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Fears of Widespread “Rate Shock” Unfounded

A House subcommittee is putting health reform in the hot seat again today, when it holds a hearing on the “looming premium rate shock” that health insurers have warned about.  But widespread rate shock isn’t looming.  In at least a few states where insurers have already proposed their 2014 premium rates, the doomsday predictions of skyrocketing premiums have not materialized.

Yes, a relatively small number of people with coverage in the existing individual insurance market can expect premium increases in 2014, particularly if they are young and healthy, are not eligible for new federal subsidies or expanded Medicaid coverage, and have a relatively skimpy plan today.  But others will pay less, and still others will be able to get better benefits for about the same premiums.

Moreover, health reform means that uninsured people and those who have health problems will no longer be shut out or priced out of the individual insurance market.  Millions of people will be eligible for new federal subsidies to help them pay their premiums and cost-sharing charges, which will offset supposed rate shock for many people.

The House Energy and Commerce Oversight and Investigations Subcommittee, collected a trove of documents from insurance companies to prepare for its hearing today.  The documents tend to emphasize the largest potential rate increases and the types of people — men, in particular — who may experience them.  Insurers developed many of these projections as the industry was lobbying to repeal or delay specific provisions of the health care law, such as the health insurance tax and new restrictions on what older people can be charged for coverage compared to younger people.  They don’t necessarily reflect the premiums these companies actually plan to charge consumers in 2014, and it’s not clear how many of the higher-rate scenarios will actually occur.

Now, the companies are preparing to sell insurance in a reformed marketplace.  We are starting to see the actual premiums that insurance companies want to charge next year, and greater transparency and competition are helping tamp down premiums, at least in some states.  In Washington state, some people would pay less in premiums or pay about the same prices for more comprehensive coverage if recently proposed premiums take effect, in contrast to what the industry had predicted.  And in Oregon, after the insurance department posted proposed rates from various insurers, two companies with relatively higher premiums said they would redo their requests and submit lower rates after seeing their competitors’ rates.

In both of those states, regulators are reviewing the insurers’ rate proposals to decide whether to approve them under health reform.  Other states are doing the same, so more data points are on the way.  We expect that they, too, will show little evidence of widespread rate shock.