Health Insurance Marketplaces in 2016: What to Expect

October 5, 2015

Affordable Care Act Private Insurance Coverage

Health Care Stakeholders | Policymakers | Media

With the third open enrollment period for health insurance marketplaces launching November 1st, this briefing took a detailed look at what consumers can expect regarding premiums, health plan availability and affordability.

Speakers provided the latest information about premium trends and drivers, health plan availability and new tools designed to help consumers make informed choices. They highlighted changes from last year and explain survey data addressing barriers to enrollment.

KEY BRIEFING POINTS
If you were unable to attend the briefing, here are some key takeaways:Sara Collins, vice president of health care coverage and access, The Commonwealth Fund
Sixty percent of consumers paid $125 a month or less for their marketplace health plans in 2015, though people in marketplace plans had higher deductibles, on average, compared to those in employer plans, said Sarah Collins, citing enrollment trends from a recent Commonwealth Fund Affordable Care Act tracking survey.

Jon Gabel, senior fellow, NORC at the University of Chicago
Health insurance premiums have a history of volatility, and premium growth almost always outpaces increases in workers’ wages and the overall consumer price index (CPI), said Jon Gabel. For example, in 1989, premiums rose 18 percent for employer-based health plans, whereas wages and CPI only went up 2 percent. With this in mind, he noted that premiums showed an average increase of 4.9 percent in CT, MD, VT, DC and RI for 2016.

Cori Uccello, actuary and senior health fellow, American Academy of Actuaries
Major premium drivers include underlying growth in health care spending, a reduction of reinsurance program funds and the composition of risk pools, said Cori Uccello. In states where individuals had the option to keep their non ACA compliant plans, healthier people chose to stay with their old plans and high-cost high-need patients switched to marketplace plans, she added. States that adopted that transition role might be seeing higher premium increases than plans in states that did not, due to the composition of their risk pool, she said.

Carrie Banahan, executive director, Office of the Kentucky Health Benefits Exchange
For the next open enrollment period, Kentucky is launching new tools and a tablet application to help consumers shop for plans, according to Carrie Banahan. She said that Kentucky also is working with brokers to play a bigger role in enrollment.

Mila Kofman, executive director, DC Health Benefit Exchange Authority
After marketplace implementation, the uninsured rate dropped by 20 percent in DC, said Mila Kofman. The largest age category in the marketplace pool is 26 to 34 year olds, indicating that DC has a healthy risk mix, she added. DC’s marketplace is launching a physician search tool to ensure that consumers aren’t taken by surprise regarding the inclusion of a provider in a network, and also a tool to allow consumers to search for plans based on their medical needs.

Ed Howard of the Alliance for Health Reform and Sara Collins of The Commonwealth Fund co-moderated.

Follow the briefing on Twitter: #OE3

Contact: Marilyn Serafini, mserafini@allhealth.org 202-789-2300

The event was sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.