(Photo: Charles Dharapak, AP)
WASHINGTON — As state health exchanges continue to announce lower-than-expected rates for health insurance, experts say both state and regional issues play a part in how much a consumer will pay for insurance beginning in January. Several factors come into play: a state’s regulations, how many insurers will participate in the state and federal exchanges, and what kind of a risk those insurers are willing to take.
“There is tremendous existing variation within the rates in the states now,” said Sherry Glied, professor of health policy and economics at Columbia University and former assistant secretary for planning and evaluation at the Department of Health and Human Services. “It’s hard to compare the old rates to the new.” Maryland’s insurance commissioner said Friday that the expected new rates for residents who will need to buy insurance starting Oct. 1 are up to 33% lower than expected, and that coverage for a 21-year-old non-smoker could cost as low as $93 a month.
In Connecticut, insurer HealthCT announced plans that would drop an average of 36% from its original proposal in the individual market; and Nevada will sell plans to young adults to cover catastrophic health situations for less than $100 a month. An HHS report released this month showed that silver health exchange plans — the lower cost plans that uninsured people are more likely to buy — are an average 18% lower than anticipated in the 11 states the department studied. “We know the rates are coming in lower than we expected,” Glied said. “They’re coming in well below the Congressional Budget Office’s estimated rates, which people thought were optimistic.”
These new rates apply only to those who are currently uninsured and who will be buying insurance through the state or federal exchanges. A health exchange or marketplace is a website that allows consumers to choose from several different private insurers. Under the 2010 health care law, Americans who buy health insurance on the state exchanges can choose from four types of plans — bronze, silver, gold and platinum. Bronze has the lowest levels of coverage and cost; platinum is the elite and most expensive. Industry surveys and records from Massachusetts, which enacted a health care law in 2006, show the overwhelming majority of people buy either bronze or silver plans.
November 19, 2024