Thread: California health exchange reveals Obamacare premium costs

May 23, 2013

California health exchange reveals premium costs

Californians received the bottom line Thursday on which insurance firms will sell policies on the state's new health-care exchange this fall and how much those premiums will cost.

The announcement by Covered California, the marketplace for such policies, brings into sharper focus the impact of the nation's health-care overhaul on families and their pocketbooks.

Thirteen health plans were picked to submit plans, with none of the state's 19 designated regions having fewer than three plans to serve consumers, Covered California announced.

Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente were among the firms chosen. Their tentative selection is subject to rate review by state regulators.

California's 19 geographic regions will average five health plans from which to choose. Even in most rural areas, consumers will have two or three options - though in a small number of counties only one plan will be available, officials said.

"Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up - creating a market that will allow millions of consumers to enroll in affordably priced products," Peter V. Lee, director of Covered California, said in a written statement.

"Because of that, we will be able to deliver exceptional value, low rates, access to health care in every region of the state, and a solid platform to achieve the dream of providinig quality health care for all Californians," Lee added.

Premiums will vary based on age, region, household size and type of coverage sought.

Requirements of Covered California's insurance policies differ from those sold in the state's individual market currently, without public subsidies, so price comparisons are not readily available.

Covered California contends that the most valid cost comparison is with health-care policies currently sold in the state's small employer market. The exchange's policies next year would range from 2 percent above to 29 percent below this year's averages for the existing small employer market in California's most populous markets.

In the capital region, encompassing Sacramento, Placer, Yolo and El Dorado counties, consumers buying through the exchange will be able to choose policies from Blue Shield, Kaiser Permanente, Western Health Advantage -- and two forms of Anthem coverage.

For a relatively basic policy, known as a "silver" plan, the total monthly premium in the Sacramento region for a 40-year-old single individual would range from $332 to $476, with federal subsidies on a sliding scale for people with incomes up to $45,960. Individuals eligible for the highest subsidy, $276 per month, would face out-of-pocket expenses of $56 for monthly premiums.

Under next year's controversial national health-care mandate, often called Obamacare, nearly all Americans will be required to have health insurance next year or pay a fine of $95 or 1 percent of their annual income, whichever is more.

Californians of low and moderate incomes who buy policies on the state's new exchange will receive federal subsidies on a sliding scale, extending to a family of four earning up to $94,200.

An estimated 2.6 million Californians will be eligible for subsidies if they buy through the exchange.

Four tiers of policies will be sold by Covered California: bronze, silver, gold and platinum. The lowest premiums are for policies with the highest out-of-pocket costs for care - and vice versa.

Californians cannot be denied coverage based on pre-existing medical conditions, prices cannot vary by gender, and insurers are not allowed to set a maximum dollar amount they will pay during a policyholder's lifetime.

All policies sold by the exchange must cover preventive care, prescription drugs, contraception, medical screenings - such as mammograms - and other "essential benefits," including pediatric, mental health, maternity and rehabilitation services.

Covered California is scheduled to begin selling policies in October for coverage that takes effect Jan. 1.

http://blogs.sacbee.com/capitolalert...#storylink=cpy

UnitedHealth, Aetna and Cigna opt out of California insurance exchange

Kaiser Permanente, Anthem Blue Cross and Blue Shield of California are all expected to participate in the state-run market for individual health coverage.

May 22, 2013|By Chad Terhune, Los Angeles Times

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Aetna--along with UnitedHealth Group and Cigna--is sitting out the first… (Bob Child / Associated Press )

Some prominent health insurers, including industry giant UnitedHealth Group Inc., are not participating in California's new state-run health insurance market, possibly limiting the number of choices for millions of consumers.
UnitedHealth, the nation's largest private insurer, Aetna Inc. and Cigna Corp. are sitting out the first year of Covered California, the state's insurance exchange and a key testing ground nationally for a massive coverage expansion under the federal healthcare law.

