COLUMBIA — As the insurance mandates of the Affordable Care Act kick in next year, South Carolinians who pay for individual health insurance coverage will pay 50 to 70 percent more, based on plans submitted to the state Insurance Department.
Four companies submitted plans for the insurance exchange that is mandated in 2014 by the federal health-care legislation, said Raymond G. Farmer, director of the S.C. Department of Insurance. Those plans had to be submitted by July 31. Another eight companies have filed plans to provide individual policies outside of the federal exchange.
The state agency crunched the numbers from all of those plans to come up with the average increase.
Overall, we expect to see average rates increase by 50-70 percent in the individual market and 10-20 percent in the small group market, Farmer said.
However, those percentages dont factor in the tax credits that will reduce the financial hit for many buying insurance on the individual market. Premiums also will vary widely based on age, whether an individual smokes and the level of insurance selected.
The state agency estimated that increases will range from 5 percent to 151 percent for those age 20, from 2 percent to162 percent for those age 40 and from 13 percent to 134 percent for those age 60.
Gov. Nikki Haleys office used the numbers to attack the Affordable Care Act.
This kind of disastrous consequence is exactly why Gov. Haley fought against Obamacare from Day 1 and will continue to fight it until the day its defunded or replaced with something that actually improves health care and lowers costs for families, said Haley spokesman Doug Mayer.
The estimates, like everything related to the health care law, carry a huge political spin.
Leaders in two Democratic states estimate the health care law will save consumers money. New York officials say individual rates in that state will go down 50 percent under the Affordable Care Act, and California officials say new rates in that state will range from a 2 percent increase to a 29 percent decrease.
Meanwhile, toss-up state Florida estimates a 35 percent increase and GOP-controlled Indiana projects a whopping 72 percent increase.
The estimates cover only the individual and small group markets. People covered by large employers, state government policies or Medicaid or Medicare are not included.
However, nationally, about 15 million people are covered by individual policies, while about 150 million are covered by large-group policies, including their employers, according to the Kaiser Family Foundation.
The individual market nationally is expected to more than double in size to about 35 million people by 2016 as a result of insurance mandates in the Affordable Care Act. The insurance exchange was designed to provide affordable options for the people who will be joining the insurance market.
Some states drew interest from dozens of companies planning to offer policies under the exchanges in those states. That increased competition should result in lower rates..
However, South Carolina opted not to form its own exchange and, instead, rely on the framework of a federal exchange. Only four companies applied and were approved for the exchange in South Carolina: Blue Choice Health Plan, BlueCross BlueShield of South Carolina, Consumers Choice Health Plan and Coventry Health Care of the Carolinas.
Consumers Choice is a consumer-oriented and -operated plan formed specifically to deal with the Affordable Care Acts changes. The other three groups have insured South Carolinians for years. The two Blues are separate companies under the Blue Cross umbrella.
Health insurance rates must now also factor in additional benefit requirements, new federal taxes/fees, required changes in how we calculate rates and guaranteed issue of coverage, said BlueCross BlueShield of S.C. in a statement regarding its planned increases. These additions and changes add unavoidable additional expense for our customers.
Despite the small number of companies in the exchange, S.C. insurance commissioner Farmer said we have a competitive market.
Georgia will have seven companies on its exchange, while North Carolina will have three companies on its.
However, Columbia-based health care economist Lynn Bailey said the choices in South Carolina are extremely limited, though probably more than she expected.
I dont see much choice, and without choice there isnt much of a market, Bailey said. Its like having Wal-Mart Sams Club and two local farmers markets.
The exact cost for an individual policy wont be clear until Oct. 1, when the numbers from all of the plans will be available online at healthcare.gov.
Consumers will be able to type in their income and family size, and be presented with a range of coverage options and costs. The tax credits, also based on income, will be factored in, giving an accurate accounting of the actual cost.