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Insurance Department Finalizes Exchange Rates

by Christine Stuart | Aug 5, 2013 5:05pm
(27) Comments | Commenting has expired
Posted to: Congress, Health Care, Labor, Legal

Adam Chiara file photo

The question of cost has been on everyone’s mind since Connecticut first decided to set up its own health insurance exchange under Obamacare. On Monday, Connecticut residents got their first look at the unadjusted rates — meaning, the rates without the inclusion of offsetting government subsidies that will be made available to lower income families.

The state Insurance Department released the final monthly premiums on its website Monday after three months of wrangling with the four participating insurers over how they calculated their risk assumptions.

The rates posted Monday still don’t take into consideration the federal subsidies individuals may receive if they make less than 400 percent of the federal poverty level, which is $94,200 per year for a family of four. The rates posted Monday also don’t consider age or location by county.

Of the three companies offering insurance in the individual marketplace, ConnectiCare Benefits is the only company whose rates weren’t changed during the review by the Insurance Department. The rates for Anthem Blue Cross and Blue Shield were lowered through the process and the exchange’s only nonprofit insurer, HealthyCT, submitted an amended application voluntarily lowering its rates after a review showed individuals looking to join the plan would be healthier than initially predicted.

Each of the companies will offer insurance through three tiers — bronze, silver, and gold. Each tier has a different actuarial value with gold being the plan that covers more and has fewer out-of-pocket costs than the bronze or silver plans. The bronze plans will cover less and have higher out-of-pocket costs, while silver falls somewhere in the middle. There also are catastrophic plans for individuals under age 30.

In the individual plan marketplace, the base monthly premium for the ConnectiCare Benefits bronze plan is $215.17, HealthyCT is $245.45, and Anthem is $236.59. Again, those are the premiums before they get adjusted for age, geographic location, and government subsidy. The premium base rate for the ConnectiCare Benefits silver plan is $269.66, HealthyCT is $310.02, and Anthem is $299.21. The gold plan is $309.64 per month for ConnectiCare Benefits, $321.22 for HealthyCT, and $346.91 for Anthem.

An independent analysis by an actuarial consulting firm released last week found that individuals and families who live in Hartford County and who enroll in an individual market plan will have the lowest average premium, while those who live in Fairfield County will have the highest in that marketplace.

All the plans are “guaranteed issue,” which means no one, even an individual with a pre-existing condition, can be turned down from purchasing a plan. The underlying legislation also eliminates gender rating, so women will no longer be paying more than men for similar insurance policies.

In the small group plan marketplace, Anthem, HealthyCT, and UnitedHealthcare, are offering bronze, silver and gold plans with monthly premiums ranging from $277.95 to $407.37 for Anthem, $298.05 to $309.05 for HealthyCT, and $271.91 to $435.72 for United Healthcare.

CTNJ file photo

Access Health CT CEO Kevin Counihan in the middle, flanked by Ellen Andrews and Kevin Galvin

Enrollment in the exchange begins Oct. 1 and the plans go into effect on Jan. 1. 2014. Everyone will have an opportunity to purchase insurance through the exchange, including the estimated 344,000 Connecticut residents who are uninsured.

Over the next few months the rates announced Monday will be entered into the software that will display the information to consumers. The virtual marketplace is expected to offer consumers a side-by-side comparison of rates and benefits for at least two of the plans they select. In the meantime, Access Health CT offers a calculator on its website at www.accesshealthct.com/how-to-save/ to give consumers an idea of what they can expect to pay based on their income and the federal subsidies available. The Henry J. Kaiser Family Foundation also has provided a subsidy calculator at this website: kff.org/interactive/subsidy-calculator/.

Kevin Counihan, CEO of Access Health CT, said the rates released Monday indicate “residents in Connecticut may actually see their insurance rates go down, while for those who may see increases, they will be far less than was predicted even just a few months ago.”

