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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Premiums Under Obamacare Run the Gamut

    4. Information about premiums may be misleading. continued...

    For example, the premiums for healthy young men may seem high compared to current premiums, she says. But insurance policies available after Jan. 1 must provide more coverage than many of those available now.

    "It's important to ask questions about how the comparison is being made when we hear premiums that sound extreme," she says. "Reasonable premium levels are being seen in the states where we have information so far."

    But "there are some outliers," she says.

    Not everyone shares Blumberg's view that premiums are generally reasonable.

    Tom Miller, JD, a resident fellow at the American Enterprise Institute, a D.C. think tank, says some people, like those under 30 and even aged 30-39, will see increases.

    Why might that be? Because the new system created by the Affordable Care Act "evens out the costs" by requiring both the healthy and the sick to get coverage, says Roberta Riportella, PhD, professor of community health at Kansas State University.

    Insurers can face major financial risk if their “pool” of policyholders includes large numbers of sick people who require expensive care. For that reason, they prefer to balance things out by insuring many healthy people who don’t cost as much. That allows a big chunk of their premiums to help pay for the care of the ill.

    Under the Affordable Care Act, almost everyone -- from the healthy 25-year-old to the 60-year-old with cancer -- will have to get coverage or pay a fine.

    Some critics warn that requiring people to get coverage is an improper intrusion of the government in insurance markets and personal freedom.

    Riportella says that even if premiums on the Marketplace are higher in 2014, the new system has a variety of protections. Insurance companies will no longer be able to set limits on spending per consumer over a year or lifetime, and they won’t be able to turn people away because they have pre-existing medical conditions. “When people understand them fully, I think they will be willing to accept some insecurity about premiums as long as they are within reason,” she says.

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