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WASHINGTON (AP) Medical claims costs the biggest driver of health insurance premiums will jump an average 32% for Americans' individual policies under the Affordable Care Act health care law, according to a study out Tuesday by the nation's leading group of financial risk analysts.
The disparities are striking. By 2017, the estimated increase would be 62% for California, about 80% for Ohio, more than 20% for Florida and 67% for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.
Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care.
"Claims cost is the most important driver of health care premiums," she said.
While some states will see medical claims costs per person decline, the report prepared by the Society of Actuaries concluded that the overwhelming majority will see double digit increases in their individual health insurance markets, where people purchase coverage directly from insurers.
Health and Human Services Secretary Kathleen Sebelius.(Photo: Scott Olson, Getty Images)
The Obama administration also questions the design of the SOA study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick. The study also doesn't take into account the potential price cutting effect of competition in new state insurance markets that will go live on Oct. 1, administration officials said.
And, those who had catastrophic plans "that don't really pay anything unless you get hit by a bus" will have to purchase heftier plans, Sebelius said, which means their insurance premiums will go up.
Recent data shows that employer insurance costs are going down, Sebelius said at Tuesday's briefing. And, insurance companies for the first time must tell consumers exactly what benefits a plan covers and how much it will cost, which forces them to be competitive, she said. The "free market" approach should keep rates low, she said.
Obama has promised that the new law will bring costs down. That seems a stretch now. While the nation has been enjoying a lull in health care inflation the past few years, even some former administration advisers say a new round of cost curbing legislation will be needed.
The SOA report did not make estimates for employer plans, the mainstay for workers and their families. That's because the primary impact of the new health Converse Laces Styles
care law will be on people who don't have coverage through their jobs.
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On the plus side, the report found the law will cover more than 32 million currently uninsured Americans when fully phased in. And some states including New York and Massachusetts will see double digit declines in costs for claims in the individual market.
"We don't see ourselves as a political organization," Bohn added. "We are trying to Converse Trainers Ladies figure out what the situation at hand is."
Uncertainty over costs has been a major issue since the law passed three years ago, and remains so just months before a big push to cover the uninsured gets rolling Oct. 1. Middle class households will be able to purchase subsidized private insurance in new marketplaces, while low income people will be steered to Medicaid and other safety net programs. States are free to accept or reject a Medicaid expansion also offered under the law.
But a prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does "a credible job" of estimating potential enrollment and costs under the law, "without trying to tilt the answers in any particular direction."
Health overhaul to raise claims cost 32
At a briefing at the White House Tuesday, Health and Human Services Secretary Kathleen Sebelius said talk about rates is "speculative" at this point, though she acknowledged that some people will see their costs go up.
Story HighlightsHHS Secretary Kathleen Sebelius says talk of rates is "speculative"Disparities of Converse Shoes For Kids Girls
For example, she said, in the past, women typically had to pay more for insurance simply because they were women. Now, men's costs will go up as women's go down because plans may not legally base fees on gender.
health care cost increases are striking state by stateNew report looks at insurance costs for uninsured, not those who get insurance through employer
said that," Foster added, "actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully." Actuaries use statistics and economic theory to make long range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.
Young people also typically have lower rates, she said, but insurers now have new rules for age based rates. In the beginning, younger people may pay more than they have in the past while older people pay less. However, Sebelius added, subsidies will help the up and coming afford that insurance.
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