HealthPocket analyzed rate filings for 3,771 plans in 45 states and found proposed Affordable Care Act premiums average a 12% rate increase for 2016. Premiums were compared for 40-year-old non-smokers in the largest city in each state.
Silver plans, the most popular exchange plan during the 2015 open enrollment period, accounting for 67% of marketplace plan selections, and 2016 rate proposals for silver plans averaged 14% higher than premiums in 2015. At a 16% increase, gold plans had the greatest average rate increases proposed for 2016. Entry-level bronze plans had 2016 rate proposals that averaged 9% higher than 2015 while platinum plans, the top-tier of the Affordable Care Act plans, averaged only a 6% increase in rates for 2016.
HealthPocket also found that rate increases varied significantly depending on the type of health plan. For example, among bronze plans examined, rate proposals for HMO and EPO plans were 20% higher than 2015 while PPOs were only 4% higher.
2016 rates represent the first time Affordable Care Act insurers have had a full year of medical claims data (including the post-deductible period) to determine rates for the new enrollee pools enabled by the law. Prior to the enactment, in most states applicants with expensive pre-existing conditions risked being rejected for privately purchased health insurance. Given the exclusion of this population in the pre-reform market, historical data on enrollee pools had limited value for setting Affordable Care Act rates.
Consumers will not necessarily pay the health insurance premiums proposed within the rate filings. The proposed rates must be reviewed and approved by the insurance regulators specific to each state in which the rates were filed. That process may result in the lowering of some of the rates proposed. Moreover, some consumers will experience less of premium increases due to subsidies while others, who are unsubsidized and pay full price for health insurance, will endure the full cost of whatever rate increases are approved.
“Given the possibility of subsidy loss on Healthcare.gov due to the King v. Burwell Supreme Court case,” said Kev Coleman, Head of Research & Data at HealthPocket, “2016 rate proposals are receiving considerable attention. A principal concern is whether these rates are affordable in the potential absence of subsidies.”
To review the full report as well as its methodology, please see “Obamacare Insurers Propose 12% Higher Premiums for 2016” at HealthPocket.com.
HealthPocket.com is a free website that compares and ranks all health insurance plans, helping individuals, families, and small businesses to make their best health plan decisions. HealthPocket publishes health insurance market analyses and other consumer advocacy research. HealthPocket’s research is nonpartisan and uses only objective data from government, non-profit, and private sources that carry no conditions that might restrict the site from serving as an unbiased resource. HealthPocket, Inc. is independently managed and based in Mountain View, California. Learn more at www.HealthPocket.com.
For more information, please contact Ryan Hughes, Shirley & Banister Public Affairs at RHughes@SBPublicAffairs.com or 703-739-5920/800-536-5920.