The disparate views of the ACA’s impact on health insurance costs reflect the political divide between federal and state officials.
Some states that have embraced healthcare reform have shown residents how the law will reduce insurance costs, while some others that have opposed the act are presenting reform as a more expensive prospect.
Under Florida law, insurance companies are required to explain to policyholders in writing how much of their premium cost increase is the result of the act’s “guarantee issue” and other mandates.
But insurers are not required to explain to policyholders one of the primary reasons that prices for health plans sold on the federally-run exchanges may run higher in Florida than in other states: Because Florida legislators this year stripped the Office of Insurance Regulation of the power to negotiate rates with insurers offering health plans on the federal exchanges until 2016.
Unlike states such as Maryland, where insurance regulators said they negotiated lower rates for health plans offered on their state’s exchange, Florida insurance officials have been relegated to simply approving plans for compliance with federal reform law.
“We’re not approving or denying rates [for individual or small group policies],’’ McCarty said. “We’re checking them for completeness. It’s an informational filing.’’
Florida insurance officials will, however, continue to regulate rate increases for so-called grandfathered health plans, sold before the adoption of the Affordable Care Act in March 2010.
Until now, health insurance has been priced at a base rate that was adjusted for the insured’s age, gender, health status and other factors.
Premiums could be increased by a factor of 10 or more for some individuals with existing conditions, or a rider could exclude coverage for the condition.
Starting January, those rules will no longer apply. Everyone will be covered regardless of health status. Women in their childbearing years won’t pay higher premiums, and older people won’t be charged more than three times the lowest premium’s cost.
Consumers who qualify to buy a plan on the exchange also will receive federal subsidies to help offset the costs.
Individuals and families earning up to 400 percent of the poverty line — which is $45,960 for an individual and $78,120 for a family of three — will be subsidized on a sliding scale. For some, depending on annual income, premiums will be capped at a percentage of their annual income.
This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.