Texas ACA rates to rise from 15% to 19% for 2016 individual market

JumpinJack · Sep 7, 2015

Texas | ACASignups.net

Texas ACA premium rates will, according to data thus far, rise from about 15% to about 19% for 2016 for the individual market. The 18.99% is the maximum, while the 15.05% is the minimum, with 16.6% being the likely premium increase.

Note: The data does not reflect any policies or types of policies that were removed from the market by the insurers because of unprofitability.

Note2: The data does not reflect whether the deductibles, out of pocket caps, copays, and the like will be exactly the same in 2016. They may be, or they may change.

Note3: This is an educated guess. Actual numbers may be very different, since all data for all states is not in, and some raise increases will not be approved, while some raises not reported yet may be higher than average.

(There is a detailed explanation on how the author compiled and came up with the rate increase percentages. See Missouri: 2016 Avg. Rate Request: 13.9% likely, 15.4% maximum | ACASignups.net )

winston53660 · Sep 7, 2015

I have blue cross blue shield here in Dallas and I have not been notified about any increase.

sangha · Sep 8, 2015

JumpinJack said:
Texas | ACASignups.net

Texas ACA premium rates will, according to data thus far, rise from about 15% to about 19% for 2016 for the individual market. The 18.99% is the maximum, while the 15.05% is the minimum, with 16.6% being the likely premium increase.

Note: The data does not reflect any policies or types of policies that were removed from the market by the insurers because of unprofitability.

Note2: The data does not reflect whether the deductibles, out of pocket caps, copays, and the like will be exactly the same in 2016. They may be, or they may change.

Note3: This is an educated guess. Actual numbers may be very different, since all data for all states is not in, and some raise increases will not be approved, while some raises not reported yet may be higher than average.

(There is a detailed explanation on how the author compiled and came up with the rate increase percentages. See Missouri: 2016 Avg. Rate Request: 13.9% likely, 15.4% maximum | ACASignups.net )

Did you even read your own link?

Those aren't increases! They're increase *REQUESTS*

And from your 2nd link

there's no way of knowing what the total weighted average market share is.

distraff · Sep 8, 2015

sangha said:
Did you even read your own link?

Those aren't increases! They're increase *REQUESTS*

And from your 2nd link

Problem is that they are actually getting their rate increases. The insurance companies have been able to demonstrate that they have good reasons for their rate hikes. In the latest round of rake hike requests, insurers have been getting their way.
Insurers Win Big Health-Rate Increases - WSJ

joG · Sep 8, 2015

JumpinJack said:
Texas | ACASignups.net

Texas ACA premium rates will, according to data thus far, rise from about 15% to about 19% for 2016 for the individual market. The 18.99% is the maximum, while the 15.05% is the minimum, with 16.6% being the likely premium increase.

Note: The data does not reflect any policies or types of policies that were removed from the market by the insurers because of unprofitability.

Note2: The data does not reflect whether the deductibles, out of pocket caps, copays, and the like will be exactly the same in 2016. They may be, or they may change.

Note3: This is an educated guess. Actual numbers may be very different, since all data for all states is not in, and some raise increases will not be approved, while some raises not reported yet may be higher than average.

(There is a detailed explanation on how the author compiled and came up with the rate increase percentages. See Missouri: 2016 Avg. Rate Request: 13.9% likely, 15.4% maximum | ACASignups.net )

The price of insurance must pay for the health care consumed. The country uses a tadge above 17 percent of gdp. So aca must charge at least the same as it must cover the cost of providing it and those of persons that do not pay.

joG · Sep 8, 2015

winston53660 said:
I have blue cross blue shield here in Dallas and I have not been notified about any increase.

In due course you will be.

winston53660 · Sep 8, 2015

joG said:
In due course you will be.

They actually send me letter way ahead of time. And trust me I'm one of their number one clients.

buck · Sep 8, 2015

distraff said:
Problem is that they are actually getting their rate increases.

In some cases they are getting more than they request, as the insurance commissioners determine the company needs larger rate increases than requested in order to ensure the health of the insurance market.

joG · Sep 8, 2015

winston53660 said:
They actually send me letter way ahead of time. And trust me I'm one of their number one clients.

Does this make you happy or unhappy?

JumpinJack · Sep 17, 2015

sangha said:
Did you even read your own link?

Those aren't increases! They're increase *REQUESTS*

And from your 2nd link

You need to re-read. It goes state by state...requests are made to the insurance commissioners...they are almost ALWAYS approved, unless way too large. The articles go into which states have approvals on the books, and they SAY that the data is incomplete. The totals given in one of the articles is for the COMPLETE data to date.

