Health Insurance

A window on Obamacare prices: Start shopping now, if you can

HealthCare.gov website seen on Nov. 12, 2014.
Adam Jeffery | CNBC

It's no secret that Obamacare's open-enrollment season starts Saturday—but the prices people will pay for 2015 health plans still are just dribbling out.

Federal officials have yet to publish, in easily accessible form, the full range of prices for Obamacare policies next year. But they began allowing customers to window-shop for plans in their area on HealthCare.gov, which covers about two-thirds of the country, this week.

That shopping function helped provide even more evidence this week that current Obamacare customers will, on average, face just modestly higher premiums next year for the most popular types of health plans.

And if those customers live in big cities in their state, they might be in for even better deals than what they now pay.

In 48 major cities across the U.S., the prices of key kinds of Obamacare plans will drop by an average of 0.2 percent, according to a new analysis by the Kaiser Family Foundation. After factoring in the effect of federal subsidies that most Obamacare enrollees qualify for, average prices of those plans will drop 0.3 percent.

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The plans that Kaiser examined are used to determine the amount of subsidy that a person gets to help pay for their premiums if they buy plans on government-run marketplaces such as HealthCare.gov.

Kaiser looked at what a 40-year-old nonsmoker earning $30,000 per year would pay for the second-lowest cost "silver" plan on an Obamacare exchange. Silver plans, which drew the most Obamacare enrollees last year, on average cover around 70 percent of health benefits—people have to pay for the rest of the medical costs out of pocket.

Kaiser analyst Cynthia Cox noted that what people actually pay for the new plans in 2015 is "really going to depend on where you live."

For example, in Anchorage, Alaska, Cox pointed out the cost of the second-lowest silver plan for the hypothetical 40-year-old will leap 28.4 percent, from $380 per month to $488 per month. After subsidies are factored in however, that person would pay just $164 of their own money, a $1 decrease.

Govt. cuts 2015 Obamacare sign-up forecast
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Govt. cuts 2015 Obamacare sign-up forecast

On the other extreme, if the 40-year-old lived in Jackson, Mississippi, he'd see a 23.7 percent decrease in the price of such a plan, from $405 per month to $309. After subsidies were factored in, he'd also be paying $1 less out of pocket, from $209 per month, to $208.

While double-digit percentage changes are occurring in premium prices for 2015, multiple analyses suggest that the average returning Obamacare customer is likely to face premiums that are higher by about 6 percent or less.

Kaiser looked at the prices of the lowest-cost "bronze" Obamacare plans in the same 48 cities for the same hypothetical person, and found they were increasing by an average of 2.7 percent. Bronze plans cover about 60 percent of medical costs.

After subsidies are factored in, bronze plans in those cities increase an average of 3.1 percent, Kaiser said.

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But not all people get subsidies.

Former Major League Baseball executive Mark Gorris, a 59-year-old who lives in St. Louis County, Missouri, told CNBC that he recently received a letter from Coventry, the health insurer that sold him a "gold" plan on HealthCare.gov for this year, and was told that "our benefits ... will remain the same, but our monthly premium will rise 22.3 percent beginning Jan. 1." Gold plans cover about 80 percent of medical costs, on average.

"I call our insurance company to see if there was a mistake and they said there was not, this is the way it is and we are free to move our insurance elsewhere," said Gorris, who had been paying $1,361.44 per month to cover himself and his 61-year-old wife Diane. "A rather cold response to a sensitive issue."

Gorris said, "I about fell over," when he heard he'd have to pay $1,665.14 per month. "It felt like a bait and switch."

Gorris said he planned to wait until Saturday to see if he could get a better deal from insurance plans sold on HealthCare.gov, the federally run Obamacare exchange that serves two-thirds of the country.

But he was surprised to hear from a reporter that HealthCare.gov enabled the ability to window-shop for 2015 health plans last Sunday. A quick check of that site showed several gold plans that were hundreds of dollars less than what Coventry was asking him to pay next year for his plan.

Rohan Hutchings, a spokesman for Coventry's parent company, Aetna, said: "Firstly, I am sorry that one of our members had an unhelpful experience recently. We aim to be as helpful as possible and to try and simplify what can be a confusing time for members."

"Our goal is to offer competitively priced products at a rate that will allow us to cover the cost of doing business and offer our customers high-quality products that meet their health-care needs," Hutchings said. "Ultimately, we believe the rates we are filing for 2015 will be competitive with the products offered by other carriers in the marketplace."

Better shop around

Cox of the Kaiser Family Foundation said such cases of prices changing for 2015 underscore the need for current Obamacare customers to re-evaluate their health insurance options starting Saturday.

"What's really important is for consumers to go back online to their marketplace or talk to a broker or assister and see how this affects you," said Cox.

That's particularly important because this year, for the first time, most Obamacare customers will be automatically re-enrolled in their existing plan unless they switch.

The window-shopping function of HealthCare.gov, along with rate-filing information at state insurance departments, enabled the Kaiser Family Foundation to assemble data about some of the 2015 premiums that will be seen in 48 large cities. However, checking out premium prices requires a person to enter individual ZIP codes to see what plans are available in that area.

And HealthCare.gov does not cover all states. Some state-run Obamacare exchanges now allow window-shopping for 2015 plans, while others don't yet.

Rate sheet to come

The U.S. Health and Human Services Department has not yet released, as it did last year, a spreadsheet that will show all the Obamacare plans across the country that will go on sale Saturday. That spreadsheet would let reporters and analysts get a complete picture of how rates are changing for next year.

Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, which administers the Obamacare program, said that compiled list of rates will be made public "soon," but did not name a day.

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HHS Secretary Sylvia Mathews Burwell, during a talk about open enrollment on Monday at the Center for American Progress in Washington, was asked by former Ohio Gov. Ted Strickland, "What do you say to critics that say you held up publishing the updated rates until after the election because you were concerned that those new rates would equate to bad news for the consumer?"

Burwell then spent nearly five minutes telling Strickland about how transparent HHS had been with information about total paid Obamacare enrollment, how many people risked loss of coverage because of problems reconciling their data about citizenship or residency status, and about what the department expects for enrollment levels next year.

She never answered the question of whether the administration kept the 2015 premium rates hidden until after the Nov. 4 election because of fear that they would spark a backlash from the public.