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Obama
health
plan hit
by
double-digit
premium
hikes
By
RICARDO
ALONSO-ZALDIVAR
ap.org
WASHINGTON
-
Premiums
will go
up
sharply
next
year
under
President
Barack
Obama's
health
care
law, and
many
consumers
will be
down to
just one
insurer,
the
administration
confirmed
Monday.
That's
sure to
stoke
another
"Obamacare"
controversy
days
before a
presidential
election.
Before
taxpayer-provided
subsidies,
premiums
for a
midlevel
benchmark
plan
will
increase
an
average
of 25
percent
across
the 39
states
served
by the
federally
run
online
market,
according
to a
report
from the
Department
of
Health
and
Human
Services.
Some
states
will see
much
bigger
jumps,
others
less.
Moreover,
about 1
in 5
consumers
will
have
plans
only
from a
single
insurer
to pick
from,
after
major
national
carriers
such as
UnitedHealth
Group,
Humana
and
Aetna
scaled
back
their
roles.
"Consumers
will be
faced
this
year
with not
only big
premium
increases
but also
with a
declining
number
of
insurers
participating,
and that
will
lead to
a
tumultuous
open
enrollment
period,"
said
Larry
Levitt,
who
tracks
the
health
care law
for the
nonpartisan
Kaiser
Family
Foundation.
Republicans
pounced
on the
numbers
as a
warning
that
insurance
markets
created
by the
2010
health
overhaul
are
teetering
toward a
"death
spiral."
Sign-up
season
starts
Nov. 1,
about a
week
before
national
elections
in which
the GOP
remains
committed
to a
full
repeal.
"It's
over for
Obamacare,"
Republican
presidential
candidate
Donald
Trump
said at
a
campaign
rally
Monday
evening
in
Tampa,
Florida.
Trump
said his
Democratic
rival,
Hillary
Clinton,
"wants
to
double
down and
make it
more
expensive
and it's
not
gonna
work.
... Our
country
can't
afford
it, you
can't
afford
it." He
promised
his own
plan
would
deliver
"great
health
care at
a
fraction
of the
cost."
The new
numbers
aren't
too
surprising,
said
Sen.
Orrin
Hatch,
R-Utah,
who
chairs a
committee
that
oversees
the law.
It "does
little
to
dispel
the
notion
we are
seeing
the law
implode
at the
expense
of
middle-class
families."
HHS
essentially
confirmed
state-by-state
reports
that
have
been
coming
in for
months.
Window
shopping
for
plans
and
premiums
is
already
available
through
HealthCare.gov.
Administration
officials
are
stressing
that
subsidies
provided
under
the law,
which
are
designed
to rise
alongside
premiums,
will
insulate
most
customers
from
sticker
shock.
They add
that
consumers
who are
willing
to
switch
to
cheaper
plans
will
still be
able to
find
bargains.
"Headline
rates
are
generally
rising
faster
than in
previous
years,"
acknowledged
HHS
spokesman
Kevin
Griffis.
But he
added
that for
most
consumers,
"headline
rates
are not
what
they
pay."
The vast
majority
of the
more
than 10
million
customers
who
purchase
through
HealthCare.gov
and its
state-run
counterparts
do
receive
generous
financial
assistance.
"Enrollment
is
concentrated
among
very
low-income
individuals
who
receive
significant
government
subsidies
to
reduce
premiums
and
cost-sharing,"
said
Caroline
Pearson
of the
consulting
firm
Avalere
Health.
But an
estimated
5
million
to 7
million
people
are
either
not
eligible
for the
income-based
assistance,
or they
buy
individual
policies
outside
of the
health
law's
markets,
where
the
subsidies
are not
available.
The
administration
is
urging
the
latter
group to
check
out
HealthCare.gov.
The
spike in
premiums
generally
does not
affect
the
employer-provided
plans
that
cover
most
workers
and
their
families.
In some
states,
the
premium
increases
are
striking.
In
Arizona,
unsubsidized
premiums
for a
hypothetical
27-year-old
buying a
benchmark
"second-lowest
cost
silver
plan"
will
jump by
116
percent,
from
$196 to
$422,
according
to the
administration
report.
But HHS
said if
that
hypothetical
consumer
has a
fairly
modest
income,
making
$25,000
a year,
the
subsidies
would
cover
$280 of
the new
premium,
and the
consumer
would
pay
$142.
Caveat:
if the
consumer
is
making
$30,000
or
$40,000,
his or
her
subsidy
would be
significantly
lower.
Dwindling
choice
is
another
issue.
The
total
number
of
HealthCare.gov
insurers
will
drop
from 232
this
year to
167 in
2017, a
loss of
28
percent.
(Insurers
are
counted
multiple
times if
they
offer
coverage
in more
than one
state.
So
Aetna,
for
example,
would
count
once in
each
state
that it
participated
in.)
Switching
insurers
may not
be
simple
for
patients
with
chronic
conditions.
While
many
carriers
are
offering
a choice
of plan
designs,
most use
a single
prescription
formulary
and
physician
network
across
all
their
products,
explained
Pearson.
"So,
enrollees
may need
to
change
doctors
or drugs
when
they
switch
insurers,"
she
said.
Overall,
it's
shaping
up to be
the most
difficult
sign-up
season
since
HealthCare.gov
launched
in 2013
and the
computer
system
froze
up.
Enrollment
has been
lower
than
initially
projected,
and
insurers
say
patients
turned
out to
be
sicker
than
expected.
Moreover,
a
complex
internal
system
to help
stabilize
premiums
has not
worked
as hoped
for.
Nonetheless,
Obama
says the
underlying
structure
of the
law is
sound,
and
current
problems
are only
"growing
pains."
The
president
has
called
for a
government-sponsored
"public
option"
insurance
plan to
compete
with
private
companies.
Republicans,
including
Trump,
are
united
in
calling
for
complete
repeal,
but they
have not
spelled
out how
they
would
address
the
problems
of the
uninsured.
Clinton
has
proposed
an array
of
fixes,
including
sweetening
the
law's
subsidies
and
allowing
more
people
to
qualify
for
financial
assistance.
The law
makes
carrying
health
insurance
a legal
obligation
for most
people,
and
prohibits
insurers
from
turning
away the
sick. It
offers
subsidized
private
plans to
people
who
don't
have
coverage
through
their
jobs,
along
with a
state
option
to
expand
Medicaid
for
low-income
people.
Largely
as a
result,
the
nation's
uninsured
rate has
dropped
below 9
percent,
a
historically
low
level.
More
than 21
million
people
have
gained
coverage
since
the
Affordable
Care Act
passed
in 2010. |
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