Millions gained coverage since Obamacare, but many are worse off as premiums soar
The Reiters buy their own coverage, but they earn too much to qualify for financial aid to lower their monthly premiums. For 2017, they bought a plan off the exchange and paid
Keeping the same coverage for 2018 would have cost the Reiters
"That's more than a lot of people's mortgage payments,"
More than a million Floridians have gained health insurance since the ACA exchange launched in 2014, and many more have seen their coverage improve as a result of the health law's benefit requirements.
But one group of Floridians is worse off.
As rates skyrocket, and uncertainty over the health law threatens to push premiums even higher, consumers who buy their own coverage and earn too much to qualify for financial aid are bearing the brunt of price increases.
"People have every right to be angry," said
Corlette said that going into 2017, health insurers on the ACA exchange raised rates to account for rising healthcare costs from prescription drugs and consumers who used more healthcare than anticipated. Other factors, including the expiration of an ACA program designed to stabilize premiums and the departure of insurers from the exchange, also contributed to the increases.
But, Corlette said, "Things started to turn around for the carriers in 2016 and then improved a lot in 2017. So the question becomes, 'If they did so well in 2017, then what's driving the premium increases for 2018?' "
Corlette said she read through actuarial reports filed by health insurers to justify their rate hikes for 2018 coverage and found a common theme: uncertainty about the future of the health law.
"Insurers do not like uncertainties," she said, "and the uncertainty swirling around the future of this market is going to cause them to hike the premiums."
The cause for uncertainty has been relentless, Corlette noted -- from
Like many ACA insurers, Florida Blue said it raised rates by 20 percent just to account for the president's canceling the subsidy that helps low-income consumers cover their out-of-pocket costs, such as deductibles and copayments.
And rates could spike even higher if
Corlette estimated that repealing the ACA's individual mandate could cause insurers to raise premiums by 10 percent.
In
"The people in
About 7 million Americans who buy their own coverage but receive no financial aid could be facing the same challenges as the Reiters, according to estimates from
In 2017, about 5.3 million Americans bought an ACA plan off the exchange, where financial aid is not available, according to the Kaiser and Mark Farrah analyses.
An additional 1.6 million consumers, including about 100,000 Floridians, bought coverage on the ACA exchange in 2017 but earned too much to qualify for financial help, according to federal regulators at the
Those consumers were more likely to cancel coverage, according to CMS estimates, which showed that about 1.5 million people dropped out of the ACA exchange
Overall, though, most consumers signed up for coverage on the ACA exchange were protected from premium increases because the health law ensures that those who earn up to four times the federal poverty level -- about
But consumers like the Reiters do not have that protection, and they can't afford to take the risk of going without coverage.
The Reiters are early retirees. Richard, 63, stopped working in 2014 after a 38-year career as a certified public accountant; Heidi, 59, retired in 2008 from teaching in public schools.
They are in generally good health.
But it's their 17-year-old son, Daniel, whose coverage they worry about the most. He has Type 1 diabetes.
"We were concerned with having a plan that covers the diabetes supplies and insulin, which can be costly,"
By switching to a lower-priced health plan for 2018, the Reiters will have a
Their benefits are also less generous. The Reiters will be responsible for 40 percent of their covered healthcare costs in 2018, and the plan does not include their preferred hospital and doctors at Cleveland Clinic Florida.
But Richard and
He calculates that the total should be less than the higher-priced health insurance plan that included
"I call it hybrid coverage,"
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