Tag Archives: ObamaCare

Rate Increases in New York

Rate Increases have started to come out for NY Small group and individuals for January 1, 2019.  Note that these are requests, not approvals.  That won’t happen until sometime in the fall.  Also note that these are averages across all that companies products.

With the elimination of the individual mandate under ObamaCare, the individual market is getting very large increases.  The baseline average increase was 12.1%, but an 11.9% additional increase has been applied for to cover the effects of the individual mandate being repealed.

SMALL GROUP

Aetna                                         16.2%

Emblem                                     12%

Empire                                         6%

Healthfirst                                 21%

MVP                                              7%

Oscar                                            3%

Oxford                                        8.3%

United                                        7.2%

 

INDIVIDUAL

Emblem                                    31.5%

Empire Healthchoice            24.0%

Fidelis                                       38.6%

Healthfirst                                15.0%

MVP HealthPlan                       6.5%

Oscar                                          25.2%

United                                        23.6%

 

 

 

New Exemptions to ObamaCare Released

“The Trump administration announced Monday that those who live in counties with no insurer or with only one choice will be able to apply for a hardship exemption from the mandate, which requires nearly all Americans to get health insurance or pay a penalty.” according to an article in CNN Money.

This means that 26% of Americans will be able to file for a hardship waiver, including everyone in the State of South Carolina, but only matters for the rest of this year.  The penalties for not having insurance are eliminated in 2019.

30% higher premiums, lower enrollment.

In the not-exactly-a-shock category, this newsbit from Reuters:

(Reuters) – About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans, a 3 percent drop from last year when 12.2 million consumers signed up, according to a final government tally released on Tuesday by the Centers for Medicare and Medicaid Services.

The tally includes both sign-ups on the exchange run by the federal government for 39 states, which was released on a provisional basis late in 2017, and on the 12 other exchanges run by Washington, D.C. and the remaining states.

CMS said the average premium before tax credits in 2018 is $621 a month, an increase of more than 30 percent from last year.

There is still a penalty for not having insurance…

Just a reminder that, while recent legislation did eliminate the penalty, it does not take affect until 2019.

Employer penalties in 2018 are at elast $2320 after the first tirty employees.

The individual Penalty is

  • $695 for each adult and $347.50 for each child, up to $2,085 per family, or
  • 2.5% of family income above the federal tax filing threshold, which the Kaiser Foundation calculator estimates is $10,650 for an average single filer

or $21,300 for the average family who file jointly in 2018

Why LI Hospital Mergers make it harder…

A recent article in Newsday points out that there is only 1 independent hospital left on the island – Brookhaven Medical Center, now know as the Long Island Medical Center.

“Hospitals are combining nationwide. There were 78 hospital deals in the United States in 2017, in which 216 hospitals, with a total of 27,386 beds, were acquired, said Lisa Phillips, editor of HealthCareMandA.com, a publication that tracks health care mergers for health care consultant Irving Levin Associates in Norwalk, Connecticut…   In the New York metropolitan area, New Hyde Park-based Northwell Health, the most aggressive acquirer on Long Island, has expanded its network into Brooklyn, Westchester County and eastern Long Island by taking over hospitals. It has added four hospitals in the past 3 1⁄2 years.”

This has made it hard on patients – especially those on ObamaCare individual policies – to find insurance that covers their doctors.  Northwell does not have a relationship with Oscar Health Plans, the most affordable of the options.  Some hospitals simply refuse to accept the reimbursement rates of the individual plans as well.   NYU Hospitals don’t have relationships with Healthfirst either.  If you live in Nassau County, you are more or less forced into expensive options – Empire and Emblem.

I believe it likely that we will see some changes to this during the year, but only time will tell.  And any midyear changes don’t help you this year, since you cannot change until January 1…

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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