Meanwhile, the biggest insurers in the state — Kaiser Permanente, Anthem Blue Cross and Blue Shield of California — are all expected to participate in the state-run market for individual health coverage.
Quiz: Test your healthcare knowledge
Covered California, the state agency implementing the federal Affordable Care Act, is announcing the winning bidders and proposed rates Thursday for its insurance exchange, where as many as 5 million residents are expected to shop for coverage next year.
The state has picked a group of health plans for each of 19 regions across California. The insurers will be selling policies with uniform benefits packaged in four broad categories of coverage. For the first time in the individual market, consumers will be able to make easier price comparisons among companies.
But the threat of higher premiums in next year's revamped market has been a major concern for policymakers who can't risk alienating too many middle-income, healthier customers who are needed to offset the increased costs of covering sicker, poorer people who have been shut out of the healthcare system for years.
UnitedHealth, Aetna and Cigna are small players now in California's individual health insurance market. More of their business is focused on large employers, where most Californians receive their health coverage. But the companies signaled a wait-and-see approach on these new government-run marketplaces.
Together, in 2011, those three big insurers had 7% of California's individual health insurance market, according to Citigroup research. In contrast, Kaiser, Anthem Blue Cross and Blue Shield had nearly 87%, collectively. Anthem Blue Cross is a unit of WellPoint Inc., the nation's second-largest health insurer.
Peter Lee, executive director of Covered California, declined to comment on specific companies ahead of Thursday's announcement. But he rejected any criticism that diminished competition could lead to higher premiums and fewer choices.
"There will be plenty of price competition for California consumers," Lee said in an interview Wednesday. "They will be benefiting from robust competition."
A spokesman for Minnetonka, Minn.-based UnitedHealth said, "We are simply taking the time to carefully evaluate and better understand how the exchanges will work to ensure we are best prepared to participate meaningfully in their development."
Joseph Mondy, a spokesman for Bloomfield, Conn.-based Cigna, said the company chose to participate in exchanges in only half of the 10 states where it sells individual health policies. Those states include Arizona, Colorado and Florida. "We will continue to offer individual plans going forward, but we've decided not to participate in Covered California in 2014," Mondy said.


Aetna, the nation's third-largest health insurer, based in Hartford, Conn., referred questions to Covered California.
Glenn Melnick, a health policy professor at USC, said there could be advantages and disadvantages if the state's three largest insurers — Kaiser, Anthem Blue Cross and Blue Shield — grab even more business through the exchange. Their increased market power could give them even better bargaining leverage with hospitals and doctors, helping them to drive down healthcare costs.
But Melnick said it remained to be seen whether "the market is competitive enough that those companies will pass along those savings."
Melnick said UnitedHealth, Aetna and Cigna may be making a mistake by sitting on the sidelines given California's size and importance in the healthcare overhaul nationwide. "California is going to be a trendsetter," he said.
Other health policy experts said the lack of these national health plans in the California exchange isn't a major problem because the exchange probably will announce some new regional competitors.
"We will see a lot of interesting competition by region," said Micah Weinberg, a senior policy advisor at the Bay Area Council, an employer-backed nonprofit group in San Francisco.
Quiz: Test your healthcare knowledge
In March, state officials issued a report estimating that, compared with what individual policies cost now, premiums may rise an average of 30% for many middle-income residents who don't get their insurance through their employers.
At the same time, lower-income consumers will reap the biggest savings and are projected to save as much as 84% off their coverage thanks to federal subsidies.
In California, individuals earning less than about $16,000 will qualify for an expansion of Medi-Cal, the state's Medicaid program for the poor. Above that threshold, individuals making less than $46,000 and families earning below $94,000 annually will qualify for federal subsidies.
Starting in January, most Americans will be required to have health insurance or face a penalty.
　
　
http://articles.latimes.com/2013/may/22/business/la-fi-health-insure-20130523

Be Covered Texas

becoveredtexas.org/‎

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Helpful Materials. There's a lot of talk about the new health care law – but what does it mean? Read Be Covered Texas' easy-to-follow brochure to learn more.

http://www.alipac.us/f9/rate-shock-c...emiums-279789/

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http://www.alipac.us/f9/new-yorkers-...change-283730/

New York state residents will be able to get health insurance next year on the Obamacare exchange for half the average price available in the state today.

The Empire State is the latest to reveal premiums that are lower than current rates. Residents in California and Oregon, among others, will also have offerings that are cheaper than many plans on the market today.