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 “Consumers in Illinois will continue to have affordable Health
Insurance Marketplace options next year. Among Marketplace
consumers, most will be able to select a plan for less than $75 per
month. Headline rate changes do not reflect what these consumers
actually pay because tax credits reduce the cost of coverage below
the sticker price and shopping helps consumers find the best deal.
Meanwhile, for the 60 percent of people in Illinois with employer
coverage, premiums have grown at some of the slowest rates on record
since the Affordable Care Act was enacted. All Illinois consumers,
no matter where they get their coverage, are benefiting from ACA
protections like no more exclusions for preexisting conditions, no
annual limits on coverage, and no cost sharing for preventive
services.”
BACKGROUND
Since the Affordable Care Act became law, health care prices have
risen at the lowest rate in 50 years. Premiums for the 150 million
Americans with employer-sponsored insurance have grown at some of
the slowest rates on record. And, a recent analysis finds that 62%
of Marketplace consumers in Illinois would be able to purchase
coverage for less than $75 per month, even if all rates went up 50
percent.
The Health Insurance Marketplace is designed for affordability.
Two important features of the Marketplace protect Illinois
consumers from the impact of rate increases.
Tax credits go up along with premiums. Tax credits are
designed to protect consumers from rate increases and keep coverage
affordable, increasing by whatever amount the cost of the
second-lowest-cost silver, or benchmark plan increases. So if all
premiums in Illinois go up by similar amounts, 77 percent of
consumers will not necessarily have to pay more, since tax credits
will increase in parallel. Last year, despite headlines projecting
double-digit rate increases, the average premium increased just $4
per month for HealthCare.gov consumers with tax credits, and 7 out
of 10 Marketplace consumers could purchase 2016 coverage for less
than $75 per month. Even if premiums and tax credits rise, the
overall cost of the ACA is still below CBO’s original projections.
CBO’s recent projections estimate that for 2019 coverage, ACA
coverage will cost $49 billion less than originally predicted.
Consumers can shop around to find the best plan. In 2016,
consumers could choose among an average of 10 plans per issuer.
Variations in provider network and drug formulary makeup from plan
to plan can offer consumers meaningful choice. Prior to the
Affordable Care Act, it was almost impossible to shop around for
health insurance. Not only were many Americans barred from coverage
due to pre-existing conditions, but those who did have insurance
through the individual market were often trapped in a plan, since
people with even small health problems could be denied coverage or
charged an exorbitant price if they tried to switch plans. Today,
any Marketplace consumer can purchase any plan during open
enrollment, and Marketplaces let consumers compare prices, plan
designs, and networks to find the best choice for them. Last year,
53 percent of returning Illinois HealthCare.gov consumers switched
plans. They saved an average of $53 per month.
Current Marketplace rates are well below initial Congressional
Budget Office (CBO) projections.
Independent researchers recently calculated that 2016 Marketplace
rates are anywhere between 12 percent and 20 percent below what CBO
initially predicted.
2017 Marketplace rate increases are subject to a number of
predictable upward pressures that will dissipate next year.
The end of the ACA’s temporary reinsurance program in 2016 puts
upward pressure on 2017 rate increases that won’t exist for 2018 and
beyond.
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Evidence suggests that some issuers priced below cost for 2014, reflecting the
uncertainties of a new market and a desire to offer strongly competitive initial
rates. With two full years of experience, many issuers are making one-time
adjustments this year to bring premiums in line with observed costs.
CBO's projections show that the law is working to cover the uninsured, while
costing less than expected. Recent estimates find that the law's coverage
provisions will cost 28 percent less in 2019 than in CBO's original projections.
Marketplace and non-Marketplace consumers are benefiting from slow health
care cost growth since the enactment of the ACA.
Since 2010, per-enrollee costs in both public and private health insurance have
grown more slowly than in previous decades – contributing to lower-than-expected
costs in the Marketplace.
Ten times as many people are covered by employers as purchase insurance in the
Marketplace and the average premium for families with employer-sponsored health
plans grew just 3.4 percent in 2016, according to the Kaiser Family Foundation
and Health Research and Educational Trust survey, extending a period of
unusually slow growth since 2010.
The White House Council of Economic Advisers calculates that the average family
premium in Illinois was $3,800 lower in 2015 than if premiums had grown at the
same rate as the pre-ACA decade.
Part of the progress in slowing cost growth is the Administration’s work to
develop new, innovative ways of paying for care that align payment with improved
outcomes which can help sustain and build on the slowdown in health care costs.
This benefits Marketplace consumers as well. CBO has consistently predicted that
Marketplace rates would grow faster than employer premiums for the first few
years, but then grow at the same pace as employer coverage.
That means Marketplace consumers will also benefit if slow health care cost
growth can be sustained and the Marketplace advances in its stability and
reaches a steady state.
The Marketplace is providing 335,243 Illinois consumers with coverage they
value, because it improves their access to care and financial security.
Nearly 4 out of 5 Marketplace consumers are very or somewhat satisfied with
their health insurance. Importantly, they are just as satisfied with their
coverage as people with employer plans.
Marketplace consumers are accessing primary, specialist, and other care they
need at rates similar to people with employer coverage and far higher than the
uninsured, thanks in part to moderate cost sharing.
The share of families struggling to pay medical bills fell for all income groups
between 2013 and 2015, and fell the most for the moderate-income families most
likely to have gained coverage through the Marketplace.
Only 7.1 percent of people in Illinois went uninsured in 2015, new Census data
show, down from 13.8 percent in 2010. That dramatic drop means 850,000 more
Illinoisans had coverage in 2015.
[U.S. Department of Health and Human
Services] |
