For once, the Obama administration and Florida officials are on the same page when it comes to forecasting monthly premiums for health plans sold on the Affordable Care Act’s insurance exchange next year: They’re going up.
But the agreement ends there.
The U.S. Department of Health and Human Services reported this week that the monthly premium for a standard mid-level plan sold on the ACA exchange will rise by 2 percent in South Florida and about 1 percent statewide in 2016.
But Florida insurance regulators reported in August that premiums will rise by an average of 9.5 percent across the state.
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The difference boils down to methodology.
Florida’s Office of Insurance Regulation looked at all health plans, including those not sold on the ACA exchange. Employer-sponsored plans were not included in the data.
HHS examined just one type of plan that is sold only on the exchange, the second lowest-priced silver plan. Those are the so-called “benchmark plans” used to calculate the amount in federal subsidies that eligible consumers can receive to help pay their monthly premiums and out-of-pocket costs, such as deductibles and co-pays.
In truth, neither figure is particularly useful for consumers, whose health insurance rates will vary depending on the plan they choose and any subsidies they receive.
Plans sold on the ACA exchange are categorized by metal level, with bronze covering the lowest percent of a consumer’s healthcare costs (60 percent) and platinum covering the highest (90 percent).
Silver plans are the most popular choice on the ACA exchange. Nearly three of four Floridians with exchange plans, or more than 1 million people selected a silver plan.
Still, the estimates provide insight into Florida’s health insurance market.
The single-digit rate increases forecast for next year signal a normalization of medical inflation, said Audrey Brown, president of the Florida Association of Health Plans.
“It shows that there's stabilization in the rates in the marketplace in Florida,” Brown said. “You've seen the rates stabilize.”