“These rates are a clear signal that the introduction of a competitive marketplace works, and gets us one step closer to our goal: access to quality, affordable health care, with freedom to choose from a variety of high quality plans for the people in Connecticut who currently don’t have it,” he said. “Our staff will be examining these rates closely in the days ahead, and look forward to providing more information on what residents can expect when they come to Access Health CT.”

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(27) Comments

posted by: art vandelay | August 5, 2013  10:23pm

art vandelay

Our Founding Fathers would be rolling over in their graves.  A large federal government reaching into every aspect of our lives is the one thing they feared most.  Ben Franklin was quoted at the final session of the Constitutional Convention as saying, “What we have here is a Republic if we can keep it”  Wilson FDR, Truman Kennedy, Johnson, Clinton & Obama have done more to bring our country into the arms of Socialism than all other Presidents combined.  The Federal subsidized rates dependent on income makes a whole class in our society ever more dependent on the federal government for their meager existence.  What a sad note for this country.  The United States would have been much better off as a nation with a purely free market health care system dependent upon supply and demand.

posted by: JH_1 | August 6, 2013  8:16am

All the articles on this topic have focused on the changes to individual plans.  Is there any information available on how the Affodable Care Act is going to impact the rates or benefits on larger, employer sponsored plans?  I have to believe that the majority of people get thier health care insurance through thier employers (above 50 people). 

I’d like to know how those plans will be affected, if at all.  Will insurance companies offset any potential profit losses on the individual side with rate increases on the large group side?  Have insurance companies hinted at doing something like this?

Is there a summary available?  Thanks.

posted by: sofaman | August 6, 2013  8:50am

The lower insurance rates now available under this system are a direct result of a more open market system. The old (absurd) system of allowing insurance companies to discriminate against “pre-existing” and women are over. Socialism? Those who throw that tired label about seem to want to forget that a single-payer system was originally a Republican idea as it reflected a system where everyone paid in and “took responsibility for their own health care.”

posted by: Christine Stuart | August 6, 2013  9:11am

Christine Stuart

Good question JH_1. The plans offered by big employers won’t be impacted by this unless the large employer decides to give you a chunk of money to go out to purchase your own insurance in the exchange. That’s a possibility. The penalties for large employers are delayed until 2015. Self-insured plans offered by large employers aren’t going to change. That’s why there’s been little focus on them. There’s no change for them except the fact that they could face a penalty if they don’t offer insurance.

posted by: JH_1 | August 6, 2013  9:24am

Thanks Christine.

posted by: DCSCT1 | August 6, 2013  9:39am

Another question that needs to be answered is how much do you pay out of pocket?  Right now they are only talking about low rates.  What are the deductibles and copays going to be?  Low rates are great but other cost could affect affordability.

posted by: Christine Stuart | August 6, 2013  10:31am

Christine Stuart

Another good point. The only way to get that information at the moment is to look at each of the filings with the Insurance Department, which to me is still in jargon. I’m efforting getting a hold of more information I can display in graphic form. Will do my best to cut through the jargon and provide visual information

posted by: LongJohn47 | August 6, 2013  11:44am

Art, you’re concerned about making people less “dependent on the federal government for their meager existence.”  I’m concerned about their existence, and how we make it less meager.  You would like a health care system purely dependent upon supply and demand.  Does that mean that a child of poor parents should get sick and die of an easily preventable/treatable disease?  Does that mean that a single mother who works two minimum wage jobs (another federal intrusion!) should go without healthcare?  Does that mean that we, as a society, should place our faith (pun intended) in charities to take care of the poor?  Do you really want a dog-eat-dog world?

