Federal health care exchange open enrollment
Runs from: Nov. 1-Jan. 31
Ryan Thompson can remember thinking health care insurance rates were high when he and his wife had their first child eight years ago.
They were paying $550 a month. Now the father of two, and partner at Pro Touch Landscapes in Gainesville, and his wife will likely have an insurance bill in the neighborhood of $1,300 a month after sharp rate hikes coming in 2017 in the federally run online market.
“I don’t know how people do it,” Thompson said.
Before taxpayer-provided subsidies, premiums for a midlevel benchmark individual plan will increase an average of 25 percent across the 39 states served by the federally run online market created by the Affordable Care Act, according to a report from the Department of Health and Human Services. Some states will see much bigger jumps in 2017, others less.
Open enrollment begins Nov. 1 at healthcare.gov.
In Hall County, the federal exchange will only have plans from two insurers, Alliant and Blue Cross Blue Shield, down from five in the marketplace in 2016, said Brett Fowler, vice president of employee benefits for Turner, Wood & Smith. Making the options even more limited is that Alliant is the only one of those two that includes Northeast Georgia Medical Center as in-market.
“We’re disappointed that companies like Humana, United and Coventry decided not to offer plans to people in Hall County through the Health Insurance Exchange for 2017,” Northeast Georgia Health System spokesman Sean Couch wrote in an email. “However, we are very pleased that Northeast Georgia Health System is a network provider for Alliant Solocare, which is sold through the Health Insurance Exchange for 2017.”
Outside of the federal online marketplace, meaning plans not eligible for government subsidies, Aetna/Coventry will be a third option for insurance customers, Fowler said.
Adding to the impact of having fewer insurers to choose from is that Humana, which Fowler called the “go-to” in Hall County in 2016, is no longer offering plans in Hall. While the Blue Cross Blue Shield and Alliant customers might be likely to fall closer to the 25 percent increase in Hall County, former Humana customers could see closer to a doubling of their premiums, according to some numbers run by Fowler.
Chris Wunn, a Flowery Branch resident who is self-employed in custom computer software development, was able to carry a catastrophic insurance plan before the Affordable Care Act’s individual mandate took effect in 2014. That plan allowed him to pay regular medical expenses out of pocket but be covered beyond the first few thousand dollars in an emergency.
“We’ve lost control of how we want to approach this,” Wunn said.
Wunn, 35, and his 33-year-old wife are both healthy and non-smokers, and they have two young children. Their current health insurance is about $965 per month. To keep the same level of coverage in the latest open enrollment, Wunn said he would have to spend between $600 and $700 more. Instead, he is going with a plan that costs about $1,000 and triples his deductible.
Fowler said insurance carriers are leaving the market because they’re losing hundreds of millions of dollars, in part because they can’t deny insurance to people with pre-existing medical conditions. Another factor is a large number of people adding insurance after open enrollment through “qualifying events” such as loss of insurance, changes in income, moving, getting married or having a baby.
Fowler said it would be hard to avoid large rate hikes becoming routine without “substantial changes” to the health care law. He added that some small employers are looking at group plans rather than individual plans because the group rates are much more stable.
Laura Colbert, director of outreach and partnerships for Georgians for a Healthy Future, an advocacy group that supports the Affordable Care Act, said most consumers shouldn’t feel the effect of the rate hikes. She said 80 percent of Georgians in the online marketplace receive subsidies.
Colbert called the hikes an “initial market adjustment” and added that “we shouldn’t expect these price increases every year.” She said some insurers probably underpriced their plans the past two years to make them attractive, suggesting this should be a “one-time issue.”
She encourages customers to shop around and see if their coverage still meets their needs and is affordable.
Couch advocated speaking with a trusted person before making any decisions.
“We always encourage people to contact an insurance agent or broker who they trust — before they select an insurance plan — to help them understand their options and choose a plan that includes their preferred providers,” Couch said.
The Associated Press contributed to this report.