Costs drop for Michigan Obamacare insurance. But only after crazy increases

How to Enroll

The next round of Affordable Care Act health insurance sign-ups begins Friday. The enrollment period runs from Nov. 1 through Dec. 15 for coverage that starts Jan. 1.  For more information, go to HealthCare.gov.

 

Obamacare insurance enrollment in Michigan opens Friday with good news — premiums costs are down 2.5 percent. But costs still are above the jaw-dropping, double-digit price increase two years ago.

“It's not where we should be, but it’s certainly better than it was,” said Marianne Udow Phillips, executive director of the Ann Arbor-based Center for Health Research & Transformation, or CHRT, which studies health care trends.

The price drops mean that 52 percent of those who buy insurance from the  Michigan Health Insurance Marketplace could have access to plans that cost $10 a month or less if they qualify for government subsidies, according to Joshua Peck, co-founder of Get America Covered, a left-leaning consumer advocacy group founded by two former Obama administration officials.

Marianne Udow Phillips, executive director of the Ann Arbor-based Center for Health & Research Transformation, worries that a six-week enrollment period doesn’t allow enough time for some consumers to sort through confusing insurance choices. (Courtesy photo)

The Michigan Health Insurance Marketplace largely serves those who don’t get health coverage through Medicare, Medicaid or their employer.

Enrollment starts Friday for plans for 2020 coverage on the Marketplace, which in Michigan and 37 other states is accessed through the government portal, www.healthcare.gov. The Marketplace, which provides individual assistance for shoppers trying to navigate the complicated world of insurance, was established as part of the federal 2010 Affordable Care Act, or “Obamacare”, and last year covered nearly 333,000 Michiganders.

Enrollment ends Dec. 15 for health coverage throughout 2020. After the deadline, consumers can get coverage only if they have a qualifying life event, such as having a child, losing coverage through an employer, or getting married or divorced.

Blue Cross Blue Shield and Blue Care Network, which together cover the lion’s share of Michigan’s Marketplace, are dropping their by 1.7 percent and 7.7 percent, respectively.

Molina Healthcare of Michigan, which offered eight plans covering 6,742 Michiganders in 2019, planned to drop the cost for its premiums by 8.8 percent, while Oscar Health, an online newcomer to the field last year with 10 plans covering fewer than 700 Michiganders, has proposed an 8.3 percent increase.

But consumers must shop carefully. 

The overall drop is a sweeping average of rate changes among nine Michigan insurers on this year’s Marketplace. Actual rates can vary significantly among plans and even county to county.

Prices also vary depending on a consumer’s age and smoking status, the county of residence, and the type of plan — from a lower-cost bronze plan, which covers less care that’s outside normal preventative services, to a platinum plan, which costs more but offers more coverage.

And the cost of a premium that has decreased still might cost more than a premium that has increased in cost.

“Maybe the one [plan] going down [in price] was $1,000 last year but the one going up [in price] was $500 last year,” said Karen Dennis, director of the Michigan Department of Insurance and Financial Services’ insurance rates and forms office.

Plus, year-to-year changes in income, for example, significantly changes final prices for individuals and families. As part of the Affordable Care Act, consumers whose income is up to four times the federal poverty level ($25,750 for a family of four) are eligible for a sliding scale of subsidies that can help lower costs.

Finally, even if everything else remains the same, a plan from year-to-year may shift costs to the consumer in other places — a higher office co-pay, for example, Dennis noted.

The price drops don’t make up for increases that averaged 27 percent across Michigan’s “Obamacare” plans just two years ago.

Insurers in 2013 set prices on wildly unknown variables. Among them: how costs would be affected by demand from previously uninsured customers or mandatory benefits required by the Affordable Care Act.

Ed Haislmaier, senior research fellow with the Heritage Foundation, a conservative think tank based in Washington, D.C., said the surge in prices for 2018 coverage reflected necessary market adjustments.

He said the premium decreases mean the market is “stabilizing and plateauing” after an “inflection point in 2018,” when insurers spiked rates to compensate for lagging costs.

Cynthia Cox, vice president at Kaiser Family Foundation, a San Francisco-based nonprofit focused on major health care issues, agreed: “We sometimes look at premium increases as a sign of failure, but in retrospect, the fact that insurers came in with these low, low prices was the failure.”

