Huge Premium Hikes Expected in PA Exchange

Premiums are poised to rise significantly in Pennsylvania in year two of the Affordable Care Act (ACA). Three insurers announced this week that they are seeking premium increases of more than 10 percent.

Highmark is asking for increases up to 15 percent, Gesinger up to 19 percent and Independence Blue Cross up to 14.9 percent. The reason, according to Highmark spokesman, is “pent-up demands for care.”

Last year, about 250,000 Pennsylvanians lost their insurance because the ACA determined their coverage was substandard. Some of those individuals received a reprieve when the Pennsylvania Insurance Commissioner allowed insurers to continue pre-ACA plans until 2016. Now, Highmark is canceling those plans to bring them up to ACA standards. Translation: get ready for hefty out-of-pocket costs.

Tom Peters of Ross Township would like to keep his $288 premium and $2,200 deductible plan another year. A similar plan on the exchange, however, would cost him $290 a month with a deductible of $6,300.

In fact, the ACA is raising deductibles so much that people are choosing to delay or forego care. The New York Times reported on several individuals who are avoiding treatment because they can’t afford their deductible. For example, Gina Brown avoided the doctor when she got an ear infection. Her deductible was $4,000.  

Discouraging necessary care is the result of government mandates that dictate what insurance must include. All ACA plans must provide “free” preventative care as defined by Washington D.C. But the fact is preventive care looks different for everyone. For cancer survivors it might mean yearly scans, for a diabetes patient it might mean regular visits with a nutritionist, while for others, immunizations and annual check-ups would suffice. What’s more, “free” preventive care is often priced into higher premiums. 

It’s clear the mountain of consumer protections within the ACA is doing more harm than good.

Only by eliminating mandates can consumers can regain control and lower out-of-pocket costs. After all, potential patients, not bureaucrats or insurance companies, are best equipped to decide which health care services matter the most.