Update on Health Care Reform

On Tuesday, I attended the South Carolina Health Underwriters Association and got alot of updated information about PPACA:

Average Premium Increase
2014 over 2013
Age 21 Age 31 Age 60
Male 81% 57% -10%
Female 35% 1% 6%

ENROLLED:  In South Carolina 43,229/55,000 enrollees, or about 80% have actually paid for their plan – and therefore actually count as being “insured.”   88.7% of these got a subsidy and the average age was 44.5  Of note is that the no-subsidy off-exchange average age was actually much younger (35), which noone could explain easily.

THE BIGGEST COMPLAINT so far has been that the carriers and healthcare.gov point fingers at each other, and neither side is helping to resolve the issue.  I personally sat with a client for 90 minutes on Monday  afternoon on hold with healthcare.gov trying to resolve an issue.  We gave up.

The deadline for 2015 plan and rate submission is June 27th.  This is interesting because the carriers have barely had time to get all the client info from healthcare.gov, and already have to figure out what to do for next year.  So my guess is that the choices of healthplans won’t change much, since the big players are generally waiting to see what happens.  But then, its Health Care Reform – it will change tomorrow!

Trends I expect will continue:

–  No out-of-network options

– Skinny Networks will continue, despite consumer complaints.  This is a national trend.

– Consumer Complaints will increase.  So far they have been centered around enrollment issues;  I expect claim issues to begin showing up shortly.

NAVIGATORS- there is a movement under way to require oversite of Navigators – who collect personal identifying information, and “help” enroll people.  Navigators report to noone, do not have E&O insurance, and have a total of 2 weeks of training.