Changes to Health Insurance Coming in 2014
There are sure to be winners and losers as the federal government finalizes new rules for health insurance plans in the coming months.
Starting in 2014, the federal health care overhaul will limit the factors that insurance companies can use in setting rates, allowing premiums to be based only on a person’s age, history of tobacco use, family size, and geographic location. And even those disparities in premium rates will be limited.
Also, the law requires health insurers to provide “essential benefits” as part of their coverage, ranging from mental health services and prescription drugs to preventive and pediatric services. That will provide a greater degree of health care security for people who buy health insurance on their own, but is will also increase the cost.
The rules, proposed in late November 2012, are likely to have the greatest impact on those who buy health insurance on their own. An estimated 350,000 Ohioans bought their own health insurance in 2010, but the number is expected to increase to 537,000 by 2014, according to a report produced by Milliman Incorporated last year for the Ohio Department of Insurance.
Ohio, overall premium
rates for those who buy individual policies are expected to rise by 55 to 85
percent. For employers with fewer than
100 workers, premium increases are expected to be 5 to 15 percent. At employers with 100 workers or more, the
increases, if any, should be less than 5 percent, according to Milliman.
Young, healthy men are likely to see the biggest premium hikes under the new rules. In part, that is because women can no longer be charged more than men for health insurance, and men who buy individual insurance will effectively subsidize the premiums of women, said Milliman.
Currently, premium rates for those on the cusp of Medicare eligibility are about six times what they are for young adults, according to Milliman. Under the new rules, those rates can be only three times as high. That is likely to lower premiums for older workers who are ill.
Health insurers are concerned that some young people will find that it is to their advantage to decline the purchase of health insurance and pay a penalty instead.
“You need the young and healthy people in the system for this to work,” said Robert Zirkelback of
Health Insurance Plans, which represents insurance companies.
There will also be implications for choice; those who are older than thirty won’t have the option of buying an individual health plan that provides only bare-bones, catastrophic coverage.
Fabien Levy, press secretary for the U.S. Department of Health and Human Services, said alternatively that young adults will benefit from the law in several ways. Those who don’t have health insurance coverage available elsewhere can remain on a parent’s health plan until age 26. Also, tax credit subsidies of premiums should defray the cost as well, according to Levy.
“For instance, we could see a product that could be offered in the marketplace that has a more narrow network design focused on the highest quality providers,” which could result in lower premiums for consumers, McGivern said.
Information taken from the
Journal, December 2012 Middletown
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