MacIver News Service | December 9, 2015
[Madison, Wisc…] Wisconsin residents shopping for insurance on the Obamacare exchange this year are finding fewer choices, higher prices, and new company names.For the past three years, HHS has released detailed information about the policies and rates available in each state. The MacIver Institute compared the data from 2015 and 2016.
It found there are 600 fewer plans to choose from for 2016. Last year there were 5,141 and this year there are 4,541.
It also found the premiums, deductibles, and maximum out of pocket increased for bronze plans on average across the state. MacIver looked at the range of rates from lowest to highest for deductibles and maximum out of pocket levels for 2015 and 2016. That information can be examined in the tables below.
| Deductibles | Individual | Family |
| 2015 | $2,500 – $6,600 | $5,000 – $13,200 |
| 2016 | $3,000 – $6,850 | $6,000 – $13,700 |
| Max. Out of Pocket | Individual | Family |
| 2015 | $5,500 – $6,600 | $10,000 – $13,200 |
| 2016 | $6,000 – $6,850 | $12,000 – $13,700 |
There are 36 rate groups based on age and family size, and MacIver did not analyze each one individually. Looking at the cheapest plans available for 30-year-old individuals, in 2015 the rate was $164 and in 2016 it is $170.75.
Two years ago, when the MacIver News Service last reported on this data, it found the most expensive plan in the state was a platinum plan for a family of four with a monthly premium of $1,852.10 or $22,225.20 per year. On the other extreme, the cheapest plan available is a catastrophic plan for a 27-year-old individual with a premium of $109.29, or $1,311.48 a year.
This time around, the cheapest plan in the state is an individual catastrophic level plan in Columbia County that costs $118.97 a month, with a $6,850 deductible and $6,850 maximum out of pocket. The most expensive plan is the Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan in Jackson County for a family with an adult over the age of 50 and at least 3 children. That plan costs $3,417.98 a month, with a $2,000 deductible and $13,700 maximum out of pocket. The premium costs alone add up to over $40,000 a year.
Upon identifying that plan in Jackson County, the MacIver Institute conducted a more thorough review of data from that area. Last year, Jackson County had 5 insurance companies to pick from on the exchange, and that number has not changed. However, some of the names have. Anthem Blue Cross Blue Shield now sells its policies through Compcare Health Service, and United sells under All Savers Insurance Company. The other three companies are Gundersen Health Plan, Health Tradition Health Plan, and Security Health Plan of Wisconsin.
Looking at the average rates for all plans in Jackson County for 21-year-old individuals and families with more than 3 children and one adult over 50, MacIver found large variations in prices and increases from 2015 to 2016. United Healthcare plan increased the most at 19 percent. Meanwhile, Health Tradition’s plans slightly decreased by 2 percent without a big impact on deductibles or out of pocket levels.
| Ind. Avg. Premiums | United/All Savers | Security | Anthem/Compcare | Gundersen | Health Tradition |
| 2015 | $352.10 | $352.03 | $386.89 | $310.12 | $278.50 |
| 2016 | $418.17 | $295.70 | $428.60 | $335.37 | $272.28 |
| Change | 19% | 17% | 11% | 8% | -2% |
| Family Avg. Premiums | United/All Savers | Security | Anthem/Compcare | Gundersen | Health Tradition |
| 2015 | $1,928.46 | $1,380.31 | $2,118.97 | $1,698.55 | $1,525.36 |
| 2016 | $2,290.26 | $1,619.49 | $2,347.46 | $1,836.78 | $1,491.28 |
| Change | 19% | 17% | 11% | 8% | -2% |
Dave Jensen, the director of HC Trends, is working on a more thorough analysis of the 2016 data, but so far, his findings are similar to MacIver’s.
“I think it’s showing that what you have is these plans are more expensive than insurers have hoped and that’s because young healthy are not enrolling,” he told MNS.
The US Department of Health and Human Services recognizes getting young people to enroll is one of its bigger challenges. It believes education is the solution.
“Ultimately, one of the key steps in addressing the many health issues facing young adults is helping each individual understand how to take advantage of the full benefits of their health coverage,” HHS’s website states.
Marketwatch Columnist, Diana Furchtgott-Roth, recently wrote that young people are already well aware of what Obamacare includes. That’s why so many have rejected it.
She wrote:
It mandates a generous, comprehensive plan that is also expensive. Young, healthy people do not want to sign up because the premiums are far higher than their health-care costs. They rightly do not see why they have to buy a plan with pediatric dental care if they have no children, and mental-health and drug-abuse coverage if they do not need it. Many would buy a simple plan, covering major catastrophic expenses, but such plans are not allowed to be sold on the exchanges. People who are signing up for Obamacare are not the young. They are sicker than average and have chronic health conditions that make them more expensive to insure.
HC Trends predicts costs will continue to rise as the program becomes fully operational.
“It’s going be worse next year because a lot of the programs meant to help the insurers will begin to expire,” Jensen said.
Congress is currently looking to end one of those programs early. The “risk corridor” program was meant to spread out risk among insurance companies on the exchange from 2014-16. Successful companies on the exchange would have to pay extra to help out companies that lost money.
Republicans say the program has morphed into a taxpayer-funded bailout program. In a letter to Republican leadership, Sen. Marco Rubio (R-Texas) explained how insurers requested $2.9 billion this year under the program, but HHS was only able to pay out $362 million because Congress acted to protect taxpayer funds.
“If the only way ObamaCare can continue is for taxpayers to bail out health insurers that lose money because of it, that’s as good an indication as any that the whole law should be repealed and replaced,” Rubio wrote in the November 24th letter.
Senate Republicans attempted to repeal the program on December 3rd, but Democrats successfully blocked it. Republicans now plan to go after the risk corridors in the annual omnibus spending bill, which lawmakers hoped to begin debating on December 7th.
Speaker Paul Ryan plans to go after Obamacare in its entirety next year.
“We think this problem is so urgent that, next year, we are going to unveil a plan to replace every word of Obamacare,” Ryan said in a speech last week.
The director of HC Trends does not seem optimistic about that possibility. He told MNS the federal government is not going to allow people to go without insurance who are currently on Obamacare.
“You’ll probably see years and decades of patches and fixes. It’ll probably eventually turn into a healthcare Frankenstein, that’s what I’m really afraid of,” Jensen said.
MNS will provide follow up report here as the MacIver Institute continues to analyze the data from HHS.