Health insurance premiums under Covered California are set to rise an average of 13.2 percent across the state next year, three years after the state’s health insurance marketplace under the Patient Protection and Affordable Care Act first began enrollment.
In the exchange’s Central Coast region, which comprises San Luis Obispo, Santa Barbara and Ventura counties, premiums are slated to rise 15.8 percent — a weighted average across all plans and consumers, Covered California spokesman James Scullary told Noozhawk.
The Central Coast region currently has two widely-used providers, Anthem Blue Cross California and Blue Shield of California, whose premiums are expected to rise, on average, 13.8 and 20 percent, respectively.
Both currently provide insurance only through preferred provider organizations, or PPOs, but starting in 2017, Blue Shield will begin offering insurance through health maintenance organizations, or HMOs, in parts of the region, Scullary said.
Kaiser Permanente will also be offering HMOs in parts of the Tri-County area with rates 5.5 percent higher than 2016 rates, on average, he said.
Eighty-four percent of the region’s Covered California consumers have the lowest-priced bronze and silver plans, which will see a regional increase of 2.3 and 1.3 percent next year, respectively.
Scullary told Noozhawk that he suspected the more expensive tiers, the gold and platinum plans, probably contributed to the much starker overall jump in rates.
Though premiums are increasing by roughly three times what they did in the previous two years, Scullary said, consumers’ financial assistance will also increase in 2017 to help absorb the rate hikes.
In 2015 and 2016, premiums rose 4.2 and 4 percent, respectively.
“This is still a competitive market,” Scullary said.
Roughly 90 percent of Tri-County Covered California consumers receive some level of financial assistance, which covers an average of 77 percent of their monthly premiums, according to Covered California’s 2017 rate booklet.
Covered California executive director Peter Lee said last week that the rising costs of medical care were to blame for the hikes, which state officials said were climbing faster than the past couple years’ rate increases.
An Affordable Care Act mechanism holding down marketplaces’ rates for their first three years has also expired.
According to Covered California’s 2017 rate guide, 66,743 people in the Central Coast region, or a little over 4 percent of the area’s population, signed up for or renewed coverage for during the last open enrollment period, which ended in February.
In 2016, 47 percent of the region’s consumers were with Blue Shield, while 42 percent were with Anthem and 11 percent were with Kaiser, which has no facilities in Santa Barbara County.
A 40-year-old single individual making $47,540 would receive $9 in federal government financial assistance with a silver plan, while paying premiums of $428 for an Anthem PPO, $319 for a Blue Shield HMO, $381 for a Blue Shield PPO and $376 for a Kaiser HMO.
That same Central Coast person would, making $17,820, pay $111, $2, $64 and $59, respectively, for those plans, while receiving $326 in federal subsidies.
— Noozhawk staff writer Sam Goldman can be reached at sgoldman@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.