Insurers, she added, “have to price high enough to break in or make a profit to be interested in the marketplace.” 

Some also blame the Trump administration which in 2017 ended cost-sharing payments to insurers. In response, insurers shifted the costs to consumers, said Nancy Baum, a policy analyst at the Center for Health Research & Transformation.

Whatever the cause, consumers felt it in their wallets.

A benchmark plan — considered the second-lowest cost silver plan — for a 40-year-old Michigander cost $254 a month in 2014, rising steadily to $278 in the 2017 coverage year. But after uncertainty and change at the federal level, rates shot up to $381 for coverage in 2018, then leveled off last year at $383, according to the Kaiser Family Foundation.

This year’s precise rates will be available when the Marketplace opens Friday with nine insurers — what Anita Fox, the director of the state’s insurance department, called “a strong lineup of insurers.”

In fact, marketplaces in two states — Wyoming and Delaware — have just one insurer providing coverage in 2020, according to the U.S. Centers for Medicare & Medicaid Services.

The Marketplace opens for the sixth year against lingering uncertainty.

In addition to pulling back cost sharing payments to insurers in 2017, Congress passed the Tax Cuts and Jobs Act of 2017, essentially voiding the rule and, in turn, setting off another court challenge to the Affordable Care Act.

And some advocates worry that changes by the Trump administration have created confusion that could mean drops in enrollment. Funding has been pulled from programs that help consumers enroll, and the enrollment period — once more than two months long — has been clipped to about six weeks.

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Comments

Kevin Grand
Thu, 10/31/2019 - 7:05am

"If you like your plan you can keep it. If you like your doctor you can keep them. Americans will be saving about $2,500/year on average with my plan." - Pres B.O.

And curiously, very little is mentioned regarding the disconnect between Obamacare acolytes regarding how the market actually works. Of course office visits (and deductibles) are going to increase!

The best thing that can happen to America is when Obamacare finally collapses on its own (or the courts finally wake up to reality) and an actual solution will have to be found that doesn't involve shifting costs away from the people who don't want to pay.

Matt
Thu, 10/31/2019 - 11:26am

Not sure if looking to the courts for solutions to healthcare mess is a good idea, in fact I'm sure it's not. Unfortunately, our health care system and over all fiscal health will continue to spiral until a fiscal collapse happens and continued borrowing isn't an option. Good solutions never come out of reaction to such a crisis. (Think 9-11!), so I'm not optimistic. Best solution may be to split healthcare into two separate systems one for those paying their own costs (out of pocket and through private insurance). And another, (Canadian or British like?), for those that do not. But I'd doubt it will happen. Having the situation of recipients having no financial stake and the state shoveling supposedly unlimited money into a system gives predictable results and will eventually fail, but alot of money is made in the meantime!

John
Thu, 10/31/2019 - 12:32pm

Why must plans change every year? Why do we have to deal with this at all every year? Why aren't medical prices posted online or available/disclosed? Insurance is for people who do not use it or only have normal year to year usage. It's lousy and overcomplicated on drugs, and generally such manadory health items like dental, eyes, and hearing are not covered. And do not get a serious illness or life gets really stressful as one manages their coverage and the medical professions demand for payment for charges no one knows until they already owe it.
Bah! Humbugs! This isn't an efficient medical care system at all. Try moving from a large city with a disease - it's a desert out there in upper Michigan, for example.

middle of the mit
Sat, 11/02/2019 - 1:27am

Thank you Bridge! I will now show Matt, Kevin and every other conservative and some dems that Obamacare IS Heritage Foundation Care, looking out for shareholder value.

https://thecorporatechronicles.wordpress.com/2012/08/28/health-care-and-...

