ACA expanded coverage ‘comes with a cost’

Oct. 29--BLOOMINGTON -- The Affordable Care Act (ACA) has extended health insurance coverage to people who didn't have it before, but small businesses and individuals not receiving government subsidies are paying for it.

That's the assessment of Jeff Gilmore, president/partner of BPA Troxell Benefits in Bloomington.

"My opinion (of ACA) hasn't changed much," Gilmore said. "It's not working as intended. There are fewer choices and rates are increasing dramatically."

ACA has helped people who couldn't afford insurance to get it by providing a government subsidy. And the act mandates coverage of pre-existing conditions. That's good, said Gilmore.

"But all of that comes with a cost and we're seeing the results of that," he said. "For the vast majority of our (small group and individual) clients, it's resulted in higher premiums and fewer choices."

Premium increases for individual plans for 2018 are ranging from 5 to 30 percent while small-group renewals are 20 to 30 percent, he said. Increases may be smaller if policyholders make plan changes, such as going with a more restrictive health care network or a higher deductible.

"Deductibles continue to rise pretty significantly in all markets," Gilmore said.

Premium increases generally are not as steep for large employers or groups.

Gilmore doesn't think Trump Administration changes to not advertise and to shorten the ACA open enrollment period (which begins Wednesday) will have a huge impact on enrollment.

"People are aware there's a penalty (if they don't purchase insurance). That hasn't changed. But it is unfortunate if you need help."

Gilmore advises people to review their health insurance plan's network of medical providers to determine whether it's possible to control costs by going with a smaller network that still provides access to needed medical professionals, and consider going with a higher-deductible, lower-premium plan.

People with questions should contact a health insurance broker, he said.

Follow Paul Swiech on Twitter: @pg_swiech

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