Idaho insurance rates are heading up. But wait! Congress may do something about that.
The
The rate hikes average 27 percent. They are driven mostly by skyrocketing "silver" plan premiums -- slated to rise by 40 percent, while "bronze" and "gold" plans increase just 8 percent and 9 percent.
"The rate increases, in particular on silver-level plans, are definitely greater than we would like," said
Why silver matters
Those "silver" plans are pivotal, for two reasons:
Reason 1: They're the only Obamacare plans that offer a special benefit for low-income people -- a subsidy that helps cover out-of-pocket costs like copays. The subsidy isn't cheap to provide; it costs about
From the launch of Obamacare to now, the federal government paid for them. But congressional
Without a guarantee that the subsidies won't fall on insurers' shoulders next year, insurance companies are setting their rates sky-high to make sure they can afford the new expense. Meanwhile, the health care industry is calling on
(Regardless of what happens, if you qualify for the cost-sharing benefit, you won't notice a change. You'll still get the benefit, it will just come from a different place.)
Reason 2: "Silver" plans also play a huge role in determining how much premium assistance people get for all health plans sold on exchanges. If a certain silver plan is suddenly 40 percent more expensive, people will get a lot more federal assistance when they buy a health exchange plan. And that could make a "gold" plan more affordable, when its higher premium used to put it out of reach for a lot of people.
That's where things could get tricky.
Right now, insurers are planning for the worst -- that the federal government will cut off subsidies.
But if federal lawmakers end up committing to the subsidies, that would drastically change how much insurers need to charge for premiums.
The rates that insurers are slated to charge for "silver" plans next year would be cut by more than 20 percent if subsidies are continued, according to the
Countdown to
The next two weeks are critical, because the
If
If
What if
Could people who chose a "gold" plan thinking they'd get more premium assistance be able to switch to a cheaper one? Would people continue paying higher premiums the whole year, or would premiums be lowered? Would insurers issue refunds?
Kelly said the Your Health Idaho exchange and the
"Your Health Idaho has been awfully nimble in the past, and we're ready to be nimble again," he said.
It's also possible that a decision will be made to end the subsidies forever. That would set in motion a different set of options for health insurers and the government.
While things in
"This year, it's more critical than ever," Kelly said of working with agents. "People need to find the plan that works best for them, understanding that things may change. And that, I think, is the message we have been imparting in the agent and broker training."
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