Higher costs and fewer choices on health marketplace for 2017

Posted: 6:29 PM, Oct 25, 2016
Updated: 2016-10-26 12:21:16Z

INDIANAPOLIS -- Open enrollment for those who have insurance from the Health Care Insurance marketplace begins next month, and many will find that they’re forced to choose a new provider for 2017.  

Premiums are expected to go up sharply under President Obama’s health care law, and many consumers will be down to just one insurer.

The changes in average monthly premiums will vary widely between states.

In Arizona, for example, the premiums are more than doubling – while in Illinois they’re projected to rise 43 percent.

But in Indiana, the premiums have gone up by almost 70 percent since the Affordable Care Act was implemented, according to the Department of Insurance. They say members who are currently enrolled in the state's largest plan may see rate increases up to an average of 29 percent.

For 2017, four carriers will be selling on the Indiana Marketplace: Anthem, CareSource, Celtic (MHS) and MDwise Marketplace. 

Four carriers have left the marketplace: IU Health Plan, Physicians Health Plan of North Indiana, All Savers and Southeastern Indiana Health Organization. More than 68,000 Hoosiers have lost their health plans because of these carriers leaving the marketplace, according to the Department of Insurance. 

For the third year in a row, small business owner Sean Wray said he and his wife will be searching for a new insurance plan.

“The companies dropped our markets. We went from Humana to IU Health and now IU Health is pulling out of our market. And we were just informed today that there are only two options available, and only one qualifies for the marketplace,” said Wray, who owns Ablog Dental.

Rhonda Peterson, who works at the Raphael Health Center in Indianapolis, is helping patients navigate the options and new premiums ahead of open enrollment.

“We’re going to look at the financial part to see if they still qualify for a subsidy or tax credit to look to see to keep their premiums at a comparable cost to what they are paying now or to look at their doctors, first of all, because they have establishing doctors, to make sure their physicians are in the network and do accept insurance,” said Peterson.

The median patient in the U.S. will see their insurance premium jump about 16 percent on the health insurance marketplace.

In addition to calculating out-of-pocket costs and checking doctors, Gregory and Appel consultant Susan Rider recommends looking at prescription coverage when selecting a plan for 2017.

“A lot of plans have a more reduced formulary list meaning that employees or consumers won’t necessarily have access to prescriptions they want based on their conversation with a physician,” said Rider.

And don’t forget the penalty for choosing not to have insurance. While it will stay at 2.5 percent, the flat fee maximum will be adjusted each year to account for inflation.

Open enrollment starts November 1.

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