Download With Health Plan Changes, Consumers Should Plan Ahead for 2017

The DC Fiscal Policy Institute blog
www.dcfpi.org
October 6, 2016
With Health Plan Changes, Consumers Should Plan Ahead
for 2017
By Jodi Kwarciany
Consumers can expect changes ahead for their health insurance - small businesses that buy health
insurance through DC Health Link, the District’s health insurance exchange, will see modest cost
increases next year on average, according to new rates recently approved by the District. Individuals
who buy insurance will face somewhat larger, but moderate, increases. The changes in insurance
premiums vary considerably by insurer and health plan, and some increases may be dramatic. With
the 2017 open enrollment season starting in November, consumers should take time to review
options and determine the best fit for their health and finances.
The good news is that DC Health Link offers an
easy and transparent way to compare plan
benefits and prices, one of the key benefits of
creating a health insurance exchange under the
Affordable Care Act. And many can use DC
Health Link to get financial assistance to help
pay for premiums.
Last week, the Department of Insurance,
Banking and Securities (DISB) approved rate
changes for 2017 health plans on DC Health
Link. Each insurer wanting to sell individual and
small group plans through DC Health Link must file preliminary rates, which DISB reviews to
determine whether increases are reasonable. DISB can require insurers to adjust rates increases it
considers unjustified (specifically, if they are "excessive, inadequate or unfairly discriminatory").
At first glance, the new rates generally show good news for consumers. Premiums for individual
health plans will increase 7.27 percent on average next year, and small group plan premiums will
increase just 0.36 percent on average.
But a deeper dive shows more much more variation, and dramatic increases in some cases. The
hardest hit are individuals who have health plans through insurer CareFirst that have a Health
Savings Account (HSAs), or a tax-free savings account used to help pay for medical expenses in
conjunction with a high-deductible health policy. CareFirst will eliminate its HSA-eligible plans,
meaning consumers currently enrolled will need to select new plans for 2017. If not, they'll be
automatically moved into plans with premium increases of up to 75 percent.
DISB notes that is a large rate increase, but that consumers will no longer have to make health
savings account contributions and that new plans will offer slightly more benefits. The problem is
that it’s currently up to the consumer how much they contribute to an HSA - and some healthy
people contribute very little - but they would have no choice other than paying much higher
premiums in a non-HSA plan. If faced with this situation, where do consumers begin?
There are tools to help individuals and small business wade through these choices. DISB's
Consumer Guide explains the 2017 changes in health plan rates, and DC Health Link's Plan
Comparison Tool for Individuals and Families can help people determine the best plan for
themselves. Additionally, consumers with incomes below 400 percent of the poverty line ($47,520
for an individual or $100,000 for a family of four) may be eligible for tax credits to reduce their
monthly premium payments, and cost-sharing reductions to lower the amount they would pay for
deductibles, copayments, and coinsurance. In fact, an estimated 2,000 DC residents could newly
qualify for financial help to make coverage more affordable if they get insurance through DC Health
Link.
Open enrollment for DC Health Link begins on November 1, 2016 and runs through January 31,
2017. No matter what situation an individual is facing, finding the right health coverage for them
and their families is possible.
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