by Paige Minemyer | Nov 7, 2019 3:50pm
Though
the average benchmark premium for Affordable Care Act (ACA) exchange plans in
2020 declined, there’s plenty of regional variability in premium costs,
according to a new analysis.
Researchers
at the Kaiser Family Foundation (KFF) compared data
from insurer filings to state regulators, state exchange websites and the
federal exchange HealthCare.gov. They found that overall, the average
unsubsidized premiums for the lowest-cost bronze, silver and gold plans
decreased by about 3% for the 2020 plan year.
However,
what individual consumers see hit their wallets varies based on their income,
the plan level they choose and where they live, according to the report. Average
premiums are set to increase in certain counties—Carroll, Tennessee, for
example, will see benchmark premiums rise 487% from $33 to $195.
“For
consumers to know how much they will pay, they must return to Healthcare.gov or
their state’s exchange each year and carefully consider their options,” the
researchers wrote.
The
analysts found that insurers are continuing to embrace so-called “silver
loading” in the absence of cost-sharing reduction (CSR) payments, which
were halted by the Trump
administration in 2017.
The
practice was insurers’ response to the end of CSRs, in which they put most
premium increases on silver plans that are used to determine federal subsidies,
creating an alternative path to reduced cost sharing.
The
Centers for Medicare & Medicaid Services have eyed policy changes that
would prevent payers from engaging in silver loading but
didn’t pull the trigger for the 2020 plan year. Agency officials also indicated
they’re open to a legislative solution that reinstates CSR payments.
As a
result of silver loading, a number of potential exchange enrollees
would qualify for zero premium bronze plans instead, according to the KFF
report. Many people who qualify for exchange subsidies would also have the
option of a “free” bronze or gold plan but would exchange the lack of
premium for other cost sharing, the report said.
Silver
plans with lowered cost sharing are typically the highest-value option for
subsidized enrollees, the analysis said.
“Low-income
consumers will need to consider whether it makes sense to purchase a metal
level other than silver, as a lower premium plan may come with significantly
higher deductibles, copays or coinsurance,” the researchers wrote.
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