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Insurance rates going up: New concerns for Obamacare

  • ASSOCIATED PRESS

    The HealthCare.gov website, where people can buy health insurance, was displayed on a laptop screen in Washington on Oct. 6. The largest health insurer in Texas wants to raise its rates on individual policies an average of nearly 60 percent, a sign that President Barack Obama’s overhaul didn’t solve the problem of price spikes.

WASHINGTON » Fresh problems for “Obamacare”: The largest health insurer in Texas wants to raise its rates on individual policies by an average of nearly 60 percent, a new sign that President Barack Obama’s overhaul hasn’t solved the problem of price spikes.

Texas isn’t alone. Citing financial losses under the health care law, many insurers around the country are requesting bigger premium increases for 2017. That’s to account for lower-than-hoped enrollment, sicker-than-expected customers and problems with the government’s financial backstop for insurance markets.

The national picture will take weeks to fill in. With data available for about half the states, premium increases appear to be sharper, but there are also huge differences between states and among insurers. Health insurance is priced locally.

Earlier this week, North Carolina’s largest insurer said it will seek an average increase of 18.8 percent.

A recent analysis of nine states by the consulting firm Avalere Health found that average premium increases for the most popular kind of plan ranged from 5 percent in Washington state to 44 percent in Vermont.

Millions of customers will be shielded from price hikes by government subsidies, which typically cover more than 70 percent of the premiums. People who don’t have access to a workplace plan can buy a policy directly on the health law’s marketplaces.

But many consumers aren’t eligible for the income-based subsidies and get no such protection. That demographic includes small business owners, self-employed people and early retirees. Under the law, most Americans are required to have health insurance or risk being fined.

Blue Cross Blue Shield of Texas has about 603,000 individual policyholders and, unlike other insurers in the state, offers coverage in every county. In a recent filing with federal regulators, a summary of which is available on HealthCare.gov, the company said it is seeking increases averaging from 57.3 percent to 59.4 percent across its individual market plans.

In a statement, Blue Cross Blue Shield of Texas said its request is based on strong financial principles, science and data. “It’s also important to understand the magnitude of the losses … experienced in the individual retail market over the past two years,” the statement said. The company says it lost $592 million last year and $416 million in 2014.

Texas is the health care law’s third-largest market, after Florida and California. Texas state regulators said the insurer’s request is confidential and they can’t comment on it. However, Insurance Department spokesman Ben Gonzalez said the state can withdraw approval if the request doesn’t meet requirements and standards in Texas law.

Wichita Falls insurance broker Kelly Fristoe said the burden of premium increases will fall hardest on rural communities where Blue Cross Blue Shield is in many cases is the only option. Metropolitan areas like Houston, Dallas, and Austin attract more insurers.

“This is going to be a very big disrupter of the market,” said Fristoe. Some relatively healthy people “would probably be willing to roll the dice and take their chances” by dropping coverage, even if it means they might be fined.

The insurer cautioned that the average premiums filed with regulators don’t represent the true bottom line for individual consumers. Some people may find that even with a higher premium, the coverage remains a good value.

Regulators can request more information from the company, but the federal government can’t order Blue Cross Blue Shield of Texas to roll back the increases, said Larry Levitt, an expert on the health care law at the nonpartisan Kaiser Family Foundation.

“Given how much money (the company) lost, it’s likely that a substantial rate increase is merited,” Levitt said.

The Obama administration said concerns about 2017 premiums are premature and overblown.

In a statement, the Health and Human Services Department said the Texas rate request is just the beginning of a process. Consumers in Texas and other states will have lower-premium options when sign-up season begins Nov. 1. If they don’t like what their current insurer is charging for 2017, they can switch.

“Consumers will have the final word when they vote with their feet during open enrollment,” said the statement.

Big premium hikes from a single insurance company have had an impact on the health care debate before.

Back in early 2010, when Obama’s health care legislation appeared stalled in Congress, WellPoint’s planned 39 percent increase for some California customers galvanized the White House and its supporters to action. Obama signed the landmark legislation a few weeks later.

