Tuesday, December 02, 2014

"Ware that swinging benchmark!" ACA Auto-renewal peril in Philadelphia

How could an ACA silver plan that cost a low-income family of three in Philadelphia $0 per month in 2014, with a $0 deductible, soar to $196 per month in the coming year?

A shifting "benchmark" silver plan and the disappearance of a large price spread between the benchmark second-cheapest silver and the very cheapest silver -- that's how,

Emily Van Yuga, an ACA outreach and enrollment coordinator for The Health Federation of Philadelphia, explained to me that last year, practically every one of the organization's clients bought that cheapest silver plan. This year, they all have to switch. Fortunately, the state is expanding Medicaid for 2015 (via a "private option" that the incoming Democratic governor, Tom Wolf, has vowed to scrap for traditional Medicaid), and most of the Federation's poor clients will will be eligible.

But the wildly swinging benchmark is a cautionary tale for 2014 ACA plan buyers who want to stay insured via the exchanges in 2015. I've laid it out in some detail on healthinsurance.org.

1 comment:

  1. I may have to read this three times to fully understand it--- and I grew up in the insurance industry! Imagine how a busy family will get lost.
    This seems to be a horrible design flaw in the exchanges. Well, that is what we get for cutting in private insurance companies.
    Other than Medicare for all, we might actually consider what John McCain proposed in 2008. Every individual would get a tax credit of $2000 or whatever, and every family would get a tax credit of $5000 or whatever.
    The results could not be worse than what you accurately describe.