health insurance premiums

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Mass. Health Insurers Report Losses; Many Premiums To Rise By 3 Percent

Health insurance rate changes for the small group market in Mass. The Q1 rates also apply to individual coverage for 2015. (Source: Mass. Office of Consumer Affairs and Business Regulation)

Health insurance rate changes for the last quarter of 2014 for the small group market in Mass. The Q1 rates also apply to individual coverage for 2015. (Source: Mass. Office of Consumer Affairs and Business Regulation)

Premiums for Massachusetts small businesses and residents who buy insurance on their own are going up.

The average increase for Jan. 1 is 3.1 percent. But this is just the base rate. Your rates could be higher or lower, depending on how much you or your fellow employees have spent on health care this year.

Insurers say premiums are going up because residents are using more care. What’s known as “utilization” in the insurance world dropped during the recession, but appears to be creeping up again. Then, say insurers, there’s the cost of some expensive new drugs, such as Sovaldi to treat Hepatitis C; taxes related to the Affordable Care Act; and the expense of dealing with the Health Connector’s failed website.

Although the average increase for Jan. 1 is just over three percent, there’s quite a range.

Shop carefully. Many of the cheaper plans will have a high deductible, so if you have a chronic disease or lots of young children, you may not want this option. You can save money by choosing a plan that limits where you seek care, but check to see if your doctor(s) are in the covered network.

Also today, the state’s three largest health plans reported that they’ve lost money so far this year.

Blue Cross Blue Shield posted a net loss of $32.2 million for the second quarter and $91.4 million loss for the first six months of the year.

“Our second quarter results reflect our continued commitment to delivering more affordable premiums to our members while we absorb costs associated with complying the ACA,” said Allen Maltz, Blue Cross CFO.

Harvard Pilgrim’s net loss through June is $10.4 million. Continue reading

Actuaries: ObamaCare Will Hike Claims Cost 32 Percent (But Not In Mass.)

Source: The Society of Actuaries' report, "Cost of the Future Newly Insured under the Affordable Care Act." (Posted with the society's permission.)

Source: The Society of Actuaries’ report, “Cost of the Future Newly Insured under the Affordable Care Act.” (Posted with the society’s permission.)

The Associated Press, delving courageously into actuarial data, reports here:

Insurance companies will have to pay out an average of 32 percent more for medical claims on individual health policies under President Barack Obama’s overhaul, the nation’s leading group of financial risk analysts has estimated.

That’s likely to increase premiums for at least some Americans buying individual plans. The report by the Society of Actuaries could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act.

…Medical claims costs are the main driver of health insurance premiums. A study by the Society of Actuaries estimates the new federal health care law will raise claims costs nationally by an average of 32 percent per person in the individual health insurance market by 2017. That’s partly due to sicker people joining the pool. The study finds wide disparities among states. The estimates assume every state will expand its Medicaid program.

Naturally, my curiosity turned provincially to Massachusetts. The full Society of Actuaries report is here, including this gorgeous infographic breaking down the data by state. I’m happy to report that New England states are looking good: Vermont and Massachusetts can expect claims costs on individual policies to decrease by over 12 percent and Rhode Island by more than 6 percent. New York can expect a whopping drop of nearly 14 percent. Compare that to poor Wisconsin and Ohio, expecting an increase of over 80 percent.

The AP piece also features some refutations from the Obama administration, including: Continue reading

When Health Care Costs Help Threaten Teachers We Need

Brookline's Edward Devotion school (John Phelan/Wikimedia Commons)

Brookline’s Edward Devotion school (John Phelan/Wikimedia Commons)

For many of us, there comes a moment when the high cost of health care suddenly turns from an abstract public issue into a deeply personal one. Often, it’s an astronomical out-of-pocket medical bill. Or a family calculation that the price of health insurance means no new car, or no summer trip.

For me, that moment came last week at a PTO meeting held at my children’s Brookline public school. At issue: plans to eliminate the “Enrichment and Challenge Support” program.

