Federally Run Insurance Exchanges Likely To See Lower Premiums

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Some health policy analysts are predicting that 2014 premium rates for individual-market health plans offered through federally run exchanges under the Affordable Care Act could be lower than expected, similar to those announced in some state-operated exchanges, Modern Healthcare reports (Block, Modern Healthcare, 7/25).

Last week, Obama touted a new HHS report that found the lowest cost plan in the individual market among 10 surveyed states and the District of Columbia would be about $320 per month, or 18% lower than previous HHS and Congressional Budget Office estimates

However, the HHS report did not include data for plans in the 34 federally run exchanges, according to a group of seven Republican House and Senate committee leaders. The lawmakers sent a letter to HHS Secretary Kathleen Sebelius this week asking her to release premium rate data from insurers applying to participate in those exchanges. They cited a separate report indicating that premium rate data for plans in the 34 exchanges would not be publicly released until September (California Healthline, 7/19).

According to Modern Healthcare, states with federally run exchanges have until July 31 to submit premium rate data for HHS approval. HHS is required to notify insurers by Sept. 4 of their application status, according to Caroline Pearson, vice president of the health reform practice at Avalere Health.

Although those premium data have yet to released, Pearson said she believes the 34 states will follow the "pattern of (rates) looking a little bit lower than expected." She suggested that competition among insurers and consumers' ability to compare prices will drive down rates.

Meanwhile, Rachel Dolan -- a health reform policy specialist at the National Academy for State Health Policy -- said the expected declines in premium rates will vary by state, in part because some states already have insurance market reforms in place and the number of insurers participating in the exchanges will differ between states (Modern Healthcare, 7/25).

Robert Wagner
Unfortunately it is comparing apples and oranges. Lower costs are a result of lower benefits and/or a restricted provider network. A good example is Kaiser in Orange County is $447 for a 40 year old currently and it will be $438 in the exchange (example of same network and very similar benefits. Anthem Blue Cross Premier PPO 5000 currently costs $195 (age 40) with full network and higher benefits vs $217 Bronze plan with a restricted network in Covered California. What is being hyped as a savings in the exchange is an apples and oranges comparison.

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