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Health Insurance & Affordable Care Act

GAO: Current Insurance Costs For Individual Policies Vary Widely

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America’s Health Insurance Plans spokesman Robert Zirkelbach said the report shows “the wide variety of choices people have on the amount of coverage they want to buy.”

Starting in January, new rules take effect that will change some of those choices, both for consumers and insurers. Insurers will be barred from rejecting applicants with health problems — or charging them more than the healthy, which they can currently do in most states.  Insurers must also include a range of “essential health benefits,” including prescription drug coverage and maternity care, which many policies currently do not offer.  The law also limits out of pocket maximums — the amounts consumers must pay in deductibles and copayments for medical care — to about $6,350 for individuals or $12,700 for family coverage.

Almost a third of plans currently offered to consumers exceed those caps, according to an earlier analysis of the government data by U.S. News & World Report and Kaiser Health News.

Some of those new rules could drive up premiums from current levels, especially for people “who purchase a low premium, high deductible” policy, said Zirkelbach. Other provisions in the law could encourage competition among insurers and more enrollment by younger, healthier people, which supporters say would help moderate premiums.

Last week, premium prices hit the news when New York State said costs for people who purchase their own coverage could fall by an average of 50 percent. Experts said that was mainly because costs in New York are currently among the highest in the country, fueled by longstanding state rules requiring insurers to take applicants regardless of their health status, without requiring everyone to buy insurance.  The Obama administration also issued a report that said average premiums in some states next year could be lower-than-expected, based on a comparison with rates projected by the Congressional Budget Office.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Wed, Jul 24 2013

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