Health Overhaul-Florida-Exchange Rates

MIAMI (AP) — Florida residents are finally getting to see what so-called “Obamacare” means for them as state insurance officials released rate details late Wednesday showing how much some health plans may cost under the new federal health law and how many providers will be participating in the state exchange.

The details come one day after Florida Insurance Commissioner Kevin McCarty said rates will rise an average of 5 to 20 percent for small businesses and 30 to 40 percent in the individual market. But he countered that those increases are partly due to the fact that consumers will receive more benefits, and the higher costs will be offset by federal subsidies in many cases.

Most of the state’s roughly 3.5 million uninsured residents will not see extreme price hikes, McCarty said.

Officials said the new insurance plans will be more comprehensive, making direct comparisons to existing plans impossible, but the Florida Office of Insurance Regulation based its comparison on the average cost of premiums for midlevel plans from 11 insurers.

The smallest increase was an HMO plan from Humana that bumped up 7 percent from $293 to $315. The largest was 59 percent from a Sunshine State Health plan that jumped from $293 to $464.

Some of the state’s largest health insurers, including Florida Blue, Cigna, Humana and Aetna, will be among 11 plans competing through the state’s new health exchange in the individual market in all 67 counties. Many counties will be able to choose from six or seven carriers. But Bay, Franklin, Glades, Jefferson and Madison were among the 20 counties where consumers will only have one option.

Lack of competition from insurers under the health care law has raised concerns in some states. President Barack Obama told Democrats administration is working to fix the problem.

Residents in Miami-Dade and Broward counties will be able to choose from nine plans. Aside from where a person lives, insurers are limited in their ability to charge consumers different prices for health care.

So how will the new federal health law change insurance benefits and prices for average consumers?

As of Jan. 1, insurers can no longer turn away the more than 7.8 million non-elderly Floridians with pre-existing medical conditions, according to federal health officials. Insurers will be limited in what they can charge to older policy holders and out-of-pocket expenses will have an annual cap. Insurers are also required to offer beefed up benefits under the plans, so while prices may increase, consumers will get an upgraded product. Some Florida insurers currently offer skimpy benefit plans at cheap rates for catastrophic coverage, but those types of plans will no longer be allowed under the federal health law.

Additionally, residents making less than $48,000 a year will receive a federal voucher to help offset premium costs. The less a person makes, the more the government will pay.

The new marketplaces, which are open for enrollment Oct. 1, will have the feel of an online travel site where individuals, families and small businesses can compare different private insurance plans. Consumers will be able to choose from bronze, silver, gold, platinum and catastrophic plans that offer a range of premiums, deductibles and co-pays depending on variables such as how many doctors you want included in your network. Insurers are offering 308 plans through the exchange in Florida, according to state insurance officials.

Individuals will have to have health insurance from their employer or purchase it, and will pay a roughly $100 penalty next year if they don’t. Anyone making below the poverty line won’t be eligible to buy insurance through the online marketplace. Federal health officials anticipate roughly 1 million Floridians will fall into a gap where they can’t get health insurance because the state rejected Medicaid expansion.

Federal health officials said the health care law will provide better options, better value, better health and a stronger Medicare program for Floridians. In many states, they said rates have turned out to be lower than previous estimates.

Educating Americans about the Affordable Care Act will be paramount for the federal government and insurers as 78 percent of uninsured adults don’t know about opportunities that will be available to them in 2014 under the new health laws, according to Enroll America, a nonprofit group sponsoring a national marketing campaign.

The insurance commission warned that enticing young healthy adults to buy insurance was also a significant concern. Many experts predict rates will rise for these so-called “young invincibles” and if too many young adults avoid the new insurance marketplace, it could throw off the entire equilibrium of the Affordable Care Act.

“I’m deeply concerned on many levels as to how this thing will roll out,” McCarty said.


Source: Associated Press