Consumers can expect changes ahead for their health insurance – small businesses that buy health insurance through DC Health Link, the District’s health insurance exchange, will see modest cost increases next year on average, according to new rates recently approved by the District. Individuals who buy insurance will face somewhat larger, but moderate, increases. The changes in insurance premiums vary considerably by insurer and health plan, and some increases may be dramatic. With the 2017 open enrollment season starting in November, consumers should take time to review options and determine the best fit for their health and finances.
The good news is that DC Health Link offers an easy and transparent way to compare plan benefits and prices, one of the key benefits of creating a health insurance exchange under the Affordable Care Act. And many can use DC Health Link to get financial assistance to help pay for premiums.
Last week, the Department of Insurance, Banking and Securities (DISB) approved rate changes for 2017 health plans on DC Health Link. Each insurer wanting to sell individual and small group plans through DC Health Link must file preliminary rates, which DISB reviews to determine whether increases are reasonable. DISB can require insurers to adjust rates increases it considers unjustified (specifically, if they are “excessive, inadequate or unfairly discriminatory”).
At first glance, the new rates generally show good news for consumers. Premiums for individual health plans will increase 7.27 percent on average next year, and small group plan premiums will increase just 0.36 percent on average.
But a deeper dive shows more much more variation, and dramatic increases in some cases. The hardest hit are individuals who have health plans through insurer CareFirst that have a Health Savings Account (HSAs), or a tax-free savings account used to help pay for medical expenses in conjunction with a high-deductible health policy. CareFirst will eliminate its HSA-eligible plans, meaning consumers currently enrolled will need to select new plans for 2017. If not, they’ll be automatically moved into plans with premium increases of up to 75 percent.
DISB notes that is a large rate increase, but that consumers will no longer have to make health savings account contributions and that new plans will offer slightly more benefits. The problem is that it’s currently up to the consumer how much they contribute to an HSA – and some healthy people contribute very little – but they would have no choice other than paying much higher premiums in a non-HSA plan. If faced with this situation, where do consumers begin?
There are tools to help individuals and small business wade through these choices. DISB’s Consumer Guide explains the 2017 changes in health plan rates, and DC Health Link’s Plan Comparison Tool for Individuals and Families can help people determine the best plan for themselves. Additionally, consumers with incomes below 400 percent of the poverty line ($47,520 for an individual or $100,000 for a family of four) may be eligible for tax credits to reduce their monthly premium payments, and cost-sharing reductions to lower the amount they would pay for deductibles, copayments, and coinsurance. In fact, an estimated 2,000 DC residents could newly qualify for financial help to make coverage more affordable if they get insurance through DC Health Link.
Open enrollment for DC Health Link begins on November 1, 2016 and runs through January 31, 2017. No matter what situation an individual is facing, finding the right health coverage for them and their families is possible.
