Average Obamacare prices drop for those with subsidies, rise for others

Despite double-digit rate hikes taking effect Jan. 1, customers of Connecticut’s health insurance exchange who already picked plans for 2017 and qualify for subsidized coverage will, on average, save a few bucks on their monthly premiums, according to figures released Thursday by Access Health CT, the exchange.

But it’s a different picture for those who don’t qualify for financial assistance – which, for a family of four means those earning more than $97,200; for individuals, the cutoff is $47,520. On average, unsubsidized customers who selected 2017 plans will see their monthly premiums rise from $401 to $477. And 22 percent of them will be moving to plans with lower levels of coverage.

The data offer a snapshot of how some customers will be impacted by the rate increases in the state’s individual insurance market, which average 24.8 percent. The figures covered 8,102 of the 9,455 people currently covered by the exchange who have already selected a plan for 2017. (It excluded those whose level of financial assistance changed significantly from year to year.)

Exchange officials said the figures show that customers who qualify for financial assistance will be largely insulated from the rate hikes. And they said it shows that people can benefit from shopping around.

But the data also underscore the challenges faced by those who don’t qualify for financial help – about 20 percent of those renewing coverage so far through Access Health. About 23 percent of exchange customers currently don’t receive financial assistance.

The average premium changes reflect not just the changes in price for each insurance plan, but other factors that affect what each person or family must pay. Those include aging – most people’s premiums rise somewhat as they get older – as well as any changes in income that could lead to higher or lower levels of financial assistance, and the specific plan chosen.

Among renewing customers who don’t qualify for financial assistance, 22 percent selected a plan in a lower metal tier, meaning that they probably will pay lower premiums than if they had maintained the same level of coverage, but will face higher costs when getting care. In 2017, the standard midlevel silver plan will have a $4,000 deductible for individuals (or $8,000 for family coverage), while downgrading to a bronze plan would leave someone with a $6,000 deductible (or $12,000 for family coverage).

By contrast, renewing customers who qualify for federal tax credits to discount their premiums were less likely to downgrade their coverage level. The lowest-earning exchange customers – those with incomes below 250 percent of the poverty level – can get both federally subsidized premiums and reduced cost-sharing, as long as they select specific silver plans. Among people in that category, 5 percent downgraded their metal tier, although it’s not clear what they were receiving before.

Of those who qualify for discounted premiums but not subsidized cost-sharing – those earning between 250 percent and 400 percent of the poverty level – 11.5 percent switched to a lower metal tier, while just under 4 percent picked a higher tier.

Overall, the average premium for renewing customers who qualify for both discounted premiums and cost-sharing will drop from $92 to $89; without the federal subsidies, their premiums would have grown from $531 to $630.

Among people who qualify for premium subsidies but not cost-sharing assistance, the average premium will drop from $217 to $214; federal subsidies will make up the difference in their actual premiums, which are rising from $525 to $631.

Compared to both of those groups, people who don’t qualify for financial assistance are more likely to be enrolled in bronze plans, which provide the lowest level of coverage available to most people. Unsubsidized customers are also on average 8 years younger than those getting subsidies, according to Access Health.

The open enrollment period for 2017 coverage runs through Jan. 31. People who want coverage that starts Jan. 1 must sign up by Dec. 15.

As of Oct. 31, 97,342 people had coverage through Access Health plans. So far, 9,455 have renewed their coverage. Another 5,570 new customers have signed up since open enrollment began.

Among current customers, 54,845 are eligible to be automatically renewed into their existing plans if they don’t take action, although as of Tuesday, 5,022 of them had picked plans on their own.

Just over 11,000 people are currently covered by HealthyCT or UnitedHealthcare, neither of which is offering insurance through the exchange in 2017. Another 12,396 customers have plans that are being discontinued. Just under 12 percent of people in each group have selected new plans for 2017. Access Health officials are tracking customers in both categories and plan to reach out to those who don’t pick new plans.

So far, ConnectiCare Benefits has dominated the market for 2017 coverage. Of the 15,571 people who picked plans for next year, 77 percent picked ConnectiCare plans, while 23 percent chose plans offered by Anthem Blue Cross and Blue Shield. Among enrollees on Oct. 31, 54 percent had ConnectiCare, 34 percent had Anthem, 10 percent had HealthyCT and 2 percent had UnitedHealthcare.

Overall, 24 percent of those who signed up picked bronze plans, up from 22 percent among current enrollees. The percentage of customers picking silver plans rose from 63 percent to 68 percent, while the share of customers selecting gold plans fell from 12.2 percent to 7.3 percent.

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