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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsVermont Is First In Nation To Propose Rates Under Obamacare
By Kirk Carapezza
Vermont, which continues to emerge as a national health care leader, released on Monday the amount it proposes to charge consumers for health insurance under the federal Affordable Care Act.
Under the proposed rates, the average cost for an individual would vary from $365.76 for the most basic package to $609.47 for the most comprehensive. Rates for family plans would be higher. People under certain income limits would get federal subsidies to pay for insurance.
Vermont is the first state in the nation to release its proposal for rates under the health benefits exchange that the federal law established. The program will be known as Vermont Health Connect. State officials say the publication of the rates will allow Vermonters who plan to seek health insurance through the Affordable Care Act to begin making choices about the coverage they want.
Under the Affordable Care Act, insurance carriers that want to serve Americans through state run health exchanges are required to submit their rates.
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http://blog.vpr.net/2013/04/01/vermont-is-first-in-nation-to-propose-rates-under-obamacare/
By Phil Galewitz
After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers predictions, there was no rate shock in the new premiums, according to the Vermont governors office and insurance representatives.
Blue Cross and Blue Shield of Vermont and MVP Health Care submitted plans with monthly premiums that range from an average of $265 for catastrophic coverage for young adults to $609 for platinum coverage, which has the lowest cost-sharing among four categories of plans.
We think this is a positive development for folks who were worried about what rates would look like in 2014, said Kevin Goddard, spokesman for Blue Cross and Blue Shield of Vermont, which is the states dominant commercial carrier, controlling about two-thirds of the market. He confirmed rates are similar to what the company now offers.
These rates are comparable to whats on the market today and thats good news, said Robin Lunge, director of health reform in the Vermont governors office. She said its difficult to do an apples-to-apples comparison because of the many benefit changes required under President Barack Obamas health overhaul. These changes, which take effect Jan. 1, include an end to annual lifetime limits in policies and a prohibition on denying coverage to people with medical problems.
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http://capsules.kaiserhealthnews.org/index.php/2013/04/no-rate-shock-seen-in-proposed-2014-premiums-in-vermont/
ProSense
(116,464 posts)russspeakeasy
(6,539 posts)ProSense
(116,464 posts)Cha
(296,756 posts)thanks ProSense
ProSense
(116,464 posts)Yo_Mama
(8,303 posts)It already had community rating and no extra charges for being old.
The state regulator is estimating a 10% increase:
Vermont also requires prices to be the same regardless of persons age. Two of the health laws biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.
Insurance industry predictions of rate shock are more likely in the majority of states that currently allow insurers to set premiums based on an individuals health status, Goddard said.
The 10% estimated increase is very comparable to last year's increase, so it's certainly no surprise and certainly not a rate shock. But the rate shocks are supposed to arise in the states that already don't have these rules.
Since more people are supposed to be covered, the pool should have more younger people in it than last year, which should bring down overall costs. But then I guess the new mandated coverages kick in and bring it up a bit.
There will be rate shocks in many states.
"Vermont is different It already had community rating and no extra charges for being old...The 10% estimated increase is very comparable to last year's increase, so it's certainly no surprise and certainly not a rate shock. But the rate shocks are supposed to arise in the states that already don't have these rules. "
...but the rates are not higher than the CBO estimates. The fact is that the age rating caps and the other mechanisms, from rate reviews to transparency, will show that insurance companies were engaging in fear mongering. We'll know soon enough.
There have been constant attempts to scare people about the law, but as it gets closer to being fully implemented some opponents are having to admit they were exaggerating.
Fast Food Chains Realize Obamacare Will Cost Them Much Less Than They Predicted
http://www.democraticunderground.com/10022580511
Yo_Mama
(8,303 posts)We will know soon. October! It's not long now.
I'm kind of glad that the federal government is operating most of the exchanges. For one thing, it's got to be more efficient. For another thing, I'm thinking that we'll get better pricing data that way. If one entity is running over half the exchanges, it's got to be easier to get info on prices, etc from all those exchanges.
I was kind of surprised at the cost, but I looked up Vermont's demographics, and it turns out their median age is very similar to the median age of the US. I thought it was older!
Nite Owl
(11,303 posts)level for federal subsidies to kick in? These rates seem terribly high, I don't care what they are in comparison to what they are now they are still way too high.
"What is the income level for federal subsidies to kick in?"
...Medicaid eligibility is up to 138 percent of the federal poverty level and the subsidies end a 400 percent of FPL.
A key element of the Affordable Care Act (ACA) is the expansion of Medicaid to nearly all individuals with incomes up to 138 percent of the federal poverty level (FPL) ($15,415 for an individual; $26,344 for a family of three in 2012) in 2014. Medicaid currently provides health coverage for over 60 million individuals, including 1 in 4 children, but low parent eligibility levels and restrictions in eligibility for other adults mean that many low income individuals remain uninsured. The ACA expands coverage by setting a national Medicaid eligibility floor for nearly all groups. By 2016, Medicaid, along with the Childrens Health Insurance Program (CHIP), will cover an additional 17 million individuals, mostly low-income adults, leading to a significant reduction in the number of uninsured people.