The program, formerly called “Gifted and Talented,” benefits all the school’s children, and works in every Brookline school. It promotes creativity and learning by inquiry. It collaborates with classroom teachers to help support advanced students, as well as all learners. It works with small groups of kids on topics from reading and writing to math, science and social studies.

Also on our school’s chopping block, separately: The part-time math tutor who works with small groups of children. (The one who prompted a friend’s son to exclaim recently, “Probabilities are fun!”)

In short, our vaunted school district may soon jettison some academic work that perhaps best embodies all the cutting-edge advice on how to train our children to thrive in the 21st-century world.

First, a disclaimer. School district budgets are exceedingly complex and depend on many imponderables, including state and federal budgets. I can by no means draw a direct line between Brookline’s health insurance costs and the decision to cut two of the best and most beloved teachers my children have had.

But here’s what struck me: The endangered program costs the district about $264,000 a year. And in response to a parent’s question, Brookline superintendent Bill Lupini said that for each percentage point that health insurance costs rise, the town must pay about $230,000.

Growth in premiums slowed during the recession, and the town had been hoping the rate news would be good. But it’s not. As of today, Alan Morse, chairman of the Brookline School Committee, says the district’s health insurance costs in the coming budget “are up about 3-1/2 percent, as opposed to the 2 percent which we were hoping for — which reduces the district’s resources available to fund next year’s budget.” Continue reading

Mass. Health Insurance Premiums Bounce Back To Highest In Country

(Source: The Commonwealth Fund)

Massachusetts is #1 again, but not in any way the state will celebrate. We have the highest health insurance premiums in the nation again, according to this annual report from the Commonwealth Fund. Massachusetts bounced back to the top again in 2011 after dropping to 9th place in 2010.

The report does not analyze why Massachusetts is back in first place, but notes that in general, health care costs are higher here because we have more generous benefits, our cost of living is higher overall, and our health care prices tend to be higher.

An important caveat: That high cost of living, and our higher incomes, need to be factored in. If you look at our premiums as a percentage of median household income, we’re actually on the low side: 18% compared to a national average of 22%. (See chart below.)

Still, this bump from 9th back to 1st is bad news. It’s also politically significant. Last year, hospitals and business leaders used this drop in health insurance costs (relative to the rest of the country) as proof that the market was working to curb health care spending. And, they argued, the drop to 9th place meant the state did not need to impose new controls. Leaders made this argument in the heat of legislative debate about what to include or leave out of the health care costs bill Governor Deval Patrick signed in August.

So what do those leaders say now? Continue reading

As Premiums Rise Slowly, More Employers Shift Some Cost To Patient

Readers, are you trying to figure out how a tiered or limited-network health insurance plan works? WBUR’s Martha Bebinger wants your story. Tell it in the Comments section or click on “Get in touch” below. She’s aiming to air more on this topic soon.

Employers across the state sit down this month for an annual meeting that many dread. It’s a briefing on how much their health insurance premiums will increase come January. WBUR’s Bob Oakes spoke with reporter Martha Bebinger about what employers can expect.

Bob Oaks: The bad news is that premiums, on average, are still rising. But the good news is that many businesses will see about the same increase or slightly lower increases than last year. What’s the range?

Martha Bebinger: Last year premiums rose 4-10 percent. This year, the increase is expected to be slightly lower, 3-6 percent. Keep in mind that these are so-called base rates. The actual rate for your company could be higher or lower, depending on the age of the employees, how much care they use and a few other factors.

(Note: Fallon Community Health Plan declined to provide their expected rate increases).

But what about this new state law that says health care costs aren’t supposed to rise any faster than growth in the state’s economy overall? With these premium increases, health care is still growing faster than most other costs. What happens?

Nothing right away. The state will eventually require hospitals, physician groups, insurers and others who deliver health care to submit plans for bringing their costs down if they exceed the state health care spending targets. But that won’t start until 2015 or 2016.

So premiums for most of us are expected to rise 3-6 percent, more or less depending on our health and the health of our colleagues. Why will we see slightly lower increases? Is Mass. figuring out how to get a handle on health care costs?