WellPoint is now Anthem, the nation’s second-largest insurer. In its home state of Indiana, it is currently seeking premium hikes from nearly 20 percent to 41 percent for coverage under the health care law.

Online:

Proposed premiums — https://ratereview.healthcare.gov

Associated Press writers Jamie Stengle in Dallas and Tom Murphy in Indianapolis contributed to this report.

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  • Forget the “rates”. Straub initiated a “facilities fee” January 1. I did NOT really mind that the co-pay for a doctor visit went up from $35 to $50. I DID, and DO mind, that the “facility fee” is $108 per visit. This is not a “fee”! It is more like a FELONY. I will be returning to Kaiser for my health care as soon as possible.

    • Really? That’s terrible. My visit co-pay at Kaiser is usually $15. That’s it except for $3 parking if I have to go to Moanalua. Prescriptions aren’t bad either.

        • Just rembered that my policy is senior advantage meaning our medicare withholding is paid to Kaiser in addition to my my contribution premiums, plus the Federal contribution for retired employee. Normally the premiums increased annually percentage wise but since Obama care the percentage has increased appreciably.

    • Facility fee? That is charged by the hospital or medical center (not the physician) and usually in cases of certain medical procedures or surgeries.

      I’ve never heard of a facility fee being charged for a doctor’s office visit.

      Before you switch insurers, think about seeing one of the many non-employed (i.e., not on the payroll of any corporatocracy) physicians at Queens? (these are all doctors who are board certified, in private practice, focused on providing compassionate, evidence based care for their patients)

      Kaiser is is great if you are young and healthy, but if you need to see a specialist, be prepared to wait (in the past even Kaiser’s own physicians were kept in the dark from receiving cutting edge care* for themselves or their own families, let alone options to offer their own patients)

      *for example a few years ago, kaiser doctors who were expecting a baby were NOT given the choice of obtaining cutting edge blood tests to identify potential birth defects/complications (as a much safer alternative to amniocentesis (a needle/invasive procedure, which in and of itself carries increased risk of birth defects); Even though other insurers (i.e. blue cross blue shield) wouldn’t pay for the test, atleast their private practice/community docs outside of the kaiser network were providing the option as an alternative for which they could pay cash)

      • “thrive” refers to the kaiser corporatocracy bank account. Don’t be fooled by their misleading ads and ‘feel good imagery’ on those expensive TV ads (which are very expensive, by the way)

  • If Clinton gets into office then it will be Obamacare as usual..she is the third term of BO. With people opting to pay the fine since it is cheaper than paying for Obamacare the Dems will probably make it a federal crime to opt out of Obamacare and set jail time. I would hate to see a third BO term and pray Trump gets in.

  • “new concerns” about obamacare. Let me translate that for you: “concerns that thinking people had from the get/go, but that our glorious media was too awash in Obama-love to report”.

  • O…”If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold.”
    ummmmm…
    Klastri…this is where you come rolling in and reiterate again that this IS O’s SIGNATURE LEGACY legislation.

  • In retrospect, if a health insurance company tells it’s stock holders, it made 2 billion in 2014, and then lost 1 billion in 2015, then to get that money back,they need to mug the clients.

  • Why is there no out rage on “we gotta sign the bill before we read/see it …ANY POLITICIAN SHOULD BE ENRAGED …WHY DON’t they comment are we giving them a pass ???

    • There was outrage on the Right, lots of it alright. BUT couldn’t do anything with Dems controlling ALL 3 branches of the Gruberment. Worst law ever passed with NO GOP for it, 100% Dems only for it.

  • What is that crumbling sound? It’s Obamadon’tcare falling down from it’s own weight, and along with it all the corrupt Democrats who supported this monstrosity. Remember, not one member of the GOP supported Obamadon’tcare, only members of the corrupt Democrat Party, of which all of our Representatives vote for without reading. Come on Hawaii, we going to give them a pass on this too?

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