By Ann Sanner
COLUMBUS: Ohioans using the new marketplaces created by the federal health care law will pay on average 41 percent more for their monthly premiums, state insurance officials said Thursday.
Small businesses can expect their monthly rates to rise an average of 18 percent, officials said.
The increases are partly due to consumers receiving more benefits under the plans than previously available.
The details from the Ohio Department of Insurance were the first glimpse from the state of what consumers could see should they purchase private insurance in the marketplaces created by President Barack Obama’s health care law, also called exchanges.
Open enrollment in the plans starts Oct. 1, and coverage takes effect in January. That’s when virtually everyone in the country will be required by the law to have health insurance or face fines.
Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get.
Republican Gov. John Kasich chose to let Washington operate the exchange, instead of having the state set up its own. The federal government will help many middle-class households pay their premiums, while low-income people will be referred to programs such as Medicaid that they might qualify for.
The health care law offers sliding-scale subsidies based on income for individuals and families making up to four times the federal poverty level, about $44,700 for singles, $92,200 for a family of four. But the state’s figures don’t take into account any subsidies that people could get.
Ohioans currently pay an average monthly rate of $236.29, according to the state’s analysis of premiums. Next year in the exchange, individuals would pay an average premium of $332.58.
The state also expects that small businesses will pay an average monthly rate of $401.99 next year in the small group market, up from $341.03 now.
Ohio’s insurance department said it took the average of premiums for all plans sold in the state at the end of 2012 and compared it to the average premium for all the plans expected to be in the exchange next year.
Yet, not all plans sold in Ohio provide as much coverage as what will be required by the federal law for the exchange next year.
The co-chair of a coalition of unions, consumer advocates and faith-based groups that back the federal law accused the Kasich administration of “playing with numbers.”
Cathy Levine, of the Ohio Consumers for Health Coverage, said people have been paying lower rates in part because those with pre-existing conditions, who are more costly to cover, have been shut out of the market.
“We’re just spreading the cost more fairly now,” she said.
Lt. Gov. Mary Taylor, the state’s most vocal critic of the federal Affordable Care Act, told reporters on a conference call that the agency’s comparison was fair.
Taylor, who is also the state’s insurance director, said Ohioans today can pick what they want in a plan based on their need and what they can afford. Next year, all plans in the exchange will have to cover a standard set of benefits, such as emergency room treatment, maternal and newborn care, and prevention.
“It’s squeezing the market,” she said. “Everyone is being forced to purchase an insurance plan that has these required benefits.”
State regulators submitted to Washington on Wednesday the health plans approved for the exchange. Ohio turned in 200 plans from 12 companies for the individual market and 184 plans from six companies for the small business market. The federal government must still sign off on the plans.
The number of plans available to consumers will differ by region, the insurance department said. But small businesses should have two to three plans to pick from while individuals could choose from at least four plans.