocates still struggle to capture a younger, healthier demographic -- one that pays into the system but uses fewer services.
"We have been focused on young adults since we started," said
Organizations like Enroll America, as well as marketplace navigators paid for by the federal government and insurance application counselors, seek to help underserved populations, like young people or minorities, get coverage.
As Americans foray into the ACA's fourth open enrollment period -- the fourth year for online insurance marketplaces -- uncertainties persist about what happens next.
Both skeptics of the law and its biggest supporters, including President
"I expect to be tinkering with the Affordable Care Act pretty much my entire time in public service," said
Before his appointment to the House appropriations committee,
"I think that there's plenty of room for money to be made by insurance companies through the exchanges. And I think that this is a temporary growing pain," he said. "The fact that other insurers are remaining shows that people think they can make money with this."
Big players leaving
In August, Aetna announced it was pulling its marketplace plans from 11 state exchanges, including
Like health insurance giants Humana and UnitedHealthcare that announced their departures earlier this year, Aetna anticipates hundreds of millions of dollars in losses from its exchange plans.
While it still serves
Departures from the marketplace by Aetna and other major insurers like
The federal government will choose alternate health plans for those customers of companies that dropped out unless consumers find another plan.
He also predicted Aetna will regroup and rejoin the online marketplace in a year.
While the fate of online exchanges as they are now remains unknown, more Americans still get their health insurance from their employers -- about 149 million.
Only about 11 million buy their insurance from the online marketplaces, and 85 percent of them receive tax credits.
Most recent government data shows that 8.6 percent of the
In 2010, when the Affordable Care Act was signed into law, 49.9 million people, or 16 percent of the total population, had no insurance, according to the
However, at least one lobbyist who represents insurance brokers says the law tackled this problem the wrong way.
"The Affordable Care Act is replete with missed opportunities," said
He said he believes the government would do better to incentivise licensed insurance agents to focus on the smaller markets.
Perhaps one of the greatest unknowns in the Affordable Care Act's future: someone other than its architect will sit in the
Republican presidential candidate
Contact the writer: [email protected], @jon_oc on Twitter
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