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Affordable Care Act Becoming Less Affordable as Florida Insurers Prepare Big Rate Hikes

| July 20, 2015

affordable care act obamacare insurance increase

This one is about to hurt. (US Army Corps of Engineers)

The U.S. Supreme Court may have upheld the Affordable Care Act for the second time, but the ruling hasn’t made President Barack Obama’s signature healthcare law any less controversial.

More people are now insured. That’s a fact and attributed to the mandate that people have insurance or get taxed for going without it. But there are winners and losers in the market. Take Wayne, who didn’t give his last name. He lives along Florida’s Gulf Coast and called in to a public radio program during a conversation on healthcare. He makes too much money for a subsidy, so he pays the full rate for his health insurance plan.

“For two years in a row I received congratulatory letters from Florida Blue telling me my insurance plan met the ACA requirements,” he said.  But received a handful of notices that they’re discontinuing that program and my rate will almost triple.”

There are growing concerns about health insurance rate hikes under the ACA. Last month the U.S. Centers for Health and Human Services reported several health insurance companies have plans to raise rates by more than 10 percent. Florida regulators have received 14 rate hike requests in that category. According to the Florida data—one request is for a 62.57 percent rate hike.

“Interestingly in Florida its about the most competitive health insurance market of any state in the country,” said Florida Blue Senior Vice President Jason Altmire. “There are 10-12 carriers depending on what county you live in.”

What you pay is also determined by what county you live in, and costs are going up for businesses, says John Howard, with Rodgers, Gunter, Vaughn Insurance in Tallahassee.

“I delivered, yesterday, five different increases, or five different group plan renewals yesterday and all three were double digit increases following the previous year’s double digit increases,” he said. “It’s a real struggle for the employer today to be able to figure out how to pay the additional cost, plus salary increases, and so forth without passing on too much to the employee.”

What to make of the increases depends largely on what side of the issue you fall on. Supporters of the law say it was designed to get more people covered—it’s succeeding there. Others say it was built to control costs—and while it may have done so for a while—prices are once again starting to climb. But the hikes don’t mean insurers are getting greedy. According to the law, there’s a cap on what the companies can spend on profits versus care.

What may be in play is market correction—or, in plain language, health insurers are starting to learn what the population when it comes to health, really looks like. This year part of the law that subsidizes carriers that have more high-risk patients goes away. Companies are adjusting for that. tax laws are contributing to the hikes as well:

“And that’s the tax on health insurance, the tax on medical devices—those impact what people are paying. So when you hear about the frustration of ‘why are my rates going up’. If we can find a way to get those out of the bill, it could stabilize the price,” said Altmire.

But major changes to the law appear unlikely. In the meantime, Rose Naff, who runs Florida’s independent insurance exchange Florida Health Choices, says consumers can try to avoid the sharpest hikes, by shopping around:

“Healthcare and health insurance is personal. And everyone’s experience is going to be different,” she said.

What the 2016 rates for Florida carriers will look like is not yet known. The Florida Office of Insurance Regulation says the requests are under review and final determinations will come later this year.

–Lynn Hatter, Health News Florida

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38 Responses for “Affordable Care Act Becoming Less Affordable as Florida Insurers Prepare Big Rate Hikes”

  1. DwFerg says:

    And this is News….? Most people with a clue knew this was inevitable… You cannot make chicken salad out of chicken feed…There is no free lunch. Try insuring 10 Million people for FREE by being on Gov’t dole (Taxes) and try to find who pays for it…Farce that the Gov’t forced on us without regret. OBAMA Care is and will become a Great Disaster..Sorry but the chickens have come home to roost. What once were 25-30 % annual Premium increases, will be 300 % for me next month….Unconscionable, unreasonable and inexplicable …

    • Merle McClung says:

      This is not a flaw in Obamacare — this is a flaw in RICK SCOTT’S ADMINISTRATION!!! Since Scott got into office, he has erased any control the state had to reign in unreasonable increases in insurance rates off all kinds. Consequently, we are paying the highest homeowners insurance rates, the highest automobile insurance rates (for no-fault! with 14-day limit on injury!), of course, health insurance rates would follow! If your rates are too high, use the market and find cheaper insurance! At least we now have a minimum standard that all insurance must meet! Fewer people WITHOUT insurance means lower premiums. Go to the exchange! You don’t have to have one of the top five carriers (who don’t participate in the exchange!) Floridians are not only paying for their own premiums, we’re paying for every other state that has expanded Medicaid while our own citizens go without! You explain the sense of that to me!

