The average premium rate hikes for popular health insurance plans sold on HealthCare.gov for 2016 will be steeper than last year.
The Affordable Care Act's third open enrollment begins Nov. 1 and runs for three months. The federal government released troves of data for every health and dental plan offered in the 34 states that completely rely on HealthCare.gov. A link on the website has additional files on Hawaii, Nevada, New Mexico and Oregon.
The data include the premiums for various age groups, full summaries of benefits, lists of covered drugs, links to provider networks, out-of-pocket maximums, coinsurance rates, deductibles and many other categories. The CMS released this level of data for the first time last year. State-based exchange data was not collected. The data also do not include current enrollment in each plan.
Some of the most important and common health plans will have significantly higher premiums next year, the CMS said. The benchmark plans, or the second-lowest-cost silver plans that determine a person's premium subsidy, will rise by 7.5% on average in 2016. People qualify for the premium tax credits if they make less than 400% of the federal poverty level and don't have employer-based insurance.
The Health Research Institute at PricewaterhouseCoopers has also studied the rate filings and found that the median increase in benchmark premiums between 2015 and 2016 is 7%. That's much higher than during the first two years of exchange operations, when the median increase was 1.6%, the institute found. Experts said carriers finally had a full year of claims data on which to base their prices and needed to adjust for the high-cost exchange population. Many insurers also may be raising rates to offset two of the ACA's three risk programs that sunset in 2017.
As in previous years, prices vary widely depending on where individuals live and how many insurers are competing in the market. Overall, there are approximately 10 health insurers offering plans per state, HHS said. However, that's a very rough figure. Some states have little competition. For example, West Virginia has only two insurers offering health plans, and the average premium of a benchmark plan there is going up by 18.5%. Further, the average number of individual plans per county across the country will drop from 58 to 50, although it's not a dip that HHS viewed as concerning, experts say.
HHS said about 90% of exchange enrollees will be able to choose from three or more insurers next year. The data do not incorporate the rash of co-op closures since Oct. 19.