The more things appear to change, the more they appear to stay the same. That’s what a consumer health advocacy group in Florida is saying about double-digit health insurance premium increases that it says have been predating, and now post-dating, the passage of the Affordable Care Act.
One such example involves 2015 rate hikes averaging 17.6% the state’s largest health insurer has proposed for its public exchange plans. Higher prices were primarily driven by many healthier members deciding to keep their existing plans and Healthcare.gov enrollment glitches that prevented or discouraged residents from signing up for the federally facilitated marketplace, explains Paul C. Kluding, senior director of public relations for Florida Blue, a nonprofit Blue Cross and Blue Shield.
Another critical issue to bear in mind is that 90% of the carrier’s marketplace membership enrolled with a subsidy, which he says means those enrollees could see less of a rate increase. “The specific rate impact on 2015 subsidies is yet to be determined, but these members likely will pay less than the non-subsidized member will,” he says.
A recent published report noted that Florida Blue raised its premiums by 11% on average on individual policies for people younger than 65 for four straight years, including the proposed HIX rates for next year, which are slightly higher than the 16.5% average in 2014, 16% in 2013 and 11.5% in 2012.
Despite the eyebrow-raising potential of this latest rate increase, Florida CHAIN, a statewide consumer health advocacy group, dismissed it as business as usual in the Sunshine State. “No one can claim in good conscience that a 10% rate increase or more would signal the advent of something new and unprecedented,” Greg Mellowe, policy director of Florida CHAIN, griped in a Kaiser Health News article that also ran in The Miami Herald. “For years, this was standard practice in Florida.”
A Florida CHAIN blog reported that annual rate hikes of 10% or more have been routinely rubber-stamped by the state’s Office of Insurance Regulation even prior to the Affordable Care Act’s passage.
About a dozen carriers will compete in Florida’s individual health insurance market next year. They include Humana, which plans to increase prices an average of 14.1% and 2.2%, respectively for its HMO and PPO customers, and Molina Healthcare, which actually proposed an 11.6% average rate decrease for all its plans.
Therein lies the rub of Florida’s health insurance marketplace, according to Florida CHAIN.
“With the 2015 marketplace rate filings, insurers and OIR worked together to eliminate even the most basic transparency, and then concocted a ridiculous excuse for doing so,” the organization’s blog charged, adding that many insurers that reported unchanged rates withheld “the true extent of their proposed changes.
“Even more amazingly, when this misrepresentation came to light,” it continued, “OIR claimed that insurers are in fact permitted to misreport basic statistics (such as overall average rate increases), even in mandatory public filings, because those numbers could somehow be considered protected ‘trade secrets.’”
The upshot is that some of the initially unchanged rates will turn into proposed increases “when they are finally revealed,” the blog noted, adding that “unprecedented rate decrease proposals are the embarrassing end result for insurers relying misinformation provided by ACA opponents.”
Whatever the case may be, Kluding boasts that Florida Blue has announced more accountable care organizations than any insurer in the state (five of 13 launched over the past year) and its patient-centered medical home is the third-largest, single-state program of its kind nationwide (4,500 physicians serve nearly 800,000 members). He says other key measures include paying for quality over quantity, as well as changing habits to promote wellness and prevention.
Shutan is a Los Angeles-based freelance writer.
Register or login for access to this item and much more
All Employee Benefit Adviser content is archived after seven days.
Community members receive:
- All recent and archived articles
- Conference offers and updates
- A full menu of enewsletter options
- Web seminars, white papers, ebooks
Already have an account? Log In
Don't have an account? Register for Free Unlimited Access