      • Michael Chaplin says:

        Everyone get real. ACA is doing its job the way it suppose to work.
        The failure of the plan is the failure of the man and the plan selected for the
        person or family. What all of you need is a good agent. MAC
        If you use Navigators or anyone else they know almost nothing about Health Insurance.
        If the ACA was run by experienced agents there would be issues but not the same number
        as today. A lot few. Obama needs to Vet the Navigators with a background check as some
        unsavory people are on board. Agents are vetted to the nth degree .

        • Merle McClung says:

          Agents are going to steer you toward the Big 5 that aren’t participating in the exchanges. Not getting my money!

  2. Lancer says:

    ACA is going to fail, it is mathematically impossible for it not to. Insurance companies will continue to consolidate because the costs cannot be justified. This makes the next play very easy…

    The government lovers will invent a new boogie man (because its never them) and will promote and pass a single payer system completely controlled by government. People will forget that government involvement has been screwing up healthcare in this country for 40+ years. No more choices, just lab rats for whatever drug pharmaceutical companies give government a discount on. Have a problem? Take a number and your government medical associate will be with you, when they get to it.

    The funny thing with statists is…when, yet, another government attempt doesn’t work, is massively inefficient and wastes resources…there is still no turning back, there’s just throwing more at the problem.

    The “rich” will still have access to better care, like they do everywhere else in the world.

  3. Bill says:

    Not a shocker 0bamacare was NEVER built to lower costs or make health insurance affordable for those who actually pay for it.

  4. Nancy N says:

    DWFerg – You really don’t understand the ACA law AT ALL if you think premiums are going up because some people are receiving subsidies for their insurance. Subsidies come out of tax money, not premiums paid to insurance companies. Insurance companies are raising premiums because the population which is now newly insured was in poor health – a population that insurance companies previously chose not to insure precisely because it is expensive. The ACA law is designed to protect those people and give them access to health care. Insurance company costs are rising as a result. Do you have a better solution to providing healthcare besides “let the sick people die so the rest of us don’t have to pay for it”?

    Lancer – Choice? What choice? Under the old system that you are so fond of, the only “choice” available to me was to have no insurance at all, and my health suffered severely as a result. This was because I am self-employed and thus not part of an employer group plan that provides me mandatory coverage regardless of my health status. I have Lupus, and no insurance company would write me a health insurance policy under the old medical underwriting system, at any price. I was literally hung up on mid sentence by multiple salespeople who called me to solicit my insurance business as soon as they heard the word “Lupus” come out of my mouth.

    Those of you whining about premium increases and lack of choice in medical care or your fears about having your precious luxury medical care messed with have no idea how arrogant you sound to the rest of us who have been struggling with the issue for years. What makes you better than me, that you should be entitled to not have to worry about these things while I have to (and might very well die because of them if you get what you want?) A quirk of genetics? Well, you better hope your turn doesn’t come. So, as you whine about your premiums going up or worry about whether you will have access to the care that you want, I say…welcome to my world, buddy.

    I will be walking around for the rest of my life on a knee with a hairline fracture that hasn’t healed properly because when I had the accident that injured it, I was uninsured and unable to seek medical care that would have properly diagnosed and treated it. I will have permanent physical limitations as a result (and I’m a relatively young woman). I’m currently fighting to get off a bunch of weight that I gained because I couldn’t afford to pay for the doctor’s visits and blood tests that would have told me my thyroid dysfunction had gotten worse and I needed a higher dose of medication.

