BY PAT LOEB
PHILADELPHIA (CBS) — When the Affordable Care Act open enrollment period begins next week customers will see some changes, including fewer choices and higher prices.
In Pennsylvania, the number of insurers in the marketplace has gone from 13 to eight. In Philadelphia, just two insurers are left and premiums are expected to rise 53 percent.
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Aviva Aron-Dine of Health and Human Services says the size of the hike reflects artificially low rates early on. Pennsylvania had among the lowest rates in the nation.
“Issuers were pricing for a completely new market, one where they could no longer exclude those with the most serious health needs,” she said, “many set prices that turned out to be too low.”
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But Aron-Dine maintains the plans are still affordable, since three-quarters of Pennsylvanians qualify for tax credits.
“Not only do tax credits bring down the cost of coverage, they adjust dollar for dollar with the cost of the benchmark plan in your area,” she explained. “So even if the cost of benchmark coverage goes up, most consumers will not have to pay more.
Aron-Dine claims costs could even go down if consumers take the time to shop for a cheaper plan. She says new features on the healthcare.govwebsite will make that easier to do.
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Healthier people will avoid buying Affordable Care Act health insurance plans as premiums climb, threatening the stability of the market, Aetna Inc. Chief Executive Officer Mark Bertolini said.
“As the rates rise, the healthier people pull out because the out-of-pocket costs aren’t worth it,” Bertolini said at Bloomberg’s The Year Ahead Summit in New York.
Premiums for health plans sold to individuals under the ACA, known as Obamacare, are going up by about 25 percent on average for next year. Bertolini said that as costs rise, more individuals will decide not to buy health plans. That’ll push premiums even higher, unless a new president and lawmakers can find fixes for the new markets created by the 2010 health law.
“What happens is the population gets sicker and sicker and sicker and sicker,” Bertolini said. “The rates keep rising to try and catch it. It’s a fruitless chase, and ultimately you end up with a very bad pool of risk.”
The government has emphasized that subsidies are available for many people to help cushion the premium increases. When they are taken into account, about 77 percent of current ACA enrollees will be able to buy health insurance for $100 or less a month, the U.S. said in a report on Monday.
Leaving the Market
Insurer Aetna itself is largely ending sales of ACA plans, because it’s recording hundreds of millions of dollars of losses on the policies. The insurer will offer individual coverage on the ACA’s exchanges in four states for next year, down from 15.
Bertolini said Aetna would consider restarting sales on ACA exchanges if lawmakers make changes to the market that would help plans bear the cost of enrollees who’ve turned out to be sicker than expected. He also said passing laws will take time, given the reluctance of some legislators to improve the ACA.
“We have the ability to get back in to the exchanges if the regulation gets it right,” he said. “I don’t think that’s going to happen any time soon enough for us to get back in before 2019, maybe 2020.”