There’s some good news and some bad news for Missourians purchasing marketplace healthcare plans under the Affordable Care Act.
The good news: Those eligible for premium subsidies will see no increase in their premiums. In fact, a 40-year-old non-smoker earning $30,000 a year will see a 2.7 percent reduction of his or her premiums to $201 a month.
The bad news: Those not eligible for subsidies will see premium increases ranging from 12 percent to 50 percent for the benchmark silver plan.
That’s according to an analysis of 2018 premium changes in Missouri by the Saint Louis University School of Law Center for Health Law Studies.
In Kansas City, the premiums for the benchmark silver plan will rise from $348 a month to $518 a month, a 48.9 percent increase, according to the analysis. In St. Louis, they’ll go up from $310 to $465, a 49.9 percent increase.
But because nearly 90 percent of Missourian who buy marketplace plans get subsidies in the form of tax credits, most of them won’t feel the pinch.
Dylan Kriegshauser, a third-year law student who helped compile the analysis, says the monthly drop in premiums for those eligible for subsidies was “a little bit surprising.”
“They’ve generally gone down a couple of dollars each year, but this is actually a $6 drop, which I believe is the biggest one we’ve seen,” he says.
Two insurers, Blue Cross and Blue Shield of Kansas City and Humana, announced they will exit the Missouri health insurance marketplace in 2018. But another, Centene, said it will offer plans in the Missouri marketplace. Along with Anthem and Cigna, that leaves three insurers statewide offering plans.
In 2017, most plans offered by insurers were PPOs, which allow patients to go out-of-network, albeit at a higher cost. In 2018, none of the insurers are offering PPOs. Instead they’re offering EPOs, or exclusive provider networks, which only cover in-network providers.
“Last year there were only 18 EPO plans on the market being offered out of, probably, 100 plans or more,” Kriegshauser says. “And then this year there are no PPO plans.”
Open enrollment for 2018 begins Nov. 1 and ends Dec. 15.
One reason for the big jumps in premiums was uncertainty over whether the federal government would continue to make cost-sharing reduction subsidies. The subsidies lower the amounts consumers pay for deductibles, copayment and coinsurance.
Earlier this month, President Trump said he would scrap the subsidies. He also signed an executive order authorizing less comprehensive insurance plans by associations of small employers – another move that many insurers and health care experts fear will destabilize the Affordable Care Act marketplaces.
Dan Margolies is a senior reporter and editor for KCUR. You can reach him on Twitter @DanMargolies.