Affordable Care Act: Data show bigger health exchange premium, deductible jumps

Consumers buying health insurance through federal and state exchanges will see their monthly premiums for the popular silver-level plans jump by an average of more than 11 percent, while also likely facing higher deductibles, a new analysis of exchange data by the Robert Wood Johnson Foundation shows.

These increases will raise the cost of health insurance especially for customers who don’t receive federal subsidies to buy insurance, which may also limit the number of people insured under the Affordable Care Act.

Average health insurance premiums for silver plans rose to nearly $300 a month for a 27-year-old male, while deductibles were up 8 percent.

The increases are even more dramatic in the gold-level plans, which have higher premiums but require consumers to pay less out of pocket for their care. These plans’ premiums increased nearly 14 percent, but deductibles dropped just under 1 percent, according to the the data, which will be released Wednesday. It is the only publicly available data with details on all of the insurance plans in 50 states plus Washington, D.C.

“A lot of the insurers talked about how they priced too low and claims exceeded premiums for a lot of them, so there’s been an adjustment,” says Katherine Hempstead, RWJF’s director of insurance coverage. “Going forward you really would expect to see the market stabilize.”

The higher premiums exceed the 7.5 percent average increase the Obama administration has highlighted for the benchmark silver plan for the 37 states using the federal Healthcare.gov exchange in 2015 and 2016. They also highlight the administration’s challenge in persuading people who don’t receive big subsidies to buy insurance to pay more for plans that have increasingly higher deductibles.

Key points from the 2016 date include:

•The average family deductible soared in states including Washington state, where it was up 76 percent or about $3,500 a year; Mississippi, where it shot up 42 percent and South Carolina, which saw a 37 percent increase.

•In North Carolina, premiums and deductibles for silver plans increased on average by about 20 percent.

•Alaska had the biggest average premium increase — 35 percent — for a 27-year-old male. Three other states — Minnesota, Montana and Hawaii — all saw increases of more than 30 percent.

•Twenty-nine states have fewer gold plans and five states are losing more than half their gold plans.

This benchmark plan is used to determine the amount of tax credits received by those who are under 400 percent of the federal poverty limit. Those who make under 250 percent of the poverty limit, or about $50,000 for a family of three, are also eligible for subsidies that reduce their out-of-pocket costs. The Centers for Medicare and Medicaid Services says about 70 percent of consumers will pay $75 or less for a plan this year. About 80 percent of people get tax credits to lower their monthly premiums.

That makes these premium and deductible increases far more of a concern for middle-class consumers.

Although the 7.5 percent average premium increase for the benchmark plan was higher than the 5 percent increase in 2015, the Department of Health and Human Services said in an October report that “this rate increase is relatively modest compared to those in the individual market before the Affordable Care Act, when consumers in the individual market regularly experienced double-digit rate increases on average.”