The Numbers Are Great (Don't Look Too Closely)

How much will health insurance cost next year? The predictions have keenly reflected the political affiliations of the prognosticators. Democrats are still clinging to the possibility of premium reductions. Republicans are having difficulty hiding their glee over the possibility, especially in Ohio, of rate increases of 70% and higher.

The first test was the release, last week, of rates for Covered California, the individual health insurance exchange for the Golden State. Though the exchange is designed to offer up to 13 insurers per area, no area will have more than six insurance companies participating. Some areas will have only three insurers! Major national insurers such as Aetna, Cigna, Humana, and UnitedHealth Care will not be available through Covered California. Anthem Blue Cross, a division of California’s WellPoint, and Kaiser Permanente, also based in California, will be offered through the exchange.

So how are the numbers? Not bad. Paul Markovich, president of Blue Shield of California, is quoted as saying that the final rates will reflect an average increase of only 13% above individual policies currently available.



The release of these rates was met with a huge sigh of relief from the Democrats. The possibility of a 40 year old purchasing coverage in Los Angeles for $250 per month meant that the Patient Protection and Affordable Care Act (PPACA) might work. Sure San Diego will be 20% higher and San Francisco 40% - 50% more, but it could have been worse. A lot worse.

It only took a few days before we got our first end-zone celebration. Paul Krugman, writing in the New York Times, noted, “Yet important new evidence – especially from California, the law’s most important test case – suggests that the real Obamacare shock will be one of unexpected success.”

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Luckily for the Democrats, Krugman, and their other apologists, Washington and the national press have been too consumed by the recent out-break in scandals – the IRS, Benghazi, and the press surveillance – and the tornado in Oklahoma to look at hard numbers. A chart like the one above takes real time and effort to deconstruct and understand. Who has time for that? Hell, I consider myself lucky that you are still reading this.

Please take a few moments away from Coasterville on Facebook and look at the above grid.

Forget who is missing among the top three choices Californians will be offered and look instead at who is there. Nine of the fifteen options are HMO products. Though many of us have had excellent experiences with Kaiser Permanente here in Cleveland, even their representatives are quick to point out that an HMO, even theirs, isn’t right for everybody. Two out of the top three options in Los Angeles are HMO’s, the type of insurer that is best suited to meet the PPACA’s requirements. Are two out of three Californians currently choosing to be covered by HMO’s? I doubt it.

The PPACA mandates that men and women pay the same price for insurance and that, among other things, maternity is covered the same as any other medical condition. Those rules are already in effect in California. The maternity coverage was instituted last year. The insured in Ohio will see a bump in their rates just from those two changes. Young healthy males will be the most affected by this change.

The rates on the chart are for the Silver Plan, a policy designed to cover 70% of the insured’s health costs. Regular readers know that the PPACA mandates four levels of coverage, Platinum, Gold, Silver, and Bronze. We are told to celebrate average rates of $242 - $351 per month for tier 3 coverage. We would freak out in Ohio.Residents of Cuyahoga County pay the highest health insurance rates in Ohio. Medical Mutual of Ohio, based in downtown Cleveland, offers a High Deductible Health Policy (HDHP) that you can pair with a Health Savings Account. The $2,500 deductible policy is $139.10 per month for a healthy 40 year old man. The commonly purchased options that have higher deductible are a whole lot less.

Those policies will be a lot higher in 2014

The above grid is a basket of apples and oranges. Individual rates aren’t compared to the current individual policies. That would look awful. Instead the rates are shown with the more volatile small group premiums.

We won’t have a grid like this in Ohio anytime soon. But when we do, the numbers will be great, just as long as you don’t look too closely.   DAVE   www.bcandb.com