United Health Care - Opting Out of Most Exchanges!
- Thread starter AllenChicago
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Somarco and Tkruger,
Why would that be the case in areas with only one carrier offering coverage? That is the situation I was referring to with my comment. The DOI approving large increases in order to keep a carrier from pulling out of the exchange entirely, leaving no coverage.
If XYZ was the only carrier offering exchange coverage in a county, then XYZ carrier would have the second-lowest silver plan that sets the subsidy, right?
It doesn't matter if the second-lowest priced silver costs $500 or $1500 a month, Joe Blow at less than 400% FPL only has to pay 9.5% (or 2% or 6%, or 9.66% whatever it has been adjusted to, you get my point) for the second-lowest silver plan.
John Doe at 405% of FPL has to cough up the $1500 for the plan.
Or $1000 for the cheapest bronze.
Or more likely go without.
Why would that be the case in areas with only one carrier offering coverage? That is the situation I was referring to with my comment. The DOI approving large increases in order to keep a carrier from pulling out of the exchange entirely, leaving no coverage.
If XYZ was the only carrier offering exchange coverage in a county, then XYZ carrier would have the second-lowest silver plan that sets the subsidy, right?
It doesn't matter if the second-lowest priced silver costs $500 or $1500 a month, Joe Blow at less than 400% FPL only has to pay 9.5% (or 2% or 6%, or 9.66% whatever it has been adjusted to, you get my point) for the second-lowest silver plan.
John Doe at 405% of FPL has to cough up the $1500 for the plan.
Or $1000 for the cheapest bronze.
Or more likely go without.
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Hmmm, gonna have to ponder that one.
Good point.
Good point.
Maybe the folks at the TN DOI are sharper than most, but my experience in GA is they really don't have the time or desire to address rate issues and who is writing what in which county(s).
GA has 159 counties. First year (2014) Blue was the only HIX carrier in something like 15 counties. Other carriers were in those counties but not on the exchange. So BX had those markets all to themselves (as far as signing up the folks that order off the dollar menu). Don't think the DOI batted an eye.
If no one is on the exchange in a dozen or so counties I doubt they will notice or care.
YMMV
As for your other comment about the dollar menu folks absorbing very little of the increase, use the search function.
GA has 159 counties. First year (2014) Blue was the only HIX carrier in something like 15 counties. Other carriers were in those counties but not on the exchange. So BX had those markets all to themselves (as far as signing up the folks that order off the dollar menu). Don't think the DOI batted an eye.
If no one is on the exchange in a dozen or so counties I doubt they will notice or care.
YMMV
As for your other comment about the dollar menu folks absorbing very little of the increase, use the search function.
It's all very clear...a rate increase to a subsidized client does not affect that client at all... In any way, provided the client stays with the 2nd low cost plan... It's just a raw fact based on the law, period.
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Tater, I thought the same thing, but TKruger gave an example which shows how screwy Obamascrew subsidies can be as the years pass.
See his post here: United Health Care - Opting Out of Most Exchanges! - Page 12
I have read the post, still don't get it. Tkruger's example is not occurring in my state, which is on the federal exchange. The dollar amount of subsidy available at identical income is much higher now than in 2014 or 2015 and is, in fact, tracking if you are basing it off the benchmark.
The plan that was benchmark in my state in 2014 for a 40 year old costs about $50 more a month for the same plan (42 year old) in 2016 at income of $25,000. The identical plan with the same carrier. The reason it is more is that other carriers have come in cheaper and now "own" the benchmark that sets the subsidy so the subsidy no longer sets the price of their plan at 9.5% of income. 6%, whatever.
However, if my subsidized client switches to the new carrier who now owns the benchmark, their costs don't increase much at all. However, they are receiving a LOT more in subsidy in actual dollar amounts.
This system doesn't promise people that they will be able to pick one plan and renew it for 25 years and their prices will never go up. It is all based on that benchmark. If your plan costs more than the benchmark, you have to pay more. It does, however, give the subsidized people a lot more options as far as what they have to pay for insurance (not if only one carrier offering one plan, but you get my point). They can always switch to the benchmark or go with a bronze plan and still be compliant.
In TKruger's example of it costing the family $650 this year, $75 after subsidy (I am rounding because math.), if everything else holds the same and it goes up to $800 next year (same plans, same carriers, same % increase and positions as far as benchmark, etc), they will not be paying $225 for the plan. They will be paying.....$75. Maybe $80 with COL adjustment. Whatever. The subsidy is going to increase to keep their costs steady.
