By Kelly J. Rooney, J.D., M.P.H.
According to the Office of the Assistant Secretary for Planning and Evaluation (ASPE) under HHS, a significant increase in premium costs for individual market coverage has occurred since the Affordable Care Act’s (ACA) (P.L. 111-148) key provisions have been effectuated. The ASPE took a closer look, comparing data on premiums from 2013 and 2017 and found an average raw increase of $244 or 105 percent. Also, 62 percent of states saw 2017 exchange premiums at least double the 2013 average (ASPE Report, May 23, 2017).
The ASPE compared average premiums using the 2013 medical loss ratio (MLR) data and the 2017 CMS Multidimensional Information and Data Analytics System (MIDAS) data from the Healthcare.gov site. The average 2013 monthly premium from the MLR data was $232. The average for plans purchased on Healthcare.gov in 2017 was $476, amounting to a median increase of 105 percent.
There was significant variation from state to state. The 39 states that used Healthcare.gov saw an increase from 2013 to 2017, but it ranged from a 12 percent increase in New Jersey to a 222 percent increase in Alabama. The states that had benefits mandates prior to the ACA experienced smaller premium increases.
There are some limitations noted by ASPE as this analysis does not account for: (1) 2017 MLR data which is not yet available; (2) plans purchased through the outside of the exchanges which is not accounted for in the CMS MIDAS data; (3) non-Healthcare.gov states’ data; and (4) the overall populations enrolling in the individual market being different in 2017 than in 2013 (more older and less healthy individuals are enrolling now).
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