GAO report a rich source on range of insurance premiums

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

How much will the Affordable Care Act affect health insurance premiums in each state when the individual mandate becomes effective on Jan. 1? Journalists are trying to answer this question as reports trickle in from various states about how much health insurers will charge starting next year. Enrollment for next year begins Oct. 1, just 10 weeks away.

To help answer this question, the U.S. Government Accountability Office released a report on Tuesday, “Private Health Insurance: The Range of Base Premiums in the Individual Market by State in January 2013.” It shows the range of base premiums before underwriting for individuals as of January of this year in each state and the District of Columbia. This report was requested by Sen. Orrin Hatch (Utah-R) and the agency made no recommendations.

The report shows the lowest, median and highest base premiums displayed on the HealthCare.gov Plan Finder site for six types of consumers:

  1. A 30-year-old, single, nonsmoking male;
  2. A 30-year-old, single, smoking male;
  3. A 30-year-old, single, nonsmoking female;
  4. A 30-year-old, single, smoking female;
  5. A family of 4 with two parents, aged 40; and
  6. A couple, aged 55.

This year, premium rates can vary based on age, gender, health status, and other factors. Beginning next year, however, insurers cannot use gender and health status to set premiums and will be restricted in how much premiums can vary based on age and tobacco use, among other provisions, the report says.

The GAO collected the data from numbers insurers submit to the Center for Consumer Information and Insurance Oversight in the federal Department of Health and Human Services.

In addition, the report includes base premiums before underwriting for one urban and one rural ZIP code in four states (one from each census region): Illinois, Nevada, Pennsylvania and Texas.

As The Washington Post’s Sarah Kliff points out, “about 20 percent of insurers don’t post their plan data, which means we’re missing about one-fifth of the marketplace.” But, it’s “probably the best data set we have on insurance premiums so far.”

Julie Appleby of Kaiser Health News notes some “eye-popping” numbers, such as plans that don’t “even kick in until medical costs of $20,000 or more are incurred by the policyholder.”

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