Making Sense of Utah s 2015 Insurance Premiums

Transcription

1 Making Sense of Utah s 2015 Insurance Premiums September 2014

2 Key Terms ACA or Obamacare Insurance Private insurance plans sold on healthcare.gov

3 Background Points to ACA Premiums ACA premiums impact consumers who purchase insurance on the individual market, not the 60% of Utahns who receive some type of employer-based insurance. Before the ACA, insurance companies raised premiums without having to explain why. Now they are required to justify rate hikes over 10% ACA requires insurance companies to spend 80% (85% for large group insurers) of collected premiums on health care and quality improvement not administrative, marketing or (1) overhead costs. In 2013, Utah consumers received $3.2 million in rebates from insurers who missed this goal. Insurance rates for individual policies increased 10% or more between 2008 and 2011 before the ACA took effect. (1) 7/28/14; A requirement of the Affordable Care Act leads to a refund for some Utah consumers, ABC-4 (KTVX)

4 Health insurance is sold in three markets Private A policy purchased directly from a private insurance company by an individual or family Small group Employer-based insurance often subsidized by the company for employees and their dependents Self-insured / Self-funded A group health plan in which the employer assumes risk for providing healthcare benefits to employees

5 Nationally, individual market premiums were rising before the arrival of the ACA Average increase in individual market premiums (United States, ) Source: Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act. Issue Brief (Commonwealth Fund) Jun;11:1-12.

6 Utah has a higher percentage of employerbased coverage than the national average Coverage status for all residents 49% Employer-based 59% Employer-based Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2012 and 2013 Current Population Survey (CPS: Annual Social and Economic Supplements (

7 In Utah, (single) employer-based insurance premiums were rising before the ACA Premium trends for Utah employer-sponsored insurance Single Coverage ( ) Source: State-Level Trends in Employer-Sponsored Health Insurance: A State-by-State Analysis; State Health Access Data Assistance Center, RWJF (April 2013)

8 In Utah, (family) employer-based insurance premiums were rising before the ACA Premium trends for Utah employer-sponsored insurance Family Coverage ( ) Source: State-Level Trends in Employer-Sponsored Health Insurance: A State-by-State Analysis; State Health Access Data Assistance Center, RWJF (April 2013)

9 Utah s 2014 premiums were among the lowest in the country $ Lowest-cost silver premium for a 40-year-old person $173 $167 $171 $154 $166 $180 $181 $164 Source: The 10 Least Expensive Health Insurance Markets In The U.S. Kaiser Health News, February 13, 2014 Note: Results based on lowest-cost silver premium for a 40-year-old person

10 Utah s competitive marketplace kept our premium prices low in 2014 Silver-level Plan Premiums (2014) 91 plans Utah National Avg. (FFM) Medical Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health Source: Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

11 84,601 Utahns signed up for coverage on healthcare.gov October 1, 2013 April 19, 2014 by October 31 by November 30 by December 28 by February 1 84,601 by March 1 by April 19 39,902 Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014

12 Utah s 2014 enrollment out-paced comparative states October 1, 2013 April 19, 2014 % of enrollment goal met - by state population Marketplace Status State Federal State population (in mil) % of overall enrollment goal Source: HHS/CMS Health Insurance Marketplace March Enrollment Report For the period: October 1, 2013 April 19, 2014

13 87% of Utahns qualified for premium subsidies in 2014 ACA Subsidy Zone (annual income by family size)

14 65% of Utahns received premium subsidies worth more than $50 a month Distribution of Subsidy Amount (Utah) Source: Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

15 Utah s ACA premiums can vary by age, smoking status, and county (in billions) 1) Age (new ratio of 3 to 1) 2) Tobacco use (ratio of 1.5 to 1) 3) Geography (by counties) Area 1: Cache and Rich Area 2: Box Elder, Morgan, and Weber Area 3: Davis, Salt Lake, Summit, Tooele, and Wasatch Area 4: Utah Area 5: Iron and Washington Area 6: Beaver, Carbon, Daggett, Duchesne, Emery, Garfield, Grand, Juab, Kane, Millard, Piute, San Juan, Sanpete, Sevier, Uintah, and Wayne

16 * 2014 Premiums by Age: Salt Lake County Age (*) Before premium subsidies Source: [2014] Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/7/2013)

17 * 2014 Premiums by Age: Utah County Age Age (*) Before premium subsidies Source: [2014] Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/7/2013)

18 2014 Premiums * by Age: Grand County Age (*) Before premium subsidies Source: [2014] Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/7/2013)

19 A preview of Utah s 2015 plans and premiums will occur at the September 18, 2014 Health Reform Task Force Meeting 2014: 91 Plans Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health 1 plan 24 plans 34 plans 26 plans 6 plans 2015:?? Plans?? plan? plans? plans? plans? plans Source: [2014] Utah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

20 PricewaterhouseCoopers (PwC) is tracking 2015 premiums changes across the nation View this map: Notes: Data accessed 8/27/14; Utah rate information is incomplete and not finalized; read more at

21 Want to learn more? Call or UHPP to schedule a presentation just like this one Jason Stevenson Education and Communications Director cell work ext. 7 stevenson@healthpolicyproject.org