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Life Health > Health Insurance > Health Insurance

GAO finds huge variation in health rates

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The range of health insurance prices available in the commercial individual and family health insurance market is wide.

In Wisconsin, for example, a single male nonsmoker, age 30, could pay $468 per year for a plan with a $3,500 annual deductible, a $4,500 out-of-pocket maximum, and a 20 percent coinsurance rate.

The same young male nonsmoker could pay as much as $3,924 per year for a plan with a $500 annual deductible, a $3,000 out-of-pocket maximum and a 20 percent coinsurance rate.

In New York state, a state that takes a more active approach to health insurance rate regulation, premiums for the young male nonsmoker could range from $1,986 to $24,324. The annual deductibles were not available on the site. The cheapest policy offered no cap on out-of-pocket expenses. Information about any out-of-pocket maximum was not available for the most expensive policy.

In Vermont, another state with an active rate regulation strategy, the young male nonsmoker could pay as little as $665 per year — for a policy with a $100,000 annual deductible — and as much as $3,505 per year, for a policy with a deductible of just $3,500. In Vermont, neither base policy would have a limit on the out-of-pocket maximum.

Analysts at the U.S. Government Accountability Office (GAO) have published those figures in a report on the range of health premiums available throughout the United States. The GAO prepared the report for Sen. Orrin Hatch, R-Utah.

The GAO analysts came up with six hypothetical standardized customers, then looked at what the minimum premium, median premium and maximimum premium figures might be for those customers.

In addition to the young male nonsmoker, the benchmark customers include a single male smoker, age 30; a single female nonsmoker, age 30; a single female smoker, age 30; a family of four, with parents age 40; and a couple, age 55.

The analysts used the government’s site to find what the annual base premium for a benchmark customer would be before underwriting.

The analysts came up with the numbers for all 50 states and the District of Columbia by looking at statewide data.

For four states — Illinois, Nevada, Pennsylvania and Texas — the analysts came up with separate data for urban and rural ZIP codes.

In Texas, for example, annual base premiums for a 30-year-old single male nonsmoker could range from $566 to $4,236 in Dallas and from $653 to $3,744 in a rural community. 

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