This week, Covered California put out a report done by the consulting group Milliman to see what premiums might be like in 2014 and beyond. This generated headlines about increased rates in some papers and decreased rates in others.
The stories were better than the headlines in providing additional context, although even those had space limitations. Even the Washington Post felt the need to dedicate a long blog post to the study.
I would highlight what the LA Times wrote in its editorial, providing caution about over-reading the study. Some key points:
* Those under $95,000 for a family of four will get financial help so premiums are not more than 2%-9.5% of income.
* Most will pay less for premium and cost-sharing; those who choose to pay more in premium will get better benefits and value.
We made similar points in our last blog post, which was highlighted in Health Wonk Review this week at Worker’s Comp Insider by Julie Ferguson.
We are pleased that estimates show that most consumers buying coverage in the individual market will get financial help and see their premiums go down–but more can be done to improve affordability. Particularly important is that almost all will be getting better coverage and value for their dollar, and no one will be shut out due to health status. Most will see premiums go down, but the slice for whom premiums go up will get better coverage and less cost-sharing when actually getting care–and they have an option of a cheaper premium plan as well.
These numbers are estimates, based on some variables that are in our control. As Covered California itself states, there are factors in our control to do more to bring down the cost of coverage, using the tools of the Affordable Care Act to provide tough negotiation with the health plans for the best value, aggressive rate review and regulation, increased enrollment, and fostering apples-to-apples price competition.
We don’t know what the rates will start at, but we no longer have to accept rates as they are–the ACA gives us the framework and the tools to make a difference, but it will be up to us in California to decides whether to use those tools.