ACA Health Premiums Up 10-15% in FL

Nov 17, 2014

The average monthly premiums for Affordable Care Act "silver plans" increased by double digits in most Florida counties for 2015, according to an Associated Press analysis.

In their analysis, AP reporters Mike Schneider in Orlando and Kelli Kennedy in Miami  compared premiums after averaging them for all silver plans, without taking subsidies into account. 

They used hypothetical customers of three different ages. The results varied. In Florida's largest county, Miami-Dade, the average of silver premiums actually went down. In other South Florida counties, increases were minimal.

But in other areas of the state, especially rural counties, increases were larger, ranging up to 20 percent in the AP analysis.

This analysis, however, doesn't mean the premiums that consumers pay will go up that much. 

Last year more than 90 percent of Florida enrollees for the Obamacare coverage received tax credits that subsidized the premium. The tax credit is based on the consumer's income, and since wages have not risen much, subsidies are likely to pay most of the cost again in 2015.   So the increase in premiums will mainly affect the federal government's cost for the subsidized premiums.

The Associated Press analysis applies only to uninsured Floridians who are eligible for enrollment on the federal exchange or Marketplace (www.healthcare.gov). It does not apply to the majority of Floridians, who are covered through their workplace or a government plan.

Even without subsidies, it is hard to generalize about premium increases because the amount depends on a person's income, age, county, smoking status, family size and more.

Health News Florida conducted a separate comparison using the "benchmark plan," the second-lowest silver plan, the one used to compute subsidies. HNF's analysis, using hypothetical individuals ages 27 and 50 with incomes of $40,000, found that:

--In Pinellas, the premium for the benchmark plan rose 9.5 percent for the younger person and 28 percent for the older one.

--In Hillsborough, the increase for the younger enrollee was 13 percent, and for the older one, 21 percent. 

--In Pasco, the increase for the younger customer was 14 percent; for the older one, it was 26 percent.

Premiums are set through bids by private health insurance companies, which must cover what the law calls "essential health benefits."  The plan level (platinum, gold, silver and bronze) is assigned by the percentage of the overall cost the company will pay, as actuaries figure it. Silver plans cover 70 percent.

Health insurance rates have risen in tandem with the price of medical treatments, hospital care and drugs.  A Kaiser Family Foundation report shows employer premiums -- and workers' share of them -- have more than doubled since 2002.