The cost of Obamacare is turning out to be higher than all but a few critics had anticipated.
Health insurance companies have submitted their Obamacare rate proposals for 2016, and many requests are for increases in the double digits. These are "individual" plans offered to those who do not get their insurance through their employer (known as "group" plans).
In at least four states - Arizona, Alabama, Idaho, and Nevada - health insurers have proposed Obamacare rate increases of at least 70%.
While that's exceptionally high, the top rate increase requests in 43 states is at least 20%.
And there are plenty of states with rate increases everywhere in between. Oregon's insurance commissioner has already approved a 25% increase for the Moda Health Plan and a 33% increase for LifeWise. Two other Oregon insurers have asked for increases of 43.97% and 51.54%.
"Rate increases will be bigger in 2016 than they have been for years and years and will have a profound effect on consumers here. Some may start wondering if insurance is affordable or if it's worth the money," Jesse Ellis O'Brien, a health advocate at the Oregon State Public Interest Research Group, told The New York Times.
Now, it's true that the rate increase proposals range all the way down to the low single digits, so the cost of Obamacare will vary greatly depending upon the state in which you live and the health plan you have.
But when you average it out, the increase is still in the double digits.
Health insurance research firm HealthPocket calculated the costs for a 40-year-old non-smoker to get an idea of what those using Obamacare can expect in 2016.
The Average Cost of Obamacare in 2016
HealthPocket found that typical premiums for all four tiers would rise in 2016, from 9% for a low-end Bronze plan to 11.75% for a top-level Platinum plan. The average Gold plan will increase by 16%, and the average Silver plan - the most popular tier, chosen by two out of three Obamacare users - would rise 14%.
"Given the rate of general inflation in the country, and the economic situation, the rate increases were surprising to us," Kev Coleman, HealthPocket's head of research and data, told CNBC.
A single person with a premium of about $300 a month now can expect an increase of about $42 a month. A family of four with a typical Obamacare premium of about $800 faces an increase of more than $100 a month.
But with many rate increases being far higher, some unlucky folks will see their premiums go up hundreds of dollars a month as of Jan. 1, 2016.
It wasn't supposed to be this way. In fact, the supporters of the Affordable Care Act promised that insurance rates would go down, not up.
But things aren't working out as they expected...
Why the Cost of Obamacare Is Rising
The Obamacare strategy was for millions of young, healthy people to sign up. They would use less healthcare than what their premiums covered, creating a surplus to help pay for the influx of older, sicker people into the system.
The healthier people have not signed up in the expected numbers. But the older, sicker people have, and it's thrown the economics of Obamacare out of whack.
"Our enrollees generated 24% more claims than we thought they would when we set our 2014 rates," Nathan T. Johns, the chief financial officer of Arches Health Plan, told The New York Times. Arches participates in the Utah exchange. The insurer has requested 2016 rate increases of 45% on average.
Other insurers have had a similar experience in the first full year under Obamacare rules that require them to accept all patients and prohibit them from charging sicker patients higher premiums.
Blue Cross and Blue Shield of Minnesota paid out 115% more last year in claims than it collected in premiums, generating a loss of $135 million.
The ACA law specifies that any rate increase over 10% is subject to review by the states. And although some states may cajole some reductions, the insurers now have plenty of hard data to justify the higher rates. If the proposed rates come down, it won't be by much.
Does Obamacare Face a "Death Spiral"?
The bigger question is whether the trend that caused the cost of Obamacare to spike will continue. If so, we could see the dreaded "death spiral" that critics warned about.
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That's when insurance costs for younger, healthier people are so high that they elect to pay the tax penalty instead. That means a higher proportion of older, sicker people in the risk pool, which, as we've seen, leads to steep rate hikes.
The fact that most of the health insurance companies asking for big rate increases are among the largest in the industry - Blue Cross Blue Shield, Aetna Inc. (NYSE: AET), UnitedHealth Group Inc. (NYSE: UNH) -- suggests that what's happening this year is a red flag.
These are the costs - and risks -- of Obamacare that its proponents didn't want to talk about back in 2009.
"This is really the first time that America's really seeing true Affordable Care Act rates," HealthPocket's Coleman said.
Beware the Cadillac Tax: If you have health insurance through your employer, as most Americans do, you may think you'll never have to deal with an Obamacare exchange directly. But one of the components of the ACA, the "Cadillac tax," is designed to undermine employer-based health insurance. You're not going to like this one bit...
Follow me on Twitter @DavidGZeiler.
- The New York Times: Health Insurance Companies Seek Big Rate Increases for 2016
- CNBC: 'Surprise'-Obamacare Insurers Desire Double-Digit Hikes
About the Author
David Zeiler, Associate Editor for Money Morning at Money Map Press, has been a journalist for more than 35 years, including 18 spent at The Baltimore Sun. He has worked as a writer, editor, and page designer at different times in his career. He's interviewed a number of well-known personalities - ranging from punk rock icon Joey Ramone to Apple Inc. co-founder Steve Wozniak.
Over the course of his journalistic career, Dave has covered many diverse subjects. Since arriving at Money Morning in 2011, he has focused primarily on technology. He's an expert on both Apple and cryptocurrencies. He started writing about Apple for The Sun in the mid-1990s, and had an Apple blog on The Sun's web site from 2007-2009. Dave's been writing about Bitcoin since 2011 - long before most people had even heard of it. He even mined it for a short time.
Dave has a BA in English and Mass Communications from Loyola University Maryland.