WOW! One Michigan individual health plan new 2018 rate at +68.97%, versus 2017

catch22

Michigan reports from September of 2017 anticipated an average health insurance plan cost increase averaging 28%.

For my annual, lady down the street report; here is the new price change:
--- 17 year old female, who requires an individual plan
--- the 2018/monthly electronically billed rate is now $198.23, versus $117.32/monthly for 2017
--- the annual deductible is $7,350
--- the policy is a BCBS Bronze PPO (pretty sure my recall is correct about the type)

Sidenote:
Recently spoke with a few retired folks folks who have supplement health plans (not full Advantage plans) and they noted they received notices from United Health that monthly premiums would go down ranging from 15-24%. Strange, eh?

Well, anyway; a report from "a person on the street". The older folks here will recall such a phrase.

And no, I don't know whether the parent is looking at other options for the above noted health insurance. All info is accurate to the best of my knowledge.

I/we would appreciate other related individual stories about health care rate changes for 2018.
Thanks.
Catch

Ted

@catch: WOW !
Regards,
Ted

PRESSmUP

Trumpcare...Making America Great Again.

To answer your question Catch regarding rate changes, my premium went up from $625 to $725, with a similar $7350 deductible. This isn't too bad, until I factor in the minor detail that my new plan doesn't cover my most expensive med, which costs $48K a year.

davidrmoran

It will be interesting to see the details on trumpcare premiums over the next months, where and for whom.

@Press, I was sorry to read about that high deductible but am really v sorry about the med required, christ, and hope your investments catch friggin' fire next year. Man.

msf

Color me skeptical - whether the plan is the same plan, whether there are subsidies involved, etc. The only thing I can say for certain with the information you provided is that this is not an HSA-qualified plan (since the max out of pocket for an individual HDHP in 2018 is $6650, less than the deductible you gave).

Likely it is a "saver" plan - that seems to be the name insurers give to plans that pay nothing until you reach the deductible, then cover 100%. (Of course preventive care is not subject to the deductible.) The $7350 deductible is also the out of pocket cap, since that's the max allowed for 2018 individual plans. So the plan must pay everything past the deductible.

I don't have quick access to data for a 17 year old, but here's the data for a 25 year old buying the BCBS PPO Bronze Saver plan in Mich. in 2017/2018:

Area 1: $232.88/$287.85 23.6% increase
Area 2: $232.88/$287.85 23.6%
Area 3: $252.14/$302.18 19.8%
Area 4: $254.55/$311.74 22.5%
Area 5: $224.21/$277.40 23.7%
Area 6: $244.68/$293.23 19.8%
Area 7: $247.34/$305.47 23.5%
Area 8: $228.31/$290.54 27.3%
Area 9: $264.19/$326.67 23.6%
Area 10: $254.80/$305.47 19.9%
Area 11: $243.24/$300.69 23.6%
Area 12: $251.18/$319.80 27.3%
Area 13: $234.56/$283.97 21.1%
Area 14: $212.90/$270.83 27.2%
Area 15: $227.10/$280.69 23.6%
Area 16: $279.12/$345.19 25.1%

2017 data: http://www.michigan.gov/documents/difs/Marketplace_Premiums_504491_7.pdf
2018 data: http://www.michigan.gov/documents/difs/2018_Marketplace_Premiums_604416_7.pdf

Catch did qualify the figure ("accurate to the best of my knowledge"), but even if accurate, it's without context and anecdotal.

The only man on the street clip I could find quickly:

davidrmoran

Pardon my not staying informed, but how does a 17yo "require" an individual plan? Does it mean she's parentless and living w/ grandparent on Medicare, or guardian?

Old_Joe

Was wondering same thing.

Ted

@MFO Members: Don't worry, its just catch 22 being catch 22, emotional overreaction to everything !
Regards,
Ted

Old_Joe

@Ted, @catch22-

Catch is certainly aware that younger people are generally included on their parent's insurance. Yet he specifies "17 year old female, who requires an individual plan".

Additionally, he says "And no, I don't know whether the parent is looking at other options for the above noted health insurance. All info is accurate to the best of my knowledge."

