Americans will pay an average premium of $328 monthly for a mid-tier
health insurance plan when the Obamacare health exchanges open for
enrollment next week, and most will qualify for government subsidies to
lower that price, the federal government said on Wednesday.
The
figure, based on data for approved insurance plans in 48 states, is the
broadest national estimate for the cost of coverage when President
Barack Obama's healthcare reform law takes full effect next year. The
prices of the new plans are at the heart of a political debate over
whether they will be affordable enough to attract millions of uninsured
Americans when enrollment begins on October 1.
Obama, who is
facing a Republican threat to eliminate funding for the law or shut down
the federal government next week, said the fierce opposition stems from
the fear that Americans will embrace the program.
"Essentially
they're saying people will like this thing too much, and then it will be
really hard to roll back," Obama said on Tuesday in a conversation
about healthcare with former President Bill Clinton. "What we're saying
is, just look for yourself. Take a look at it, and you will discover
that this is a good deal for you."
The Obama administration is
counting on signing up 7 million Americans, including 2.7 million
younger and healthier consumers who are needed to offset the costs of
sicker members, in the first full year of reform through the state
exchanges.
A major factor in determining the price was the level of competition
among insurance companies, with rates significantly higher in states
with fewer players, the U.S. Department of Health and Human Services
said in its report.
The new health plans are organized in five
tiers with different monthly premiums and out-of-pocket costs:
catastrophic coverage, bronze, silver, gold and, in some areas,
platinum.
The national average cited by HHS refers to the
second-cheapest among silver plans on the market - which many healthcare
economists expect to be the most popular for their balance of coverage
and out-of-pocket costs. On average, the least expensive plans in this
group were reported in Minnesota, where it costs $192 per month, and
Tennessee, $245.
At the high end of pricing are states with large
rural populations, where it can be more expensive to deliver
healthcare: Mississippi at $448 per month; Alaska, $474; and Wyoming,
$516. Florida came in right at the national average at $328.
U.S.
Senate Republican Leader Mitch McConnell said the new plan prices were
still a costlier proposition for Americans, based on what they may have
paid for individual plans in the past. Under the Affordable Care Act,
insurance plans must cover a wider range of preventive and other medical
services and cannot turn away applicants based on prior illnesses.
"Even the Administration is having a terrible time spinning this law,"
McConnell said in a statement. "About the best they could claim was that
some premiums would be lower than projected. Note that I didn't say
lower, but lower than projected."
HOW AFFORDABLE?
Debate over whether Obamacare will prove affordable for millions of
uninsured Americans has intensified in the past few months, as states
have announced rates. States that have supported the law said it would
lead to lower prices. Others that have opposed the reform - including
Georgia, Florida, and Indiana - warned of "rate shock" for consumers
compared with what they could buy on the individual insurance market a
year ago.
HHS said the average price was 16 percent lower than
its own projections on premiums. In addition, consumers who earn up to
400 percent of the federal poverty level, or $62,040 for a couple, will
qualify for subsidies that will lower the price further.
The data
is mostly based on 36 states where the federal government will operate
the insurance exchange.
About 14 other states and the District of
Columbia are running their own exchanges. Three states - Hawaii,
Kentucky and Massachusetts - had not released premium information at the
time of the report.
States with the lowest average premium tend
to have more insurance companies offering plans, the report said. It
said eight issuers on average were selling plans in the states with
average premiums in the lowest 25 percent, while states with average
premiums in the top 25 percent had only three insurers on average.
Pricing varies widely not only by state but by community. For instance,
Florida has 67 different geographical rating areas, and their prices
for the second-lowest-cost silver plan range for a 40-year-old from $239
to $352 a month.
"The take-up of the exchanges is going to vary significantly by state
and by community as word gets out," said Michael Sparer, professor of
health policy at Columbia University's Mailman School of Public Health.
Texas has been among the Republican-led states most fiercely opposed to
Obamacare, but its monthly rates came in below the national average,
HHS said. With 76 plans to choose from in Austin, a 27-year-old would
pay $169 per month for the lowest-cost mid-tier one. In Dallas-Fort
Worth, that monthly premium was $217, from 43 plans available, the
report said.
"The rates in Texas are looking good," said Gary
Cohen, who is charged with overseeing the exchanges at the Centers for
Medicare and Medicaid Services.
Insurance industry surveys show
rates are the most important factor in drawing consumers to the
exchanges, which is key to making the healthcare overhaul work.
Another concern has been that insurance companies will limit access to
doctors to keep prices low. Cohen said that these so-called "narrow
networks" were a trend before the Affordable Care Act took effect.
The law was adopted in 2010, but two of its main pillars, the health
exchanges and the expansion of Medicaid, take effect in 2014. Household
names like UnitedHealth Group Inc, Aetna Inc, WellPoint Inc and Humana
Inc will sell plans on at least some exchanges. Newcomers such as
Medicaid specialist Molina Healthcare Inc will also play a role.
source
Thursday, September 26, 2013
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