Cast your gaze back 100 years or more, before unions, before workplace regulations, before any real safety net.  Think about tenant farmers living as serfs in the South, about immigrants huddled in appalling conditions in big cities, about children working twelve hour days in horrific factories, about Gilded Age aristocracy and the phalanx of personal servants who made their lifestyle possible—is this the world you prefer?

posted by: Christine Stuart | August 6, 2013  11:49am

Christine Stuart

JH_1, A reader reminded me that I forgot to add that in addition, come Jan. 1. 2014, these large employer plans won’t be able to discriminate based on pre-existing conditions for adults anymore (already barred for kids).  This, plus the elimination of lifetime limitations and new caps on admin. costs (Medical Loss Ratios), both already in effect, means that the cost of health care through these plans will likely be affected as well.  Not a huge effect, but some.

posted by: art vandelay | August 6, 2013  12:25pm

art vandelay

To Long John 47,
I’d much rather live in a society with a small federal government. Granted the society you described needed reform. Yes the Unions helped elevate the middle class, and government regulations abolishing child labor and food safety were necessary.  Unions have long outserved their usefulness in our society and have become parasites.  Detroit, the automobile industry are excellent examples of what what Unions can do to destroy a municipality and private corporations. No I’m not professing children die because they lack health care.  Ronald Reagan even believed in some sort of safety net.  What Obamacare and other federal programs are doing is bringing this nation closer to a society patterned after Soviet Russia back in the Stalin years.  That is what I do not want.  We have too many people in power idolizing the works of Karl Marx instead of Adam Smith and Locke.

posted by: LongJohn47 | August 6, 2013  2:27pm

Art, I’m pleased to know that returning us to 1900 isn’t your goal.  At the same time, I truly doubt you’ve done any reading on the Soviet Union under Stalin, or you’d know how ridiculous it is to compare the U.S. today under any President with that time and place. 

Obama is definitely not a socialist—his health care plan was first conceived and promoted by conservative think tanks as an answer to the Clinton proposals, and it was subsequently implemented by Governor Romney working with a Democratic legislature in a true, bi-partisan effort. 

The extent of federal intervention at the individual level under Obamacare is to require that you and I and everyone else have coverage or pay a tax.  The rest of the mandates are directed at private industry as they take on millions of new customers, many of whom will be subsidized so they can buy insurance.  Nothing could be further from socialized medicine, unfortunately.  It’s a poor substitute for “medicare for all”, but it’s the best he could get passed in Congress.

posted by: art vandelay | August 6, 2013  5:35pm

art vandelay

To LongJohn47,
You may be correct in that the Obamacare outline was a compromise to Hillarycare initiated by the Republicans. Please do not associate National Healthcare (Socialized Medicine) with the conservatives. It was a goal of the Wilsonians, New Dealers & Progressives under Johnson that were promoting it. I’ve always been a believer that nobody should declare bankruptcy because of a sickness, nor anyone be denied healthcare. My belief is that Obamacare or a single payer system is too far to the left, and a middle ground policy should be instituted. If Obamacare is so great, why are federal employees trying to exempt themselves.  Why are unions who promoted Obamacare bailing out? It’s my firm belief that Obamacare was designed to fail so a single payer system can be substituted.  It’s what the Democrat Socialists in Obama’s Administration ultimately want.

posted by: LongJohn47 | August 6, 2013  9:29pm

Art,

The individual mandate originated with the Heritage Foundation, which I believe is rightfully thought of as conservative.  And in addition to he Democratic Presidents you named. Teddy Roosevelt and Richard Nixon also proposed national healthcare.

Here’s a clip from Wikipedia on the history of Obamacare:

