New sign-up season, new woes for Obama health care law
WASHINGTON — President Barack Obama is leaving the White House in a few months, but the troubles of his signature health care law continue to make headlines. With premiums rising by double digits and many consumers scrambling to replace coverage because their insurer bailed out, the 2017 signup season that starts Nov. 1 looks challenging.
Obama says it’s just “growing pains” but critics see the threat of market collapse, a death spiral. Here are some questions and answers for consumers ahead of the law’s fourth open enrollment season:
I buy my insurance directly, so why are my premiums going up so much if I don’t use healthcare. gov?
The 2010 health care law aimed
to create a single market in each state for health insurance purchased by individuals. That’s increasingly true as older plans that predate the law fade away.
So consumers who bypass the public insurance exchanges and buy individual policies from an insurer are not insulated from premium increases. And they lack incomebased subsidies available to customers inside government marketplaces.
The administration estimates that 6.9 million people currently buy coverage outside the marketplaces, and of those, nearly two-thirds would not be eligible for subsidies if they looked within the exchanges.
Another group, roughly 1.5 million people, buy policies through the exchanges, but make too much to qualify for subsidies.
The people in these two groups will bear the brunt of premium increases.
Minnesota dairy farmers Dave and Ann Buck say their monthly premium of $1,650 for a family plan could jump to more than $3,000 next year.
What does the Obama administration say about rising premiums?
Officials finally acknowledged the price jump this week, revealing that premiums for a midlevel benchmark plan are going up an average of 25 percent across the 39 HealthCare.gov states. (It’s slightly less — 22 percent — when remaining states running their own marketplaces are factored in.)
The administration calls it a temporary market “correction” because insurers had set their premiums too low in previous years. Officials estimate 72 percent of HealthCare. gov customers will still be able to find a plan for less than $75 a month after taking into account subsidies.
Caveat: Those large subsidies tend to go to lowerincome consumers.
Are premiums going up because some insurers are leaving the market?
While there’s strong evidence that competition among insurers helps to keep premiums in check, it’s not clear that insurers bailing out is the main reason driving doubledigit increases.
Insurers say their new customers turned out to be sicker than expected, and not enough younger, healthier people have signed up to help defray costs. Also, the law’s internal system to help balance out gains and losses among insurers has not worked well.
I’m a returning customer to the health insurance marketplace. What should I look for this time?
It probably makes more sense than ever to shop around.
If your insurer left the market, HealthCare.gov will try to automatically match you up with a similar plan from another carrier. You don’t have to accept that match, but it could be a starting point for shopping.
Administration officials say a smoother website should make it easier to compare plans on features that consumers care about, such as which doctors participate. HealthCare. gov has been improved for mobile devices.
Depending on availability, consumers will have a new option of picking “Simple Choice” plans, clearly flagged on the website. These plans make it easier to compare premiums and provider networks.
Tip: Make sure to check your income information and update if needed.