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ACA changing state health insurance scene, lawmakers told

ACA changing state health insurance scene, lawmakers told

Nov 13, 2013 - By Eric Blom, Staff Writer

Before the Affordable Care Act took effect, 25 companies sold health insurance in Wyoming, but now there are just six.

The Affordable Care Act has transformed the insurance market in Wyoming, according to reports state legislators heard at meetings Nov. 5 and Nov. 6 in Lander.

Lawmakers were in Fremont County for a meeting of the Joint Labor, Health and Social Services Committee and for one of the Select Committee on Health Benefit Exchanges.

During the meetings, Wyoming Department of Insurance staff said the price of health insurance went down for some people but up for others, and fewer companies now are selling health insurance in Wyoming.

A small number of people have been able to enroll in the new federal health insurance exchange at HealthCare.gov, while roughly 3,200 individuals had their existing insurance canceled. Many residents, however, were able to keep their old plans that were grandfathered into the new system.

The federal Affordable Care Act created the exchange, which opened Oct. 1. Wyoming's Legislature elected not to operate its own online marketplace.

From 25 to six

Before the Affordable Care Act took effect, 25 companies sold health insurance in Wyoming. Now, there are six.

Two companies, WINhealth Partners and Blue Cross Blue Shield of Wyoming, sell plans in the exchange and outside it, said Wyoming Department of Insurance Commissioner Tom Hirsig. Four others sell plans outside the exchange.

WINhealth had processed more than 70 health insurance applications from the exchange since Oct. 1, said company president and CEO Stephen Goldstone in an interview Nov. 5. He said he thought the low numbers were a result of technical problems.

"Our sense is the problems with HealthCare.gov are being worked out," Goldstone said. "We have a backlog of people we're working through."

Blue Cross Blue Shield also saw a slow start but found the situation is improving, spokeswoman Wendy Curran said in an interview.

"Our experience, particularly this past week, has been much better," she said. "We have been receiving more application files."

Initially, Blue Cross Blue Shield had technical problems with the exchange that caused applications to be incomplete or contain inaccurate information so the company could not process them, Curran said.

She did not have exact numbers, but Curran said Blue Cross Blue Shield has had fewer applications through the exchange than WINhealth has seen.

Eight health insurance companies have left Wyoming completely, and nine are maintaining plans they already sold but are not selling new ones, Hirsig said.

Limited options

The reduction in companies has "limited the options," Hirsig said, but Wyoming is in a better situation than some states with larger populations. He pointed to Indiana, with 6.5 million people, that has only one company selling policies in its exchange.

Thousands of Wyoming residents also lost coverage when companies left. The companies that left had ensured a 3,200 individuals with an additional 20 individual plans and 22 small groups plans, which may cover more than one person, according to a Department of Insurance report.

Hirsig did not know how many individuals had plans grandfathered in but said, "there were quite a few plans" that were.

Plans could be "grandfathered" if they met some of the new stipulations the Affordable Care Act requires of new policies. Grandfathered plans can continue unless a company makes a substantial change to them.

Most premiums cheaper

A comparison showed premiums for similar health insurance plans before and after implementation of the Affordable Care Act would go down for some people but up for others, said deputy insurance commissioner Stephanie McGee. Regulations in federal law make new plans somewhat different from those offered in the past, and none offers the same coverage.

The report contrasted plans that were as similar as possible.

In the comparison, the only demographic seeing a premium increase was 27-year-old males, who saw the same plan rise from $280 a month before the law to $401 a month. A female of the same age would see her premium for a comparable plan drop from $513 a month to $401 now.

The example for a health insurance plan for a family of four went down from $1,512 a month to $1,452, a 60-year-old male would save $158 a month and now pay $1,039, and a 60-year-old female would pay $81 less for a similar plan and pay $1,039 a month.

Those rates are not the actual prices many people would pay for coverage, McGee said.

Subsidies provided by the Affordable Care Act would lower the cost of insurance plans purchased through the exchange, effectively lowering the premiums for many people. Individuals or families with incomes up to four times the poverty level would qualify for assistance with their insurance.

Federal guidelines show the poverty level for an individual is $11,490 per year, a married couple is $15,510 and a family of four is $23,550. As such, individuals earning less than $46,960 a year, married couples making less than $62,040 and families with less than $94,200 in annual income would qualify for some level of subsidy.

The size of the subsidy depends on the household income relative to the federal poverty level for the household size.

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