The plan that ultimately became the Patient Protection and Affordable Care Act consists of a combination of measures to control health care costs and an insurance expansion through public insurance (expanded Medicaid eligibility and Medicare coverage) and subsidized, regulated private insurance. The latter of these ideas forms the core of the law’s insurance expansion, and it has been included in bipartisan reform proposals in the past. In particular, the idea of an individual mandate coupled with subsidies for private insurance, as an alternative to public insurance, was considered a way to get Universal Health Insurance that could win the support of the Senate. Many healthcare policy experts have pointed out that the individual mandate requirement to buy health insurance was contained in many previous proposals by Republicans for healthcare legislation, going back as far as 1989, when it was initially proposed by the politically conservative Heritage Foundation as an alternative to single-payer health care.[164] The idea of an individual mandate was championed by Republican politicians as a market-based approach to health-care reform, on the basis of individual responsibility: because the Emergency Medical Treatment and Active Labor Act (EMTALA), passed in 1986 by a bipartisan Congress and signed by Ronald Reagan, requires any hospital participating in Medicare (nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay.[20][165][166]
When, in 1993, President Bill Clinton proposed a health-care reform bill which included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations, Republican Senators proposed a bill that would have required individuals, and not employers, to buy insurance, as an alternative to Clinton’s plan.[165] Ultimately the Clinton plan failed amid concerns that it was overly complex or unrealistic, and in the face of an unprecedented barrage of negative advertising funded by politically conservative groups and the health-insurance industry.[167] (After failing to obtain a comprehensive reform of the health care system, Clinton did however negotiate a compromise with the 105th Congress to instead enact the State Children’s Health Insurance Program (SCHIP) in 1997).

posted by: art vandelay | August 6, 2013  11:31pm

art vandelay

To LongJohn47,
It seems you history of National Health Care starts W/Clinton.  I strongly suggest reading Das Kapital and other Socialist Utopian works written in the 19th Century. If we do not understand our history, we’re doomed to repeat it.

posted by: ASTANVET | August 7, 2013  9:16am

Longjohn - just because a person runs under a party, does not make them a conservative.  Teddy Roosevelt is a great example of a progressive republican, John McCain, Graham, GHWB, GWB, Nixon, So when you say it was a republican idea, no, it was a Progressive idea - progressivism is akin to socialism - so please, just because someone is associated with the Republican party doesn’t mean they have [r]epublican principles.  It is important to know the difference.

posted by: LongJohn47 | August 7, 2013  9:41am

Art,

Vague references to Communism are totally out of place in today’s debate.  You seem fixated on a threat that barely existed in this country and passed into irrelevance even in “Socialist” countries years ago. 

The Soviet Union no longer exists.  China is Communist in name only, and while Lenin might approve of totalitarian control through a single party state, Marx certainly wouldn’t.  Vietnam actively pursues capitalism.  Cuba is taking tentative steps toward private ownership and small scale businesses.  Only North Korea is left, and you’d be hard pressed to find anyone in this country who advocates going down that path.

You acknowledged in an earlier post that “government regulations abolishing child labor and food safety were necessary”.  How do you square that with a “small federal government”?  Do you approve of food safety standards but not the Clean Air Act?  Is regulating child labor okay but not setting a minimum wage? 

The Founding Fathers would be just as shocked to see the growth and economic domination of corporations, which didn’t exist in the 1700’s, as they would be by the size and scope of modern government.

The modern state is large, complex, cumbersome, and sometimes inefficient.  It’s certainly imperfect.  But it has grown organically to meet the needs of an ever-evolving economy and society, and while you might trim around the edges you’ll never take it back to some earlier age.

What you fail to understand is that the people, acting through their government, are perfectly justified in achieving collectively what is in the national interest.  But collective action is not “socialism”, certainly not as Marx and Engels defined it. 

For them, the state would “wither away”, everything would be owned in common, and society would live in perfect harmony.  They were delusional, and no one takes Das Kapital or the Communist Manifesto seriously as a roadmap to the future.  And by waving a “red flag”, you join them in irrelevancy.

posted by: LongJohn47 | August 7, 2013  11:03am

ASTANVET,

Was Richard Nixon a Progressive?  Orin Hatch?  Charles Grassley?  Mitt Romney?  Bob Bennett?  This is just a short list of Republicans who supported national health care and/or an individual mandate as a means to universal coverage.