It’s not clear Bob. There are a number of things happening to slow the rise in health care premiums. Hospitals and doctors are agreeing to lower increases in the contracts they sign with insurers. And patients are seeking less care. This could be the ongoing effects of the recession, and patients putting off elective knee surgery, for example. It could also be that more and more of us have health insurance that doesn’t cover all the costs of a test or treatment. Some patients with a high deductible or higher co-pays, are putting off or just not going to the doctor or hospital to avoid those costs.

Brian Pagliaro, Senior Vice President for Sales at Tufts Health Plan.  (Courtesy of Tufts Health Plan)

Brian Pagliaro, senior vice president for sales at Tufts Health Plan. (Courtesy of Tufts Health Plan)

More employers are buying coverage with high deductibles or other types of insurance to save money. What kind of changes should patients be ready for?

High deductible plans are a common way that employers save money. These plans are cheaper because they shift some of the cost to the patient. Employers can save even more money by cutting expensive hospitals out of their coverage. This is what’s known as a limited network plan. And the fastest selling product for a few insurers is what’s known as tiered coverage. With tiered health plans, patients can go wherever they want, but they might pay $2,000 or more to deliver a baby at Brigham and Women’s Hospital for instance and nothing at, say Melrose Hospital. Continue reading

Turnbull: Stop Kvelling, We Still Need Aggressive Action To Halt Rising Premiums

By Nancy Turnbull
Harvard School of Public Health

Lots of kvelling recently by policymakers, providers, and others about a new Commonwealth Fund Study that everyone says shows that Massachusetts no longer has the highest health insurance premiums compared to other states; instead, we are #9.

I heard at least four people cite this study from the podium on Friday at a conference sponsored by the Massachusetts Association of Health Plans. Depending on the person doing the bragging, the study was touted as: proof that we don’t need more regulation because market forces are working to control health insurance premium increases; evidence that state regulatory action to control premiums has been effective; or as a counter to critics of national health reform, many of whom attack the Affordable Care Act with the contention that despite (or because of) health reform in Massachusetts, our state has the highest health insurance premiums in the country.

Reeling with cognitive dissonance, I just spent some time reading this Commonwealth Fund study. I find an interesting and more nuanced story but one which, at the end of the day, does nothing to dampen my sense of urgency about the need for aggressive action to deal with rising health insurance premiums. Continue reading

Premiums Are Rising, But Mass. No Longer Tops The Most Expensive List

WBUR reports:

According to a new survey, Massachusetts no longer has the most expensive health insurance premiums in the nation, but rates are still high.

The Commonwealth Fund reports on average, premiums in the state cost about $14,000 — the ninth highest in the country.

Overall, the report says that “employer health insurance premiums increased 50% from 2003-2010,” while “employees’ share of premiums increased 63%.”

Here’s the nifty interactive map that compares premiums by state.

FactCheck.Org: ObamaCare’s Effect On Rising Premiums

How will Obama handle the health law in his speech tonight?


Everyone’s entitled to their own opinion, but not their own facts. That’s one of my favorite sayings. So I’m always thrilled when FactCheck.Org, a project of the Annenberg Public Policy Center, takes on a health topic and separates out the spin.

Here’s their take on the politically charged question of whether federal health reform — aka ObamaCare — is to blame for the latest jumps in health insurance premiums, and if so, to what extent. Bottom line: Maybe for about 1 percent out of 9. Their summary:

Health insurance premiums for employer-sponsored family plans jumped a startling 9 percent from 2010 to 2011, and Republicans have blamed the federal health care law. But they exaggerate. The law — the bulk of which has yet to be implemented — has caused only about a 1 percent to 3 percent increase in premiums, according to several independent experts. The rest of the 9 percent rise is due to rising health care costs, as usual.

Furthermore, the increase caused by the law is a result of the increased benefits it requires, a factor Republicans generally ignore. So far, insurance companies have been required to do the following: Continue reading