I know this upsets you, but it is true. The rates that BCBS would have had to charge for PPOs was so large that they opted to remove them entirely in my state, leaving only the pitiful HMOs.

winston53660 · Sep 17, 2015

joG said:
Does this make you happy or unhappy?

both.

JumpinJack · Sep 17, 2015

winston53660 said:
I have blue cross blue shield here in Dallas and I have not been notified about any increase.

If you get your insurance through the government website, you will find out there the new prices, during the enrollment period.

I don't know what they do about policies people buy directly from them or through an agent.

Do you have a PPO? If so, those are being removed in my state. Too expensive for BCBS. So they're only going to do HMOs here. I have not rec'd a notice of that, even tho I have a BCBS PPO.

We find this stuff out during the enrollment period. I think that starts in November? I can't recall.

JumpinJack · Sep 17, 2015

joG said:
In due course you will be.

The ACA is run through "enrollment periods," which are defined periods of time. I think there are two enrollment periods. That's when we find out info on the next years' policies. I think the enrollment period for 2016 starts in November, but I'm not sure.

Then there's another enrollment period Jan-Mar the next year. You can't buy an individual HCA policy at any other time, unless there are special circumstances.

sangha · Sep 17, 2015

JumpinJack said:
You need to re-read. It goes state by state...requests are made to the insurance commissioners...they are almost ALWAYS approved, unless way too large. The articles go into which states have approvals on the books, and they SAY that the data is incomplete. The totals given in one of the articles is for the COMPLETE data to date.

I know this upsets you, but it is true. The rates that BCBS would have had to charge for PPOs was so large that they opted to remove them entirely in my state, leaving only the pitiful HMOs.

No, the increases are not "almost always approved" and BCBS withdrew their PPO because they couldn't compete because other plans were cheaper.

The info you've posted in this thread has been proven to be mostly inaccurate.

joG · Sep 18, 2015

JumpinJack said:
The ACA is run through "enrollment periods," which are defined periods of time. I think there are two enrollment periods. That's when we find out info on the next years' policies. I think the enrollment period for 2016 starts in November, but I'm not sure.

Then there's another enrollment period Jan-Mar the next year. You can't buy an individual HCA policy at any other time, unless there are special circumstances.

That is interesting. I wonder why it is set that way.

JumpinJack · Sep 18, 2015

sangha said:
No, the increases are not "almost always approved" and BCBS withdrew their PPO because they couldn't compete because other plans were cheaper.

The info you've posted in this thread has been proven to be mostly inaccurate.

No, dear. Other plans were not cheaper than BCBS PPO plans. BCBS plans were the cheapest. How do I know? Because that's why I bought the BCBS PPO policy.

Yes, dear. Most rates are approved....insurers know beforehand what they can request, and what would likely be rejected. WHICH IS WHY BCBS WITHDREW its PPO policies. It didn't want to go through the process of trying to get a big rate increase that it knew would probably be rejected.

As I stated, info is based on the data thus far.

I know this pains you. But I merely report facts. The facts are what they are. The final numbers will be in soon.

sangha · Sep 18, 2015

JumpinJack said:
No, dear. Other plans were not cheaper than BCBS PPO plans. BCBS plans were the cheapest. How do I know? Because that's why I bought the BCBS PPO policy.

The important word there is "were". The PPO plans *WERE* the cheapest, but were no longer going to be.

Yes, dear. Most rates are approved....insurers know beforehand what they can request, and what would likely be rejected. WHICH IS WHY BCBS WITHDREW its PPO policies. It didn't want to go through the process of trying to get a big rate increase that it knew would probably be rejected.

As I stated, info is based on the data thus far.

I know this pains you. But I merely report facts. The facts are what they are. The final numbers will be in soon.

First of all, it has already been proven that you are not posting facts. Several of your claims have been proven to be, at best, fiction.

Secondly, most rate increases are not approved as is. They are either rejected or revised downwards.

Finally, I am not your dear.

Greenbeard · Sep 19, 2015

JumpinJack said:
No, dear. Other plans were not cheaper than BCBS PPO plans.

PPO plans are inherently more expensive. The care isn't managed so no provider is accountable for managing health or resources appropriately, and those plans usually end up paying higher prices on top of that disorganization. Pretty much all research shows that health care--all the way from the level of the individual patient up to the system-level--works better when it flows through primary care, not circumvents it. That's true for health and it's true for costs. PPOs are a luxury and in an environment where individual consumers and employers are increasingly price sensitive (and insurers and provider are being held accountable for health outcomes), many are realizing it's one they can't afford.

This is true everywhere. For instance, the largest self-insured employer plan in Massachusetts (the state employees/retirees) just got rid of its PPO offerings this summer because they were undermining its cost containment goals.

