Look for which premiums state regulators are using for their comparisons. Under the health law, coverage sold through new marketplaces to individuals and small businesses include a range of types, from the lowest-cost bronze plans that have the highest deductibles to higher-premium platinum or gold plans, where you pay fewer out-of-pocket costs. But premiums are just one part of the cost of health insurance. When considering a report on rates, ask which type of coverage was highlighted and how much the deductibles and co-payments are. Was it the low-cost bronze plan price, the slightly higher priced silver plans or the highest priced platinum or gold? Or some combined average?
You are not average. Many of the estimates are based on averages, which really don’t reflect what any individual consumer will pay. Premium prices will vary based on a person’s age, where they live and the insurer they select. Generally, younger people – especially those few who are buying high-deductible coverage now -- may see an increase in premiums, while older or less healthy people may see their rates go down.
Subsidies will offset costs for many people. Most people shopping in the new marketplaces are expected to qualify for a subsidy to offset part of the cost of the premiums. Sliding-scale subsidies will go to those earning between about $11,590 and $46,000 a year as individuals. Those who get subsidies will also likely pay a portion of their household income – from 2 percent to 9.5 percent – toward the premium cost.
Last, but certainly not least - premium changes are unlikely to affect you at all. The rates submitted to states and the federal government are for coverage sold to individuals and small businesses with fewer than 50 workers that are not self-insured. Currently, the vast majority of Americans with insurance coverage get it through their jobs – and they generally work for companies with more than 50 workers. Large firms already offer coverage similar to what the health law will require insurers to offer individuals and small firms, so little change is expected. The new rates are most likely to affect people who buy their own coverage. About 15 million do so currently and an estimated 7 million more are expected to do so next year because of the health law.
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.
Thu, Aug 01 2013