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Ohio: PPACA Could Push 660,000 Out of Group Health Market

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The Patient Protection and Affordable Care Act (PPACA) could cut the number of uninsured Ohio residents by 790,000 in 2017, but it also could increase premiums for the 735,000 residents who have individual coverage by more than 55%.

Consultants at Milliman Inc., Seattle, have included those projections in a forecast report prepared for the Ohio Department of Insurance.

The Ohio department commissioned the report to help regulators know what to expect in 2014, when major PPACA provisions are set to kick in, and a few years further along, in 2017.

PPACA opponents are still fighting in the courts and in Congress to block implementation of PPACA.

If the act takes effect as written and works as drafters expect, PPACA is supposed to require major medical insurers to sell policies that meet minimum benefits requirements on a guaranteed issue, mostly community-rated basis starting in 2014. Individuals and employees at small employers are supposed to be able to buy coverage using tax credits through a new system of health insurance exchanges.

Today, about 10 million non-elderly Ohio residents have some kind of government or commercial health coverage or go uninsured. About 15%, or 1.5 million, were uninsured in 2010, and that percentage could drop to 7.1%, or 712,000, in 2017, the Milliman consultants estimate.

The Milliman consultants suggest that the total number of people covered by insured and self-funded group plans could fall to 5.4 million in 2017, from 6.1 million in 2010.

The number with some kind of individual commercial coverage could increase 735,000, from 350,000.

The percentage with some kind of government coverage, or coverage provided by a private insurer but paid for in whole or in part by the government, could increase to 31%, from 20% in 2010.

Although the percentage of residents with coverage could rise by about 7.9%, the price of individual health insurance coverage might rise about 55% to 85%, excluding the impact of medical inflation, the Milliman consultants predict.

“This is primarily driven by the estimated health status of the new individual health insurance market and the expansion of covered benefits,” the consultants say.

The new tax credits are supposed to help individuals earning less than 400% of the federal poverty level pay for coverage, but U.S. residents with incomes over 400% of the federal poverty level who are in the individual market would have to pay for the coverage out of their own pockets.

People with religious objections to owning health insurance could get exemptions. In other cases, high-income individuals who choose not to buy health coverage would have to pay what PPACA describes as being an individual responsibility penalty.

Other PPACA consequences coverage from National Underwriter Life & Health:


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