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Affordable Care Act plans becoming tougher sell to healthy customers

Higher premiums, more narrow networks put squeeze on consumers

While insurance companies strive to attract healthy customers needed to keep premiums low, many middle-class Americans without access to subsidies are struggling to find plans that are affordable, according to the Wall Street Journal.

For the most popular plans, the article says, insurers have raised premiums steeply, and have increased out-of-pocket costs. Many insurers attribute this to the fact that they are no longer allowed to boost premiums specifically for people with existing health conditions, so they must increase the overall premium for everyone.

An analysis conducted by the WSJ compared the same plans in three different cities--Atlanta, Oklahoma City, and Charleston, West Virginia--for someone who does not qualify for subsidies. Across the board, in each city, the person would see an increase in his monthly plan price, but either keep the same deductible or have a lower one. When going with the cheapest plan in 2016, Atlanta saw a decrease in monthly cost, but an approximate 58 percent deductible increase. In Charleston, the monthly cost essentially stayed the same, but the deductible went down by approximately 73 percent, and both stayed the same in Oklahoma City.

The result of this scenario is that many people cannot avoid paying more for insurance next year, and must settle for plans that may not have certain providers in their network. Higher premiums, fewer doctor options and thinner coverage make it tougher for insurance to be appealing for healthier customers, whose participation is vital to keep premium prices down, according to the article.

The Obama administration has encouraged people to shop around for lower coverage, pointing out that patients may be able to save up to about $400 annually by price comparing plans. The issue, however, comes from the fact that these savings generally apply to those who are on Medicaid or Medicare and qualify for subsidies, and does not account for those who make too much to receive government assistance.

To learn more:
- read the Wall Street Journal article (subscription may be required)

Related Articles:
HHS: Consumers who shop around save money
Premium cost affordability survey reveals importance of insurance subsidies
ACA exchange plans' cost-sharing methods vary widely