Ohioans’ choices limited in 2017 insurance marketplace

ST. CLAIRSVILLE — Residents of Belmont, Jefferson and Monroe counties will have a choice of two insurance carriers participating in the Affordable Care Act marketplace in 2017, state officials said.

However, only one insurance company is offering coverage through the federal marketplace for customers in Harrison and Guernsey counties next year.

Ohio Lt. Gov. Mary Taylor, who is also director of the Ohio Department of Insurance, shared that information during a conference call with media representatives Friday.

“Many counties in Ohio are going to have a pretty significant impact under Obamacare going into 2017,” Taylor said.

This year, 17 insurance companies are selling plans in the ACA exchange in Ohio, but only 11 companies are entering the marketplace for 2017, she said.

In comparison, only two insurance companies are in the 2017  federal marketplace for the whole state of West Virginia.

Regarding coverage for Ohioans, Taylor said, “In 2016, all 88 counties had at least four carriers. In 2017, 20 counties will have only one carrier and 27 will have only two carriers.”

Community Insurance Co. (offering an Anthem plan) and CareSource Ohio Co. are the 2017 marketplace carriers for Belmont, Jefferson and Monroe counties, she said. Community Insurance Co. is the lone carrier for Harrison and Guernsey counties.

In 2016, less than 250,000 Ohioans signed up for coverage through the federal marketplace at www.healthcare.gov, she said. The total number of participants for 2017 will not be known until open enrollment ends.

She said, “We’re already starting to hear from Ohioans with questions.”

Taylor said people can obtain more information about the federal marketplace by visiting www.healthcare.gov or calling 800-318-2596. Ohioans also can call the Ohio Department of Insurance’s consumer hotline at 800-686-1526 or seek information online at www.insurance.ohio.gov.

Premiums in individual markets in Ohio have increased 91 percent since 2013, with an increase of nearly 13 percent this past year, the state director said.

“No doubt, there is some concern and some consumers who are frustrated. We certainly understand that,” she said.

Taylor noted that many carriers have pulled out of exchange marketplaces across the country because they were losing money on the exchange.

She explained, “Enrollment is not what they expected. Those enrolling are sicker and require more medical expenses than they (carriers) predicted. Quite honestly, not enough younger, healthy people are signing up to offset the cost. It is affecting all carriers.”

The Ohio Department of Insurance reviews all insurance plans sold in the state and any premium requests. Insurers have to justify their proposals to the state agency.

“Premiums are going up, more broadly speaking. It’s the nature of the beast, so to speak, with Obamacare,” Taylor said. “Insurance companies are choosing not to sell in the exchange. It’s the same dynamics about the population being sicker than originally anticipated. They’re also feeling this same thing.”

She said, “As premiums increase, the subsidy is going to go up. It’s a math calculation. That percentage is going to be covered. Absolutely that is true. But it is relevant to point out that as those subsidies increase, the taxpayers are paying the burden, with those tax dollars sent to Washington to pay those subsidies.”

Individual consumers are not the only ones affected by rate hikes.

“The overall impact of Obamacare is hitting small employers as well. They are still required to provide mandated coverage under Obamacare. They are seeing premiums rise as exchange premiums have gone up,” Taylor said.

“Small business has been impacted dramatically by the cost of what it is to provide health insurance to their employees,” she said. “They (employers) think it is important and they’re really struggling with this. It’s harder and harder for them to do that because the cost has gone up so dramatically.”

Taylor cautioned consumers to be aware of provider networks when choosing an insurance plan. She said, “They should take a look so that they have a good understanding of what doctors are in or out of network. Especially if it’s an individual who has a medical condition, they’re going to want to know.”

She also urged people to “look at what the deductibles are and what other out-of-pocket costs are that they have to bear. They have to incur those costs, regardless of what subsidy they get to pay the cost of the premium.”

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