We surely need clarification before dismissing this as an "emotional overreaction to everything". Your unhelpful comment simply proclaims your personal bias and long-term dislike for Catch's postings, which is very old news for some of us.

msf

OJ - I agree with what you wrote, except for highlighting "required".

The ACA, which has not been repealed, continues to require everyone to have coverage (or a waiver). Only the mandate's penalty for failure to comply has been changed by "striking '2.5 percent' and inserting 'Zero percent'". (That's text from HR 1.)

I might have highlighted "individual plan". Why is a teenager with a parent required to have an individual plan? "Individual" here may carry a double meaning - non-family, but also marketplace plan as opposed to Medicaid or group plan.

This is the context I meant was lacking. Even granting the figures, something else is going on here.

Old_Joe

@msf- Exactly. There is a disconnect between "17 year old female, who requires an individual plan" and "the parent is looking at other options."

I'm hoping that Catch will clarify the situation.

BTW, wishing you good health and a gratifying new year. Thanks again for your continuing positive, informed and extremely helpful input to MFO.

Best wishes- OJ

johnN

..

davidrmoran

It was I who initially misemphasized / misfocused on require, but yes, regardless, something is unrevealed here, surely, and while I am not as strict as many about anecdote posting, this is so wack that one must be careful not to directly and blindly pass along horror stories from a neighbor.

I mean, our issue discourse is polluted enough; more editorial hygiene in '18, I urge.

Old_Joe

Is "editorial hygiene" like "clean up your act"?

davidrmoran

yes, but worse and more!

shoulda said intellectual hygiene

one of the big worldwide goals for the new year, for sure

msf

It's not so much about anectodes as it is about applying sound reasoning.

Anectodal information to advance a story is fine if the anecdote is representative. That's the way class action suits work - one first shows that the individuals suing are representative of a larger group, and then their stories are used to advance the case.

Presenting anecdotes to suggest that they are representative is backward, or as colorfully phrased above, "wack".

For example, the numbers could be accurate but not representative because this person was heavily subsidized in 2017, but perhaps not so much now if she's entering the workforce.

Here are figures to back up that speculation. I only used Flint Mich as a sample, since we've already seen that increases didn't vary wildly across the state. For 2017, a 16 year old female (17 again is only for the movies), nonsmoking, could get the Premier Bronze Saver plan for $239.39 unsubsidized. In 2018, this 17 year old would pay a rack rate of $295.28. That's a 23.3% increase.

If income remained the same from year to year, the subsidized rates should be roughly the same, or even drop, because of a quirk in how the government's termination of CSR plays out. I've explained this before, and Michigan fits the pattern. This is further data pointing to unknown subsidy/income factors. The fact that everyone gets a different subsidy also illustrates why anecdotes without context can often mislead.

You can still find 2017 quotes here:
https://www.healthpocket.com/individual-health-insurance

(Do a search and then on the results page, switch the mode from 2018 to 2017)

catch22

What I know, assume and information I am able to provide:
---First, this will be my last venture into an information area not directly related to investing..... "of thought you may like to know" such as this; as I don't have enough days left on this planet for chasing such informational items. I will have to "rein in" my curious mind to such things and dissolve my "OT" community aspect of MFO.
1. The "folks" in this write live in the same small community. Strictly a causal (see them at the grocery store thing) acquaintance and sometimes a hand wave from the car if I happen to be outside in the yard and they drive pass the house. I don't even know if they go to church or not,etc. We've chatted about this and that over the years (grocery store chat).
2. Assumptions: Over the years, "the chat" has allowed me to assume they have a decent pension and I don't know about SS or Medicare. I presume the 17 y.o. female may be a legal dependent via guardianship (don't know true family relationship.... parents dead or otherwise.) The "required" I noted in the initial write is my presumption that they want to provide health insurance, not they they must by law.

LASTLY, as to the rate increase noted; I relate this to "whomever" in this country for any type of insurance. If one has health insurance, a common practice is that the insured receives a letter before the enrollment period that if they choose to maintain their current plan........do nothing, take no action. 'Course, the kicker is the enrollment period.
One feels their existing plan is just fine, makes no changes; and then discovers a hugh rate increase for the new plan year. Sorry, you're screwed. Imagine @Ted , discovering the same circumstance for your auto, home or other insurance policies; and you're stuck with the plan and rate increase until the next enrollment period. Hell of a way to run a country, yes?