This is a personal blog of mine that I have posted on, those are my words and my posts.

https://www.youtube.com/watch?v=fCZ8vK2oByU

Here is the Heritage foundation rep pushing for a universal plan that goes across the nation.

https://www.youtube.com/watch?v=zU7-G50Xvus

Here is a Heritage foundation rep saying they don't back it.

https://www.youtube.com/watch?v=4DW6IKG9d_8

Here is a comparison of both plans

https://www.youtube.com/watch?v=9s-N4c36waw

Here is Romney blaming Obama and Obama telling you that Obamacare was based on Romneycare.

https://www.youtube.com/watch?v=LeHiSWGFryk

A journalist from the Wall Street Journal will tell you how Mitt feels about how many rights the State has over you

https://www.youtube.com/watch?v=y6DrH6P9OC0

Here is Mitt telling you how it is. Isn't it conservative to not be a "free rider"?

https://www.youtube.com/watch?v=9IJsiBHYTFg

Here is Cato institute telling you that is exactly what it is! Free Market health care, but Government mandated. But notice, they are blaming Romney and NOT the Heritage Foundation.

As long as WE the people can not gather together and demand a discount (bulk purchasing), those who have investments....they aren't going to go that way. Liberal or conservative. Period.

Costs will continue to rise. That is how they want it. Who cares about your health? We need be to be profitable for CEO and shareholder value.

Get used to it.

Rick
Sun, 11/03/2019 - 12:51pm

Yes, despite every effort by the Republicans to sabotage, disable, block and destroy the only health insurance available to 'little people' (not rich) ACA continues to help millions.
So Kevin - what and where is the Republican 'option'? There never has been one, just a bunch of stock talking points.
If we made it the law of the land that ALL - INCLUDING OUR STATE AND FEDERAL LEGISLATORS - had the same health insurance options we'd see a lot of change.
Look at other developed countries (or just all countries) and see what people get. The USA is way, way down the list.
There's no real reason except for the GOP's hatred of our poor and middle class populations. They work hard for the rich and big corporations and do everything they can to make life miserable for everyone else.

Medcare for All
Tue, 11/05/2019 - 1:19am

To all the union people who don't want Medicare for All, I say wait until you get cancer and your doctor recommends a treatment that BCBS says is not medically necessary. I was happy my employer offered BCBS thinking it was the best healthcare insurance, but it sucks. Now I have to pay out of pocket if I want the treatment, despite already paying the extremely high premiums, deductibles, and copays.

For all the people who say they are against Medicare for All, I say just hope that you never get cancer. In the USA, we don't have healthcare, we only have healthcare insurance and when some bureaucrat at the insurance company your employer chooses denies your doctor recommendations, you are out of luck and out of pocket, or plain and simple, you just die perhaps after having mortgaged your house and gone bankrupt. I'm lucky I'm not poor, but I can't understand why I have to pay out of pocket for treatment my doctor recommends, after having met all my premiums, deductibles, and copays.

This is all because the insurance companies are greedy and make huge profits by denying coverage when it is most needed. Beware of the new low-cost insurance plans peddled now! You won't have coverage when you most need it. Bernie is absolutely right. We are the richest country in the world and we pay more than twice as much as western European countries on healthcare, yet we have poorer outcomes.

I'm awake now, like most nights because I can't sleep. I'm so sad wondering what will happen to my family if I die now. If you don't care about me, it's okay, but think about everyone you know with cancer and think about your loved ones who have yet to be diagnosed. I'm not old, I'm just unlucky to be living in the USA where our government has its priorities messed up.

We have a president that only cares about himself, to the extent that he's in bed with Putin, our arch enemy, our nemesis. I've never seen the USA in such a hellishly scary state. That bothers me also because I fear for my family when I am gone. What country did we leave them? The future looks very bleak for everyone.

God bless President Obama for at least trying, despite the Republicans who continue to undermine Obamacare, especially by eliminating the mandate to buy insurance. That act alone caused insurance to skyrocket for everyone paying.

Now it is time for Medicare for All. Eliminate the unnecessary greedy middleman and the outrageous CEO salaries of private insurance companies. We also need campaign finance reform with fighters like Sanders, Warren, and Yang who don't take corporate money. Get the corrupt lobbyist money out of government. The Democrats are the only ones offering us HOPE. Climate change activism and protecting our environment are essential to healthcare and national security, yet Republicans continue to make things worse. I pray that by this time next year Americans with vote for change, in big numbers.

I prefer Warren/Yang or Warren/Booker. It's time to make America better, nice again.