Some KC area residents will see higher premiums for ACA plans

Kansas City Star (MO)

Oct. 27--Premiums will go up substantially next year for some Kansas City area residents enrolled in health insurance plans through the Affordable Care Act's marketplace.

How much will depend on which plan people have right now.

And while Kansas City area residents in Missouri will be able to choose among four providers, people in Johnson and Wyandotte counties will have only two options.

Open enrollment for the third year of ACA marketplace plans starts Sunday for coverage that begins Jan. 1. People who enroll in the plans are eligible for premium subsidies based on their income.

New data for the 37 states that use the federal HealthCare.gov marketplace, rather than run their own exchanges, suggest that premiums for next year will be going up far more in the Kansas City area than in many other large cities.

The monthly premium for the benchmark silver plan will increase by an average of 6.3 percent for the 30 cities included in the new data from the Department of Health and Human Services. But in the Kansas City area, premiums for that plan will jump by 20.1 percent next year.

Plans come in four tiers: bronze, silver, gold and platinum. The benchmark plan -- the second-lowest-priced silver plan in any market -- is used to set subsidy rates in that market.

Premium changes for benchmark plans in other cities range from a 35.2 percent increase in Tulsa, Okla., to an 11.8 percent drop in Indianapolis.

Rates appear to have escalated in Kansas City because Coventry, which had the second-lowest-priced silver plan this year, raised its rates for 2016 by an average of more than 25 percent, said Ron Rowe, vice president for sales of Blue Cross and Blue Shield of Kansas City.

That put a more expensive silver plan from Blue Cross into the second-lowest priced slot. Monthly premiums for that Blue Cross plan will average $280 next year, roughly $50 more than the Coventry plan cost this year.

"They raised their prices higher than we did," Rowe said. Blue Cross increased its premiums for marketplace plans by about 12 percent for 2016.

"Affordability is a top priority for our customers," Coventry spokesman Rohan Hutchings said in a statement. "Our goal is to offer competitively priced products at a rate that will allow us to cover the cost of doing business while offering our customers high quality products."

In 2016, the lowest-priced silver plan from Coventry for the Kansas City area will average $304 per month, but Kansas residents won't be able to enroll in it. Coventry decided recently to pull out of the ACA marketplace in Kansas for 2016.

"After reviewing our national footprint, the competitive landscape, market conditions and the portfolio of plans we offer, we reluctantly came to the decision that we could no longer meet the needs of our individual on-exchange members in Kansas," Hutchings said.

That means about 20,000 residents of Johnson and Wyandotte counties who are in Coventry now will have to shop for plans from Blue Cross or UnitedHealthcare, the two other marketplace insurers offering coverage in 2016.

Residents on the Missouri side of the Kansas City area will still be able to choose plans from Coventry, as well as from Blue Cross, UnitedHealthcare and Humana.

Because plans and premiums change, it's best to shop for plans each year, experts say. People who switched their ACA plans from 2014 to 2015, while staying in the same tier, saved an average of $400 on premiums compared to those who stayed in the same plans, an HHS study found.

A benefit from having premiums rise significantly for the benchmark silver plan, Rowe said, is that premium subsidies for all plans in the region also will rise significantly. That means "the taxpayers got a big rate increase," he said.

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