From: SF Chronicle – 10/16/16
Next year’s health insurance rates for individual policyholders are starting to hit mailboxes, and that’s proving to be painful for some California consumers.
Covered California, the state’s health insurance marketplace created by the federal health law, warned in July that 2017 premiums would go up an average of 13.2 percent, or more than triple the average 4 percent rate increases that consumers have seen since the exchange started offering coverage in 2014.
Around 90 percent of Covered California’s
1.4 million Enrollees get some federal aid to help cover the cost of their premiums. The increases will be felt most acutely by those policyholders who make too much money to qualify for those subsidies. These are self-employed people or those who otherwise don’t get health insurance through their employers.
“I was in favor of Obamacare,” said Ted Weinstein, a self-employed literary agent in San Francisco, referring to the Affordable Care Act. “Now I’m taking it in the shorts with a 27 percent rate increase (next) year.”
Weinstein, who emphasizes he supports expanding coverage to the millions of Americans without health insurance, said he’s frustrated that his Anthem policy, which cost $773 a month in 2014 when the major elements of the health law kicked in, has now shot up to over $1,300.
About 10 million Americans who buy individual health insurance either through or outside the state and federal marketplaces don’t receive any federal subsidies to help lower their costs, according to the Congressional Budget Office. Weinstein, for example, does not qualify for a subsidy.
President Obama’s signature health legislation has come under fire in this election season, with major insurers like Aetna and UnitedHealth retreating from the marketplaces, as well as the rising premiums. Even the law’s supporters, like Minnesota Gov. Mark Dayton, a Democrat, are lobbing criticisms. Dayton last week declared the Affordable Care Act “no longer affordable,” with individual premiums in the state exchange increasing next year by an average of 50 to 67 percent.
California has been largely considered successful in rolling out its exchange and keeping premiums under control, but this year is proving to be challenging.
While rates are going up an average of 13.2 percent statewide, Covered California’s largest insurers — Anthem and Blue Shield of California — are increasing rates by 17.2 percent and 19.9 percent respectively. The state has no laws or regulations that cap premium increases.
“Things are working better in California than almost everywhere else, but it’s still not perfect,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a nonpartisan health research and communications organization. “If open enrollment goes poorly, it’s possible there could be further plan exits and bigger premium increases this next year.”
This year’s open enrollment period starts Nov. 1 and ends Jan. 31, 2017, but people can sign up outside that period under special circumstances such as if they lost their coverage due to a job loss, divorce or move.
Anthem and Blue Shield have blamed the increases on several reasons, including higher-than-expected use of medical services by members, increased cost of prescription drugs and high costs incurred by people who signed up for coverage outside the open enrollment period.
The burden of the higher rates isn’t being shared equally throughout the state. Northern California historically has had higher premiums than Southern California for a variety of reasons including hospital-network mergers, but some of the contrasts are stark.
In Santa Clara County, premiums are going up a weighted average of 9.2 percent, while people in San Francisco will see their rates increase by 14.8 percent, according to figures released by Covered California. Meanwhile, in Monterey, San Benito and Santa Cruz counties, where there is little competition among providers, average premiums are skyrocketing by 28.6 percent.
Covered California, which started sending out renewal notices on Oct. 5, has recommended that consumers shop around and compare plans.
The exchange offers 11 plans, but the number of choices varies by region. Covered California officials estimated 7.4 percent of enrollees can choose from only two plans. San Francisco, by contrast, offers six different carriers.
Weinstein, 54, said similar coverage from other insurers cost about the same, but he’s most disturbed by benefit changes in his plan that no longer provide coverage if he wishes to visit an out-of-network doctor or hospital.
Weinstein said Republican presidential candidate Donald Trump’s message about how the Affordable Care Act is not affordable resonates for many Americans. While he doesn’t support Trump’s solutions, he said Trump talks more directly about the law’s problems than does Hillary Clinton, the Democratic nominee.
“Real people who are paying out of pocket are getting ravaged with rate increases,” he said. “Until they address that, Obama and Hillary and everybody else are not going to get any public support.”