Dive Brief:
- Insurance premiums for people in the individual markets are between 22.7% and 78.2% more costly on average than they were before implementation of the Affordable Care Act, according to a new HealthPocket study.
- HealthPocket looked at monthly premiums in the individual markets in large metropolitan areas across the country before and after implementation of the ACA. They tabulated the unsubsidized costs for non-smoking men and women aged 23, 30 and 63. For the youngest group, plan premiums rose 78.2% for men and 44.9% for women; for 30 year olds, they increased 73.4% for men and 35.1% for women; and among 63-year-old group, they grew by 22.7% for men and 37.5% for women.
- The study authors noted the issue is a complicated one. Post-ACA plans were very different than earlier ones in a few ways. Insurers could not deny applications due to pre-existing conditions so more enrollees after reform likely needed costlier care. Later plans were required to provide essential benefit coverage, making them more robust.
Dive Insight:
The authors concede that comparing plans before and after implementation of the ACA is a challenge. In some ways, it is like comparing apples and oranges. Not only are the patients on the plans different, but so too are the plans. Insurers on the individual market now must provide coverage for the 10 categories of essential benefits. The authors noted that this includes oral and vision care for children and maternity and newborn care. Before the exchanges were created in 2014, fewer than 2% of plans covered all of these areas: 92% excluded children's dental care, 87% excluded pediatric eyeglasses, 67% excluded delivery and 64% prenatal and postnatal care.