Some health insurance companies are asking for big price increases next year, and that has again riled critics of the federal health care law. But early analysis shows those steep hikes may not affect the majority of consumers.
The numbers released last week came out of a June 1 deadline, under the Affordable Care Act, that requires insurance companies to tell government regulators when they're requesting price hikes of more than 10 percent. Some officials opposed to the law, like Sen. Steve Daines, a Republican from Montana, decried the increases.
"Blue Cross Blue Shield, which is Montana's largest insurer, is asking for an average increase of 23 percent for Montanans enrolled in individual plans," he told colleagues from the U.S. Senate floor last week.
While that sounds scary, it turns out that Blue Cross Blue Shield in Montana is actually asking for large price hikes on just two plans it wants to offers in the state. While it's not yet public how many they'll offer in 2016, they currently offer 50 plans.
Caroline Pearson, vice president for health reform at the consulting firm Avalere Health, has been digging into available numbers on insurance pricing across several states. She says such price hikes are not the norm. She's not seeing anything like a 20 percent average increase in the price of monthly premiums.
"Those are not necessarily the plans that hold the bulk of enrollment," she says. "So, while some of those plans may be going up a lot in price, that doesn't mean a lot of enrollees are necessarily affected."
In the handful of states where data is available (Connecticut, Maryland, Michigan, Oregon, Virginia, Vermont, Washington state and Washington, D.C.), Pearson says the majority of people buying health coverage on exchanges won't face serious sticker shock.
"We have seen that about 6 percent average rate increases are expected for 2016," Pearson says.
As Avalere looks at the less expensive plans, she says, "We're seeing anywhere from a 5 percent increase for the lowest-cost plan available, to a 1 percent increase for the second-lowest-cost plan available. So we're really looking at very modest increases — very consistent with what we saw from 2014 to 2015."
Pearson also points out that the price increases — big or small — are by no means final. They're requests from insurance companies. And, in a lot of states, insurance commissioners have the ability to reject price increases they judge unjustifiable. The actual prices of health plans being sold on the exchanges will be final this fall.
This story is part of NPR's reporting partnership with Montana Public Radio and Kaiser Health News.
Transcript
ARI SHAPIRO, HOST:
There was recently news that health insurance companies are asking for big price increases next year. That has riled up critics of the federal health care law. Now as experts start taking a closer look, the price hikes may not be as big as they seem. Montana Public Radio's Eric Whitney reports.
ERIC WHITNEY, BYLINE: The numbers released last week came out because the Affordable Care Act requires insurance companies to tell government regulators when they're requesting price hikes of more than 10 percent. Republicans like Montana Senator Steve Daines jumped on them. Here he is on the Senate floor last Thursday.
(SOUNDBITE OF ARCHIVED RECORDING)
SEN STEVE DAINES: Blue Cross Blue Shield, which is Montana's largest insurer, is asking for an average increase of 23 percent for Montanans enrolled in individual plans.
WHITNEY: Scary, but it may not actually be true. Blue Cross Blue Shield in Montana is only asking for large price hikes on two health plans. They're currently selling more than 50 plans in the state, and it's not yet public how many they want to offer in 2016. Caroline Pearson is with the consulting firm Avalere Health. She's dug into the early numbers across several states and isn't finding anything like 20 percent average increases in premium prices. Those big requested price hikes are not the norm.
CAROLINE PEARSON: Those are not necessarily the plans that hold the bulk of enrollment in exchange. So while some of those plans may be going up a lot in price, that doesn't mean a lot of enrollees are necessarily affected.
WHITNEY: In the handful of states where data is currently available, Pearson says, the majority of people buying health coverage on exchanges won't face serious sticker shock.
PEARSON: About 6 percent average rate increases are expected for 2016. And when we look at some of the low-cost plans in the market, we're seeing anywhere from 5 percent increase for the lowest-cost plan available, a 1 percent increase for the second-lowest-cost plan available. So, you know, we're really looking at very modest increases, very consistent with what we saw from 2014 to 2015.
WHITNEY: Pearson also points out that the price increases - big or small - are by no means final, either. They're requests, and in a lot of states, insurance commissioners have the ability to reject price increases they judge unjustifiable. The actual prices of exchange health plans will be final this fall. For NPR News, I'm Eric Whitney.
SHAPIRO: And this story is part of a reporting partnership with NPR, Montana Public Radio and Kaiser Health News. Transcript provided by NPR, Copyright NPR.
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