[Congressional Record Volume 163, Number 178 (Thursday, November 2, 2017)]
[Senate]
[Pages S6997-S6998]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTHCARE
Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed
in the Record a copy of the article, ``More ACA Plans to Come With No
Premiums in 2018,'' by Anna Wilde Mathews and Christopher Weaver that
was published in the Wall Street Journal on October 27, 2017.
There being no objection, the material was ordered to be printed in
the Record, as follows:
More ACA Plans To Come With No Premiums in 2018
Insurers selling Affordable Care Act plans have a
compelling new pitch: free health insurance.
When sales of plans on the law's exchanges begin Nov. 1, a
growing number of consumers around the country will be able
to get coverage for 2018 without paying any monthly premium,
according to health insurers and an analysis of newly
available federal data.
In nearly all of the 2,722 counties included in the data,
some consumers will be able to obtain free health insurance
because they qualify for larger federal premium subsidies
that cover the full cost of a plan, according to the new
analysis.
The growing availability of no-premium plans is a side
effect of a decision by President Donald Trump's
administration to end federal payments that are used to
reduce out-of-pocket costs, such as deductibles, for low-
income enrollees. The administration didn't halt--and
indirectly bolstered--the federal subsidies that help
consumers with their insurance premiums.
The new analysis doesn't project exactly how many consumers
could be eligible for the no-premium plans, a figure that
depends on variables including people's income, household
size, age, location and access to other types of health
coverage.
In the coming weeks, insurers are gearing up to promote the
no-premium option. Amid uncertainty about the future of the
2010 health law, known as Obamacare, many insurers have
pulled back from the law's marketplaces. Many of the
remaining ones are worried about losing enrollment next
year--largely among consumers who aren't eligible for
subsidies and won't be able to get premium-free plans.
Insurers hope the no-premium insurance draws in more
enrollees, particularly those they need most: people with few
health needs. Healthy consumers help bolster the stability of
the market by balancing out the health costs of sicker
enrollees.
``We absolutely will be promoting this opportunity to get
coverage at a zero price,''
[[Page S6998]]
said Wendy Curran, a spokeswoman for Blue Cross Blue Shield
of Wyoming, which is mentioning the no-premium plans in
print, radio and social-media advertising. ``We hope those
younger people will say, `Well yeah, if it's not going to
cost me anything, sure.' ''
Ms. Curran said it was ``astounding even to us'' how many
people will be able to get no-premium insurance in Wyoming.
The no-premium plans will also receive a hefty promotional
push from insurance agents. EHealth Inc. and HealthMarkets
Inc., both big national agencies, said they're preparing to
highlight the option in advertising and other outreach.
``It's just the idea of something free being really
appealing,'' said Nate Purpura, a vice president at eHealth.
The company's surveys have consistently shown that price is
the most important factor in consumers' choice of plan, he
said.
Availability will vary by age and income, but some
enrollees who don't have a very low income may be able to
land zero-premium coverage, according to the analysis of
federal data conducted by consulting firm Oliver Wyman, a
unit of Marsh & McLennan.
The firm found that zero-premium ACA exchange plans would
be available next year to at least some consumers in a total
of 2,692 counties, out of 2,722 in the study.
A 60-year-old making about $36,000 a year could find free
2018 plans in 1,590 counties, while one with income of about
$48,000 could do so in 654 counties, according to the
analysis, which used data released Wednesday for plans
available on HealthCare.gov, the federal marketplace used by
39 states.
For 2017, no-premium plans were available in many places
for the very lowest-income enrollees, but for those at
slightly higher levels, they were much more scarce. For
instance, in 2017, a 60-year-old making about $36,000 could
find free plans in about 300 of the counties.
That is what is different in 2018, said Kurt Giesa, a
partner at Oliver Wyman. The zero-premium plans are ``much
more prevalent now than they were,'' he said.
In California, which isn't included in the federal data,
consumers must pay a minimal $1 a month. But there is a
``huge increase from last year'' in the number of people who
will be able to buy virtually free plans, said Peter V. Lee,
executive director of Covered California, the state's ACA
exchange. Covered California currently has about 1.1 million
enrollees who receive federal-premium subsidies, and more
than half of them will be able to buy a plan for $1 for 2018,
he said.
The growing availability of no-premium plans is tied to the
complicated dynamics of the 2010 health law, as well as a
recent move by the GOP president.
Under the law's rules, subsidies that help pay for premiums
are available to people making up to about $48,000 a year.
Those subsidy amounts are linked to the cost of the second-
cheapest silver plan in an enrollee's location. So, when
silver premiums go up, subsidies go up.
Earlier this month, Mr. Trump's administration cut off
federal payments to insurers for covering certain out-of-
pocket costs for low-income enrollees in silver plans. In
response, insurers raised premiums on their 2018 policies
sharply to cover the extra expense, now coming out of their
pockets--and in many cases, they loaded the extra boost only
onto the silver plans.
Because the separate premium subsidies, which Mr. Trump
didn't cut, are linked to silver-plan prices, those subsidies
are rising, too. In many states, the costs for cheaper bronze
plans are going up much less rapidly than silver plans, so
many more people will wind up being eligible for no-premium
plans.
On the flip side, those who don't get premium subsidies
under the 2010 law may be responsible for the full brunt of
steep rate increases, though they may be able to mitigate the
impact by staying away from silver plans.
For those who can get free plans, the lure may be
irresistible.
Medica, an insurer that is offering exchange plans in
states including Iowa, Nebraska and Wisconsin, is running ads
in some places that say ``$0 premium plans for individuals
who qualify.'' It is also sending letters to some current
exchange enrollees with bronze plans, who are likely to be
enrolled with Medica in 2018, informing them that they can
stop paying premiums next year. ``That's a nice letter to
get,'' said Geoff Bartsh, a vice president at Medica.
Jerry Dworak, chief executive of Montana Health Co-op,
said, ``of course we're hoping that'' young and healthy
enrollees flock to the no-premium plans.
``If they see that it's free, why not take it?,'' he said.
Mr. Dworak said that a person making as much as $33,000 a
year could get one of his company's Idaho plans and pay no
premium.
The plans may attract more older consumers than younger
because premiums and subsidies rise with age, making free
plans more available to older people.
And for some, the zero-premium plans won't actually be the
best deal, insurers and insurance agents say. The silver
plans could be cheaper overall for people who use much health
care, despite their higher premium costs, if these people are
eligible for the health law's cost sharing help.
According to HealthCare.gov, for instance, a 40-year-old
man in Cheyenne, Wyo., who makes about $24,000 a year could
get a zero-premium bronze plan, but he could pay as much as
$6,650 over the course of 2018 in deductibles and other out-
of-pocket charges. Or he could get a silver plan that would
cost him around $125 a month, but cap his out-of-pocket costs
at $2,450.
``There's this trade-off,'' said Michael Z. Stahl, a senior
vice president at HealthMarkets, who said the company's
agents will walk through the pros and cons with clients.
____________________