Will current Individual health insurance rates stay the same when Health Care Reform takes effect on Jan. 1st?

(The following information pertains to Individual and Family Health Insurance for those 64 years old or younger in California.)

Will current Individual health insurance rates stay the same when Health Care Reform takes effect on Jan. 1st?

We do not yet know what the rates will be. But rates are expected to be announced by the carriers in Sept. Those rates will take effect on Jan. 1st when the bulk of the ACA (Obamacare) rules take effect.
What we do know is that individual rates, which have traditionally been low in California, will rise to the level of the higher group rates. Young people will probably see their rates skyrocket. Those in older age groups will probably see more moderate increases.
The increases will likely be due to these factors:
1) The half dozen premium taxes, fees and other charges that will be levied to pay the expenses of the Federal program and the State-sponsored Exchanges.
2) The age band ratio changes from 1:9 to 1:3. Previously, the ratio could be as much as 1 to 9 of a younger person’s rate to that of the oldest age group. Under ACA, that ratio will be compressed to 1 to 3. This will drive up rates for young people while moderating those for the older groups.
3) Guarantee-Issue will result in higher rates. Previously the individual plan “pools” consisted of people who were generally healthy when they enrolled. With guarantee-issue, carriers will have to take all comers including those with significant pre-existing health conditions who previously could not qualify for these plans. This will drive up claims, and therefore premiums.
The carriers and the Exchanges will open for enrollment on Oct. 1st for plans to start on Jan. 1st. Plans will be offered both inside the State Exchanges and outside. The selection of plans within the Exchange will be more limited, but will allow you to apply for low income subsidies. Plans outside of the Exchange will have a much wider selection but will not be able to offer subsidies.
Premiums for similar plans will be the same, inside or outside of the Exchanges.

Phil Lee

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