Medicaid does not cover many low-income adults today. To qualify for Medicaid prior to health reform, individuals had to meet financial eligibility criteria and belong to one of the following specific groups: children, parents, pregnant women, people with severe disability, and seniors. Non-disabled adults without dependent children were generally excluded from Medicaid unless the state obtained a waiver to cover them. The federal government sets minimum eligibility levels for each category, which are up to 133% FPL for pregnant women and children but are much lower for parents (under 50% FPL in most states). States have the option to expand coverage to higher incomes, but Medicaid eligibility levels for adults remain very limited (Figure 1). Seventeen states limit Medicaid coverage to parents earning less than 50 percent of poverty ($9,545 for a family of 3), and only eight states provide full Medicaid coverage to other low-income adults. State-by state Medicaid eligibility levels for parents and other adults are available here.
The ACA expands Medicaid to a national floor of 138% of poverty ($15,415 for an individual; $26,344 for a family of three). The threshold is 133% FPL, but 5% of an individuals income is disregarded, effectively raising the limit to 138% FPL. The expansion of coverage will make many low-income adults newly eligible for Medicaid and reduce the current variation in eligibility levels across states. To preserve the current base of coverage, states must also maintain minimum eligibility levels in place as of March 2010, when the law was signed. This requirement remains in effect until 2014 for adults and 2019 for children. Under the ACA, states also have the option to expand coverage early to low-income adults prior to 2014. To date, eight states (CA, CT, CO, DC, MN, MO, NJ and WA) have taken up this option to extend Medicaid to adults. Nearly all of these states previously provided solely state- or county-funded coverage to some low-income adults. By moving these adults to Medicaid and obtaining federal financing, these states were able to maintain and, in some cases, expand coverage. Together these early expansions covered over half a million adults as of April 2012.
Eligibility requirements for the elderly and persons with disabilities do not change under reform although some individuals with disabilities may become newly eligible under the adult expansion. Lawfully residing immigrants will be eligible for the Medicaid expansion, although many will continue to be subject to a five-year waiting period before they may enroll in coverage. States have the option to eliminate this five-year waiting period for children and pregnant women but not for other adults. Undocumented immigrants will remain ineligible for Medicaid.
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http://www.kff.org/medicaid/quicktake_aca_medicaid.cfm
Nite Owl
(11,303 posts)I'm going to save this info
Humanist_Activist
(7,670 posts)next? I ask, because my fiancee is on Medicaid in MO, and her income is 1,170 dollars a month, which is less than the $15,415 income limit for individuals, yet Missouri Medicaid still requires her to have a 393 dollar spend down every month(think of it as a deductible), before the medicaid kicks in. Note, this is her only income, its fixed, and its from disability, not sure if that affects it. I'm just wondering if the spend down will go away in 2014.
ProSense
(116,464 posts)next? I ask, because my fiancee is on Medicaid in MO, and her income is 1,170 dollars a month, which is less than the $15,415 income limit for individuals, yet Missouri Medicaid still requires her to have a 393 dollar spend down every month(think of it as a deductible), before the medicaid kicks in. Note, this is her only income, its fixed, and its from disability, not sure if that affects it. I'm just wondering if the spend down will go away in 2014.
...goes into effect, anyone earning up to 138 percent of FPL will be eligible for Medicaid. Some states are still rejecting the expansion, but I think they'll eventually cave.
Yo_Mama
(8,303 posts)I don't think it will go away next year, but that would depend on the state legislature. There is nothing in ACA that would prevent it.
Humanist_Activist
(7,670 posts)She already makes less than a full time minimum wage worker makes, imagine an additional 25% of that just gone, no way that's even remotely a livable wage.
Yo_Mama
(8,303 posts)Because then she should get Medicare 2 years after going on Disability?
I looked up the Medicaid spenddown thing for MO Healthnet, and it's basically an insurance premium, or you can pay medical bills and qualify that way. What she's paying is nearly the Vermont insurance premium for a single person!
I don't know whether next year in MO she could buy insurance on an exchange and do better. MO is supposed to be participating in the Medicaid expansion (or at least the governor has proposed it) but I don't know if that will relieve her of the spenddown.
bluestate10
(10,942 posts)I would love to see my New England state join with Vermont, New Hampshire, Connecticut and Maine, once Le Page is gone, to form a massive buying pool that covers millions of people and Hundreds of thousands of businesses. Such a buying pool would exert enormous power on rates and would be accountable to the voters in the member states.
grantcart
(53,061 posts)insurance companies to pool in under populated regions.
In any case the MLR is fixed.