@msf Pretty sure this is the plan, although this is only an overview.
https://www.bcbsm.com/index/plans/michigan-health-insurance/2018/catastrophic/premier-ppo.html

The question remains as to why the EXTREME rate increase for this particular plan???

Regardless, the below rate increase list for Michigan remains disgusting high.

Just for the heck of it, the below list is what I found from a Nov. 1, 2017 online document for Michigan health plans:

Here's the anticipated increases:

Blue Care Network: 22.6%
Blue Cross Blue Shield of Michigan: 31.7%
McLaren Health Plan: 26.6%
Meridian: 59.4% (Meridian has a “heavy enrollment in silver CSR plans” which explains the dramatic difference in the rate increases if CSR are funded versus if they aren’t)
Molina: 42.8%
Physicians Health Plan: 22.8%
Priority Health (HMO and POS): 19%
Total Health Care USA: 27.59%

Lastly, lastly.....from original post: Sidenote:
Recently spoke with a few retired folks folks who have supplement health plans (not full Advantage plans) and they noted they received notices from United Health that monthly premiums would go down ranging from 15-24%. Strange, eh?
Any thoughts ??????????

Time to say good-bye, Catch
Good Bye

Old_Joe

@catch22- Thanks for the additional info.

Best regards- OJ

msf

"--- the policy is a BCBS Bronze PPO (pretty sure my recall is correct about the type)

"Pretty sure this is the plan, although this is only an overview.
https://www.bcbsm.com/index/plans/michigan-health-insurance/2018/catastrophic/premier-ppo.html"

That explains part of the confusion. This is a catastrophic plan, not a bronze plan. I should have questioned the bronze plan.

Normally it would be weird for a teen to purchase anything but a catastrophic plan, but if she was able to get a big subsidy based on little to no income in 2016, a bronze plan might have made sense (catastrophic plans do not get premium subsidies). Getting that subsidy might be why the individual plan was "required".

So "bronze" might still be correct for the 2017 plan, even though she's buying a catastrophic plan in 2018 (perhaps because she doesn't now qualify for as large a subsidy).

It seems there are so many ways to play the system, especially with kids (something I hadn't looked at before now). This particular anecdote serves to illustrate how complicated buying children's insurance can be. For example, part of the increase may be due to the fact that starting in 2018, the ACA allows insurers to charge more for teens than for younger children.

Another factor is the complicated new rule, approved last year by the Obama administration, that allows insurance companies to assign more of a family’s overall premium cost to children in individual market and small group policies, starting in 2018.

It also allows insurers to charge higher rates for teens than for younger children beginning at age 15, because teenagers typically rack up bigger medical bills. Up until now, the ACA has not allowed any difference in the amount charged for children from birth to age 20.

http://www.latimes.com/business/la-fi-obamacare-health-insurance-premiums-20171102-story.html

While that's talking about family plans, one would expect something similar on child-only individual plans, though more digging is clearly needed.

Edit: A little more info on subsidies and child-only plans:

Q. Can a young adult qualify for subsidies on the exchange even if she has access to health insurance ... through her parents’ plan?

A. It depends. Assume for the moment that the young adult is not claimed as a dependent on her parents’ tax return. Even if she has access to her parents’ insurance, she can shop for a plan on the state marketplace. In addition, if her income is between 100 and 400 percent of the federal poverty level, she may qualify for subsidies

https://www.nbcnews.com/health/health-care/young-adult-insurance-quandary-stay-parents-or-go-it-alone-f8C11300070

Old_Joe

Good Grief!! Are normal mortals expected to understand all of this and make rational decisions?

davidrmoran

http://www.michigan.gov/difs/0,5269,7-303-12902_35510-313357--,00.html

http://www.michigan.gov/difs/0,5269,7-303-12902_35510-279964--,00.html

https://www.legalconsumer.com/obamacare/topic.php?TopicID=9&ST=MI

http://enrollmichigan.com/

http://www.uofmhealth.org/patient-visitor-guide/newoptions

http://obamacare-guide.org/michigan
this one may have agenda of some sort, did not drill down

etc.

