GAO Report Uncovers 2015 Healthcare Premium Range Variation
By - The United States Government Accountability Office (GAO) has released a report providing new information about 2014 and 2015 healthcare premium ranges and plan availability. GAO examined levels of disparity among health plan options and premiums, comparing current options to those from 2014. A dual focus is as follows: how the number of available health plans has changed and how insurance premium ranges, according to data from the Centers for Medicare & Medicaid Services (CMS), has also changed among states and counties.
Last year, the Patient Protection and Affordable Care Act (PPACA) altered how payers establish health insurance premiums and the purchasing process of individual market health insurance plans. One example of such, says GAO, is that the PPACA banned healthcare insurers from refuting healthcare coverage or from varying healthcare premiums according to gender or health status. Concurrently, the PPACA mandated health plans be marketed according to their metal tier category – bronze, silver, gold, or platinum – to make comparisons between plans a tad smoother, notes GAO. Additionally, the PPACA mandated states establish health insurance exchanges so consumers can compare plans effectively and efficiently.
A summary of GAO’s findings: variable ranges present
The GAO notes variation exists among those healthcare premiums assessed. “[In] Arizona the lowest-cost silver plan option for a 30-year-old was $147 per month in both years, but in Maine, the lowest-cost silver plan options for a 30-year-old were $252 in 2014 and $237 in 2015. In the 28 states included in GAO’s analysis, from 2014 to 2015 the minimum premiums for silver plans available to a 30-year-old increased in 18 states, decreased in 9 states, and remained unchanged in 1 state,” the GAO maintains.
“At the county level, GAO found that premiums for the lowest-cost silver option available for a 30-year-old increased by 5 percent or more in 51 percent of the counties in the 28 states. GAO also found that the range of premiums — from the lowest to highest cost — differed considerably by state,” says GAO. It was additionally noted that in Rhode Island, 2014 premiums for silver plans available to a 30-year old individual on or off an exchange ranged from about $240 monthly to $266 monthly – a 10 percent variance. However, in 2015, this range hit 32 percent, with a monthly low of $217 and a high of $285.
In stark contrast to this, a 270 percent difference was noted in Arizona in 2015 with a monthly low of $147 to a high of $545. Arizona’s numbers for the previous year indicated a 244 percent variation.
Additionally notes the GAO, [Healthcare] consumers in 88 percent of the counties had access to six or more bronze exchange plans, consumers in 94 percent of counties had access to six or more silver exchange plans, and consumers in 71 percent of counties had access to six or more gold exchange plans. Not all consumers had access to platinum plans, however, the availability of platinum plans generally also increased from 2014 to 2015.”
The most economically advantageous silver plan option for a 30-year old increased between 2014 and 2015 by 18 percent, adds the GAO.
“Based on the full premium costs, on an annual basis in 2015 a 30-year-old in Arizona who was not eligible for a premium tax credit could have spent $1,082 less on the lowest-cost silver plan available to them compared to what the same consumer in Maine could have spent on the lowest-cost silver plan available to them,” confirms the GAO. Those states with minimum 2014 premiums exceeding the average were more likely to have dropped the following year in comparison with those states with average minimum premiums that were less than the 2014 average, says GAO. Premiums were more likely to grow than shrink from 2014 to 2015, GAO adds.
As RevCycleIntelligence.com reported, 27 percent of employers anticipate the largest PPACA compliance increase in 2018. Whether or not 2016 will indeed be the most expensive year yet for employers because of upcoming Affordable Care Act compliance administrative actions and aftermath is yet to be seen.
