Rising Premiums Price Some Missouri And Illinois Consumers Out Of Health Care Exchange

July 16, 2018
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Insurance premiums for plans on healthcare.gov have become more expensive, but most people who buy exchange plans on healthcare.gov receive tax credits to help them offset costs. Those who don’t receive those credits bear the brunt of those higher prices.

Dave Kovaluk/St. Louis Public Radio

The rising costs of insurance plans available through the federal healthcare.gov website may make them unaffordable for some people in Missouri and Illinois.

Premiums for exchange plans on healthcare.gov have become more expensive, but most people who buy exchange plans on healthcare.gov receive tax credits to help them offset the cost and are insulated from rising costs. But those who don’t receive those credits bear the brunt of those increased prices.

According to a report the Centers for Medicare and Medicaid Services released this month, 28,000 people in Missouri who didn’t receive that assistance left the health care exchange all together in 2017. In Illinois, more than 105,000 people without financial help dropped their exchange plans.

Individuals who make more than $48,000 a year or a family of four with an income of $98,000 a year do not receive federal subsidies. Even if they’re making an otherwise comfortable living, they’re still feeling squeezed, said Cynthia Cox, director of health reform and private insurance at the Kaiser Family Foundation.

“Some people, they might be making $100,000 a year and have a family of four,” Cox said. “That’s normally a pretty good income, but if you’re having to spend say $15,000 on health insurance, then that’s eating up quite a bit of your take-home pay.”

The region’s drop in the number of unsubsidized enrollees is in line with national trends. According to a CMS report released this month, the enrollment gap between subsidized and non-subsidized consumers is growing. Nationwide in 2017, enrollment dropped 20 percent for those not receiving federal financial premium assistance, compared with a 3 percent drop in those who do receive subsidies.

Those not receiving tax credits make up a small percentage of healthcare.gov enrollment. In 2017, 88 percent of the 213,000 Missouri customers on the exchange received tax credits; that same year, 81 percent of Illinois’ 314,000 enrollees did.

Many of the people leaving the exchange won’t do much better finding Affordable Care Act-compliant plans on the individual insurance market, Cox said.

Instead, many consumers are opting for short-term plans that don’t need to adhere to Affordable Care Act’s coverage guidelines. For example, those plans can turn away people with certain health problems, and they don’t have to offer essential health benefits, she said.

Those plans can be desirable for healthy people, but not for those with chronic health conditions. “If you’re priced out and sick, you might not be able to get those short-term plans because they deny people with pre-existing conditions,” Cox said.

Conservative critics of the Affordable Care Act want to see more of those plans that are free of Affordable Care Act mandates and regulations.

“Short-term insurance offers many families struggling to pay for coverage in the individual market access to affordable plans, but their three-month maximum coverage period is too limited and requires people to constantly renew their coverage,” analyst Charles Katebi of the conservative libertarian think tank the Heartland Institute wrote in April. “By expanding short-term plan coverage periods to as long as one year, these health insurance options would become much more useful to tens of thousands of families across Missouri.”

In Missouri, Republican legislators sought to increase the duration of short-care plans from three months to 364 days, but that measure died before the end of session.

Cox said she expects more people to leave the exchange after the government stops enforcing the insurance requirement in 2019.

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Story source: Side Effects