Vermont carriers might charge about as much for individual coverage in 2014 as they charge for comparable coverage today, but residents could have a harder time using high deductibles to hold down premiums.
That conclusion comes from a comparison of preliminary Vermont Health Connect exchange 2014 rates with actual 2013 plan premium data.
The Vermont exchange appears to be the first Patient Protection and Affordable Care Act (PPACA) exchange to show the public what PPACA exchange coverage prices might look like.
For singles, for example, the proposed average monthly premiums range from $265 for bare-bones catastrophic coverage, which would be offered only to adults under age 30, up to $609 for top-tier, “platinum” coverage.
The carriers would offer bottom-tier bronze plans and mid-tier silver plans in versions that were compatible with health savings accounts (HSAs) and versions that were not compatible with HSAs.
Today, the lowest deductible widely available with Vermont individual policies sold online is $3,500.
In 2014, Vermont Blue would charge $370 per month for bronze, non-HSA coverage with a $3,500 deductible. MVP would charge $362 for a similar policies with a $3,500 deductible.
Today, MVP is selling an individual policy with a $3,500 deductible through eHealthInsurance.com for $364 per month.
For new business, the lowest deductible available with an individual plan sold through the Vermont Blue website is $5,000. Monthly premiums for coverage with a $5,000 premium start at $457 per month.
A consumer could now hold monthly premiums to $128 per month by choosing an MVP plan with a $25,000 deductible, and to $69 per month by choosing a plan with a $100,000 deductible.
In 2014, PPACA will forbid a non-grandfathered, “self-only” plan from letting the total out-of-pocket spending limit — the sum of the deductible, coinsurance payments and co-payments – for “essential health benefits” (EHB) from exceeding the maximum out-of-pocket spending limit for HSA plans. This year, the maximum HSA plan out-of-pocket spending limit is $6,250.
Starting in 2015, the U.S. Department of Health and Human Services (HHS) is supposed to adjust the maximum out-of-pocket spending limit to reflect increases in health insurance premiums.
Vermont regulators are posting the proposed exchange plan rates as part of preparations for the start of the PPACA health insurance exchange system — the birth of a new system of Web-based health insurance supermarkets.
PPACA opponents continue to fight to block implementation of PPACA.
If the PPACA health insurance and exchange provisions take effect on schedule and works as drafters expect, carriers will have to sell any new individual and small-group coverage that takes effect on or after Jan. 1, 2014, without taking personal health information into account. Carriers will be able to make only limited use of personal information other than location and age when setting coverage prices.
PPACA also calls for states or HHS to make health insurance exchanges available in all 50 states and the District of Columbia by Oct. 1, with the coverage sold through the exchanges starting to take effect Jan. 1, 2014.
The Vermont department already has taken applications from the carriers that want to sell “qualified health plans” (QHPs) through the Vermont exchange.
The department has said that it will take public comments on the proposed rates for 30 days and complete it review of the rates by June.