If there is a place where "subsidies aren't keeping up with price increases" it is typically because some carrier has come in with prices well below the increase of last year's benchmark plan. Subsidized people may not be able to keep their original plan, but there ARE plans available at a similar price point to what they were paying. I agree that sometimes the options being offered are crap, but they do have options.
My off-exchange people above 400% FPL who don't make tons of money have gone from purchasing a silver plan in 2014 to a decent bronze in 2015 to a bottom of the barrel bronze in 2016 because of these rate increases.
They are already down at some of the cheapest compliant plans. There is nowhere else for them to go in 2017. In my area, a 63 year old couple who is not subsidized is paying $5000 more a year for worse insurance than in 2014.
The plan that was benchmark in my state in 2014 for a 40 year old costs about $50 more a month for the same plan (42 year old) in 2016 at income of $25,000. The identical plan with the same carrier. The reason it is more is that other carriers have come in cheaper and now "own" the benchmark that sets the subsidy so the subsidy no longer sets the price of their plan at 9.5% of income. 6%, whatever.
However, if my subsidized client switches to the new carrier who now owns the benchmark, their costs don't increase much at all. However, they are receiving a LOT more in subsidy in actual dollar amounts.
This system doesn't promise people that they will be able to pick one plan and renew it for 25 years and their prices will never go up. It is all based on that benchmark. If your plan costs more than the benchmark, you have to pay more. It does, however, give the subsidized people a lot more options as far as what they have to pay for insurance (not if only one carrier offering one plan, but you get my point). They can always switch to the benchmark or go with a bronze plan and still be compliant.
In TKruger's example of it costing the family $650 this year, $75 after subsidy (I am rounding because math.), if everything else holds the same and it goes up to $800 next year (same plans, same carriers, same % increase and positions as far as benchmark, etc), they will not be paying $225 for the plan. They will be paying.....$75. Maybe $80 with COL adjustment. Whatever. The subsidy is going to increase to keep their costs steady.
If there is a place where "subsidies aren't keeping up with price increases" it is typically because some carrier has come in with prices well below the increase of last year's benchmark plan. Subsidized people may not be able to keep their original plan, but there ARE plans available at a similar price point to what they were paying. I agree that sometimes the options being offered are crap, but they do have options.
My off-exchange people above 400% FPL who don't make tons of money have gone from purchasing a silver plan in 2014 to a decent bronze in 2015 to a bottom of the barrel bronze in 2016 because of these rate increases.
They are already down at some of the cheapest compliant plans. There is nowhere else for them to go in 2017. In my area, a 63 year old couple who is not subsidized is paying $5000 more a year for worse insurance than in 2014.
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As noted by Yagents shortly after the example of my post the SLCSP rates vary state to state. In FL they remained fairly constant over the last 3 years whereas in AZ they did not.
Thus the mention of the fact that the SLCSP rate being a moving target. I hope that this clarifies things a bit further.
Thus the mention of the fact that the SLCSP rate being a moving target. I hope that this clarifies things a bit further.
Yes, it does vary by state. Because insurance rates vary by state. But the proportion of income a person is expected to pay is set by Obamacare. A person at 151% of FPL in TN is going to have the same expected contribution for insurance as the person at 151% of FPL in FL. Amount of subsidy to get them to that point will vary based on local prices.
The reason that subsidies would have remained constant between two years is because the rates (for the SLCSP) didn't change that much from year to year. They could have gone down, if the SLCSP price went down. In TN in 2015, the now-defunct co-op basically dropped their prices to 2014 benchmark prices in 2015 to attract customers. (the other carriers raised prices significantly).
So the subsidies didn't actually go up in real dollars much. They dropped out of the market in January and the subsidies for those applying later in the year shot up in actual dollar amounts because the SLCSP now cost 30% more than before. Very screwy on some people's taxes. Expected contribution of a family at 151% of FPL for SLCSP stayed the same, the difference was the plan being offered at that price.
The reason that subsidies would have remained constant between two years is because the rates (for the SLCSP) didn't change that much from year to year. They could have gone down, if the SLCSP price went down. In TN in 2015, the now-defunct co-op basically dropped their prices to 2014 benchmark prices in 2015 to attract customers. (the other carriers raised prices significantly).
So the subsidies didn't actually go up in real dollars much. They dropped out of the market in January and the subsidies for those applying later in the year shot up in actual dollar amounts because the SLCSP now cost 30% more than before. Very screwy on some people's taxes. Expected contribution of a family at 151% of FPL for SLCSP stayed the same, the difference was the plan being offered at that price.
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