New blockbuster drugs are just one factor. Mitchell said insurers tell her a big problem is patients who seek care outside of their network. So Mitchell agreed to let insurers require that most members name a primary care doctor and get a referral from that doctor for out of network care. It’s a change she says will save money and improve care.

“All over the country, everybody is saying, medical care is better if you have one doctor who is your major doctor,” she said.

Mitchell said it would help if patients stopped going to the top academic hospitals where a routine test can cost two or three times more than at a local community hospital. But she said there’s too much focus on blaming the patient.

iguanaman · Sep 19, 2015

JumpinJack said:
No, dear. Other plans were not cheaper than BCBS PPO plans. BCBS plans were the cheapest. How do I know? Because that's why I bought the BCBS PPO policy.

Yes, dear. Most rates are approved....insurers know beforehand what they can request, and what would likely be rejected. WHICH IS WHY BCBS WITHDREW its PPO policies. It didn't want to go through the process of trying to get a big rate increase that it knew would probably be rejected.

As I stated, info is based on the data thus far.

I know this pains you. But I merely report facts. The facts are what they are. The final numbers will be in soon.

Here's a fact for you. I just got a $608 check from my insurer for overcharging on premiums. Thanks ACA.

274ina · Sep 22, 2015

Not relevant, the cap on HC costs is the same. 5-9% of pay.

JumpinJack · Oct 29, 2015

sangha said:
No, the increases are not "almost always approved" and BCBS withdrew their PPO because they couldn't compete because other plans were cheaper.

The info you've posted in this thread has been proven to be mostly inaccurate.

BCBS didn't withdraw because of lack of people buying their plans. They withdrew because they lost millions of dollars and needed over 40% rate increase. They requested a 20-something rate increase and didn't get it.

No other PPOs were cheaper. BCBS had the cheapest PPOs, which was why theirs were the biggest sellers.

I think they also withdrew from Florida.

JumpinJack · Oct 29, 2015

iguanaman said:
Here's a fact for you. I just got a $608 check from my insurer for overcharging on premiums. Thanks ACA.

That's because that was for 2014, and because that insurer made too large a profit, under the ACA.

What insurer was it? Not BCBS, was it? Since BCBS is withrawing all of its PPOs from FL, I think, because it lost too much money.

sangha · Oct 29, 2015

JumpinJack said:
BCBS didn't withdraw because of lack of people buying their plans. They withdrew because they lost millions of dollars and needed over 40% rate increase.

I did not say they withdrew because of lack of people buying their plans.

Try again

JumpinJack · Oct 29, 2015

Greenbeard said:
PPO plans are inherently more expensive. The care isn't managed so no provider is accountable for managing health or resources appropriately, and those plans usually end up paying higher prices on top of that disorganization. Pretty much all research shows that health care--all the way from the level of the individual patient up to the system-level--works better when it flows through primary care, not circumvents it. That's true for health and it's true for costs. PPOs are a luxury and in an environment where individual consumers and employers are increasingly price sensitive (and insurers and provider are being held accountable for health outcomes), many are realizing it's one they can't afford.

This is true everywhere. For instance, the largest self-insured employer plan in Massachusetts (the state employees/retirees) just got rid of its PPO offerings this summer because they were undermining its cost containment goals.

Agreed....PPO coverage is better and is the standard for insurance coverage in the U.S. It pays providers more under contract, so providers are more likely to take a PPO policy than an HMO one.

If you've ever had HMO coverage, you know why they cost less. It's very difficult to use, and is burdensome on the providers.

Even so, the HMOs cost a lot more than the pre-ACA PPOs. A lot more money, and a lot less coverage. That's the ACA in a nutshell.

JumpinJack · Oct 29, 2015

sangha said:
I did not say they withdrew because of lack of people buying their plans.

Try again

Ah...you ARE a young fella, aren't you?

1. You said....BCBS withdrew because other plans were cheaper.

2. The only reason other plans being cheaper would have any impact on BCBS withdrawing is if other people bought the other plans more.

3. Fact: BCBS had the cheapest PPOs (and the cheapest HMOs).

4. Fact: BCBS was the biggest provider in the ACA in the state.

5. Fact: BCBS lost millions of dollars on the PPOs, which was why it withdrew them all. It lost millions because the amount of claims paid far exceeded the amount of premiums rec'd. And the premiums were not cheap. (As I've said...mine was the cheapest PPO yu could get; it was $655/mo., bronze. It would be less if you're younger, of course.)

Also, it looks like there won't be any PPOs in my area for 2016 (maybe I saw one from a co. I wouldn't use....it's really a hospital that self-insures...but I'm not sure if that was a PPO.) The people are sicker than they thought.

Don't blame me. I used it only twice...for two preventive exams. That's it.