And to say “Progressivism is akin to socialism” is as stupid as saying conservatism is akin to fascism.  It’s really tiresome to hear this bleated again and again.  Give it a rest.

posted by: ASTANVET | August 7, 2013  4:10pm

Well longjohn, i see you’re into name calling - nice - but the history of progressivism is rooted in marxism - you may want to read up on that… and yes, there are progressives on both sides, they are directly opposite to what I believe - Federalism, republicanism, individual freedom and liberty - I don’t know what you stand for sir, but it certainly isn’t that.  I’m not an anarchist, i’m not a fascist. (you may want to read up on fascism (national socialist party) - before you start calling conservatives fascists.

posted by: LongJohn47 | August 7, 2013  5:59pm

ASTANVET,

I didn’t call anyone a fascist.  Perhaps you missed the point.  I quoted what you said about progressives and said that using language like that was as stupid as saying something similar about conservatives.

So now you’re saying that “the history of progressivism is rooted in Marxism”, but a quick look at the debates in the late 1800’s and early 1900’s shows that most socialists rejected Marxist thinking and developed their own remedies for the ills of their societies.  Similarly, conservatives are not necessarily monarchists, though there may be some who cross that line. 

I believe in individual freedom and liberty as much as you do.  And I’m okay with federalism, as long as it’s not used to prop up discrimination or to deny people the right to vote, as has been the case, especially in the South.  Not sure what you mean by “republicanism”, but I’m sure you can enlighten me.

posted by: ASTANVET | August 7, 2013  8:45pm

Dude, seriously - you don’t know Marx’s theory of history?  just google it - and from my friends at wikipedia - Republicanism is a political values system that has been a major part of American civic thought since the American Revolution.[1] It stresses liberty and “unalienable” rights as central values, makes the people as a whole sovereign, rejects aristocracy and inherited political power, expects citizens to be independent in their performance of civic duties, and vilifies corruption.[2] American republicanism was founded and first practiced by the Founding Fathers in the 18th century. This system was based on early Roman, Renaissance, and English models and ideas.[3] It formed the basis for the American Revolution and the consequential Declaration of Independence (1776) and the Constitution (1787), as well as the Gettysburg Address (1863).[4]
Republicanism may be distinguished from other forms of democracy as it asserts that people have unalienable rights that cannot be voted away by a majority of voters.[5] Alexis de Tocqueville warned about the “tyranny of the majority” in a democracy, and advocates of the rights of minorities have warned that the courts needed to protect those rights by reversing efforts by voters to terminate the rights of an unpopular minority.[6]
The term “republicanism” is derived from the term “republic”, but the two words have different meanings. A “republic” is a form of government (one without a hereditary ruling class) while “republicanism” is a political ideology that can appear in republics or monarchies.[7]

posted by: LongJohn47 | August 7, 2013  11:49pm

ASTANVET

Thanks for the primer on “republicanism”.  Sounds good to me.

As to Marx, his theory of history is meaningless today.  He was the one who ended up on the ash heap of history.  Progressives aren’t Marxists, regardless of how many times you say they are

posted by: art vandelay | August 8, 2013  10:55am

art vandelay

To LongJohn47
In regards to Progressives wanting a large centralized government performing more tasks, YES Progressives ARE MARXISTS. It’s exactly what Marx professed in his writings.

posted by: Christine Stuart | August 8, 2013  12:53pm

Christine Stuart

The commenting on this article has gotten off track so I’m going to remove the commenting unless you guys can get back on topic, which would be the exchange rates.

posted by: JamesBronsdon | August 8, 2013  2:45pm

Let’s determine who are the Trotskyites and who are the Bukharinites first.

posted by: ASTANVET | August 8, 2013  5:36pm

Sorry Christine

posted by: judgejoyce | August 9, 2013  7:39pm

I have many friends who will still not be able to afford insurance at the rates you have listed.  I am a supporter of the Affordable Care Act, but those rates do not appear to be “affordable.”

posted by: LongJohn47 | August 9, 2013  10:30pm

If they can’t afford it they may qualify for subsidies