Department of Insurance, Securities and Banking (DISB) for approval. The projected impact of changes in the ACA Risk Adjustment program.ĬareFirst submits proposed rates to the Maryland Insurance Administration (MIA), Virginia Bureau of Insurance (VBOI) and the Washington D.C.Changes in the level of sickness of the members insured by CareFirst BlueCross BlueShield.The impact of expected changes to fees imposed on health insurers, such as CareFirst, under the requirements of the Affordable Care Act (ACA).This includes cost increases for specific medical services and goods, as well as increases related to rising utilization of those services and goods. An increase in the cost of medical care.The primary factors driving CareFirst’s proposed premium rate changes are: The report examines premium costs from the two largest metropolitan areas of each state, using data from public insurance records obtained from the Department of Health and Human Services.According to the Center for Medicare and Medicaid Services (CMS), qualified health plan insurers, such as CareFirst BlueCross BlueShield and CareFirst BlueChoice (collectively, CareFirst), must post a notification on its website explaining the necessity of rate increases. He also noted that the study doesn’t weigh policies based on enrollment, meaning that it includes the costs of insurance plans that may have few enrollees. “Attendant to that would be an increase in premiums to be able to appropriately cover those costs.” “If you’re expanding the services you’re covering, and you’re increasing the number of less healthy people in your risk pools, that’s going to increase costs,” Mr. The Affordable Care Act requires insurance policies to include 10 “essential health benefits,” including pediatric dental and vision care, maternity care and newborn care, even for policyholders with no children or whose children are adults. The reasons for the premium increases start with the Affordable Care Act’s prohibition on rejecting applicants with pre-existing conditions, which means that insurance companies must account for the additional costs of covering chronically ill or disabled people.Īnother cost driver is the heightened benefit mandate. “In other words, the subsidized costs of health insurance do not disappear but instead change payers.”Ī spokeswoman with the Department of Health and Human Services declined to comment because she had not seen the report. “Another important consideration in the discussion of subsidized premiums is that the subsidized portion of the premium still must be paid by the government through the money it collects from the nation,” says the study. PHOTOS: Celebrity mugshots: Stars behind bars The report also notes that somebody pays for the subsidy, even if it’s not the policyholder. “That’s what we like to refer to as a subsidy gap.” “So you still have this issue of health insurance rising for that very young group and, depending on where they are with respect to income and premium, they may not qualify for a subsidy,” Mr. Coleman points out that not everyone in that bracket qualifies because their premiums must exceed a certain percentage of their income. The study doesn’t include the federal premium subsidies offered to those earning 100 percent to 400 percent of the federal poverty limit, but Mr. The price increases for 63-year-olds were less dramatic: a 37.5 percent increase on average for women and 22.7 percent for men. And the cost for them went up very ,” Mr. “Obviously they’re very important, and as much as they’re healthier, they tend to use health care less, so you want to try and have as many of those people enrolled as possible. The eye-popping increases among younger insurance buyers could be a problem for Obamacare’s long-term solvency given that young people need to enroll to offset the higher costs associated with older policyholders. PHOTOS: These pro-gun celebrities may shock you “It was a higher amount than I had anticipated.” “I was surprised in general to see the differences in terms of the average premiums in the pre-reform and post-reform markets,” Mr.
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