Most states have similar resources, of varying degrees of usefulness / helpfulness

msf

Old_Joe said:

Good Grief!! Are normal mortals expected to understand all of this and make rational decisions?

Apologies for the confusion (or no apologies, since I'm just reporting it). The short answer, which DavidR implied, is that as a consumer you just need to go with the flow and deal with existing options. If, on the other hand, you're interested effecting change, whether at the grass roots level, by pushing legislators, or by any other means, the more knowledgeable you are on a subject, the better.

For example, Trump said that he knows taxes "better than the greatest CPA". You have to get up pretty early in the morning to address experts like that.

davidrmoran

rates of increase slowing significantly; this is real news if it persists

https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#item-health-spending-growth-slowed-now-pace-economic-growth_2017

bee

For the last three years I have gone through the health exchange in my state for health insurance (ACA insurance). I had the same plan - a Bronze plan, Health Savings Acct compliant, PPO - each year.

Here are the numbers:

A small amount of additional Self Employment income has actually help lower my AGI, but as the ACA subsidy has grown each year less of my Insurance premium is deductible making my FPL% move closer and closer to the 400% threshold.

The math (tweaking AGI) can get pretty complex and becomes very critical to stay eligible. One dollar over the 400% FPL can mean thousands of dollars more in premiums since the subsidy goes away.

davidrmoran

You're paying <$1800/y for health insurance?

msf

A quick observation: The big increase in subsidies this year (due in part to the elimination of CSRs) can have the effect, as seen here, of reducing net premiums (after subsidies) of non-silver plans for 2018.


There is a nasty circular reference problem with the self-employed and ACA subsidies.

As a self-employed person, you're generally allowed to deduct your net premiums (after subsidy) "above the line" (i.e. reduce your AGI).

Those net premiums (and thus AGI) depend on the size of the subsidy. But the size of the subsidy depends on your AGI. A circle.

If you earn one extra dollar that put you over the 400% threshold, you wind up paying $585/mo, or $7020/yr extra in premiums. That allows you to take an extra $7020 in "above the line" deductions. That brings your AGI back below the 400% threshold.

But now that you're below that threshold, you get the $7020 in subsidies, so you can't reduce your AGI by $7K. It's back above the 400% FPL. So you don't get the subsidies.

And so it goes, 'round and 'round.

The IRS has recognized the problem and given rules to deal with it. The problem is created by the fact that a $1 shift in income makes such a big difference in subsidies.

https://www.healthinsurance.org/faqs/my-premium-subsidy-is-dependent-on-my-agi-but-im-self-employed-so-my-agi-is-dependent-on-my-premium-help/

PRESSmUP

davidrmoran said:

@Press, I was sorry to read about that high deductible but am really v sorry about the med required, christ, and hope your investments catch friggin' fire next year. Man.

As a noteworthy follow-up...my (nationally recognized) retina specialist from the Cleveland Clinic took exception to my insurance company's denial of coverage for my required medication, since it really is the standard of care for treatment. They interceded with the insurance company on my behalf to approve a formulary exception...so I now have coverage from this point forward, and after my appointment earlier today, I actually met my $7350 deductible by noon.

The moral of the story is...don't take what your insurance company tells you without investigating and pushing back if appropriate.

MikeM

Congrats @PRESSmUP. That's great!

PRESSmUP

Thanks Mike...now I just need to write a check for $7350. But I'm good from this point forward.

Old_Joe

@PRESSmUP- Wonderful news! Very happy that things worked out on the meds.

msf

@PRESSmUP - That's great!

It sounds like you're going to be maxing out each year. A good strategy if you expect that is to select the plan where the total premiums plus the max out of pocket is the least. I wound up getting a platinum plan that way that saved me money.

Because my insurer decided to shut down for 2018 (completely, not just one market), I've been talking with doctors a lot about insurance.

One specialist I see (fortunately just for observation) said that he was in the process of terminating his contracts with a major regional insurer. They would not allow him to do something (I wasn't clear on what) that was standard treatment and he felt essential for him to practice good medicine. Even after appeals. Sounds like your situation, only your appeal was more successful.

Congratulations, and good health.