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Life Health > Health Insurance > Health Insurance

What could members of Congress pay for coverage?

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Members of Congress may be able to choose between cutting their monthly health insurance premiums 8 percent in 2015 or accepting increases of about 7 percent or 12 percent. District of Columbia insurance regulators have given information about the possible rate changes in a summary of public exchange “qualified health plan” rate proposals.

The Patient Protection and Affordable Care Act (PPACA) requires members of Congress and their staff members to get their health coverage from the PPACA exchange system. The U.S. Office of Personnel Management (OPM) has implemented the law by requiring members and many staffers to get coverage through the Small Business Health Options Program (SHOP) division at the District of Columbia’s locally run DC Health Link exchange, rather than through the government’s Federal Employees’ Health Benefits Program.

Aetna, CareFirst, Kaiser Permanente and UnitedHealth all offered plans through the D.C. SHOP exchange in 2014, and Aetna, CareFirst and Kaiser Permanente offered individual QHPs through the exchange.

In 2015, the individual and SHOP divisions are on track to offer the same carrier choices.

D.C. regulators say rates could fall 8 percent for UnitedHealth plan enrollees. Rates could go up an average of about 7 percent or 8 percent for enrollees in Aetna and Kaiser plans, and more than 10 percent for CareFirst plan enrollees.

See also: Some state PPACA exchanges report big gains

For SHOP coverage that started January 2014, the approved monthly rates for a 27-year-old ranged from a low of $144.23 for the cheapest bronze coverage to a high of $377.84 for the most expensive platinum coverage. A 55-year-old could have paid anywhere from $343.81 to $900.67.

In 2015, the proposed rate range for a 27-year-old could start at $147.76 and go up to $418.42. For a 55-year-old, the cheapest plan would cost $352.22 and the most expensive would cost $997.43.

In the individual market, monthly rates for a 27-year-old could range from $151.46 to $341.09. For a 55-year-old, rates could range from $295.70 to $813.09.

The proposed 2015 rates are subject to change. Last year, D.C. exchange carriers cut some rates between the time rates were proposed and the time the rates took effect.


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