    I work hard. I pay my bills. Why should I have to go through all of that simply because I was born with the genetic code for several auto-immune disorders? Because, for those of you who are asking for the ACA law to go away, that is what you are asking for. You are saying that drawing a bad card in the genetic lottery makes me unworthy of the healthcare that you take for granted as a right.

    What makes you so worthy?

    • Franklin says:

      So your a hard working person but you didnt have insurance ???? How is that ??? Why didnt you have insurance ?? And your wrong about your reason for cost going up .

      • Nancy N says:

        If you actually READ WHAT I WROTE, you would have seen that the reason that I didn’t have insurance before the ACA law was because I have a serious pre-existing condition that caused every insurance companies to refuse to sell me insurance. I’m self-employed and so I don’t have access to an employer plan that is so-called “guaranteed issue”, required to sell me insurance no matter my medical condition. Millions of other Americans with pre-existing conditions were in the exact same situation as I was, and have been helped immensely by the ACA law just like I have been.

        And just saying I’m wrong doesn’t make it so. That’s the playground equivalent of “nuh-uh” not an actual argument.

    • Michael Chaplin says:

      I am for NancyN. The interesting part about ACA is the whiners especially the conservatives are enrolling in Obamacare. Individuals with health problems were discriminated against in the past.
      Unfair to individuals with health issues as Nancy. Many people have been helped with ACA and the major proponents will remain intact. Guaranteed issue being the # 1. You will find the whiners most
      likely do not have health issues or have a group carrier covering them. Nancy said it… right!

  5. Anon says:

    And this is a surprise to whom???

  6. Dwferg says:

    For those who need health insurance and cannot afford it, let the Government find the money to pay for it. Do Not expect healthy people to pay more for their Own health insurance because of poverty or people’s poor health choices. Obesity, smoking and alcohol abuse. It is merely a redistribution of wealth , Obama and his followers favorite policy . Sorry for the misfortunate, many of whom are here Illegally. So , should I pay for their health care too. How about 300 % premium increases. Should I just accept it because the insurance companies are in bed with the administration ? Maybe you have better solutions whoever you are !

  7. Yellowstone says:

    What seems so very strange to me is the simple fact that we are all required to buy automobile insurance. A portion of most premiums go to protect the others who have no insurance (No fault). And who is complaining?
    ACA was designed just as Nancy said – “to protect those people and give them access to health care”.
    Those whining about ACA should also beat the drums for paying those excessive premiums for auto insurance.
    All insurance companies are owned, profit making business. A lot of them owe generous and expected dividends to their shareholders (another form of upward income distribution – ‘trickle up theory’). These companies will continue to raise hell until they wring out every dime they can from the folks who can afford to pay.
    Their only choice at the moment is to raise their minimum deductibles and lower access to healthcare, and sadly raise their premiums to satisfy their ownners and shareholders. (Are any of you aware of the salaries these insurance officials are paid? Where do think that money comes from?)

    Finally, the ACA provides a comfy income to insurers as well to help things along.

    Think of the huge expense the folks who have no insurance gobble up when they use the ER. Who do you think is paying for those expenses – beside the fact they are using up very valuable resourses.

    Think these through – what we need is system designed to protect all of us – some for lack of adequate healthcare – and those who can afford it from paying more local taxes to support the ERs. The creation of this parimutual healthcare system; where everyone pays to protect all us is now legal and functioning!

    Go get health insurance – you deserve it!

  8. m&m says:

    We have to pay for those who get it free. That’s Obama care and another way to try and destroy America..

  9. DrArt says:

    NancyN – I agree with you whole-heartedly. I, too, am a business owner and have had to struggle with finding health insurance that is affordable, and, as comprehensive as possible to cover as much as possible for both my employees and my family. There were years that I and my family had no coverage, nor could afford such for employees. At a certain point I literally had to lay people off to have the funds to get coverage for others.
    Yes, people see themselves as islands detached from the rest of the mainland, say they want nothing to do with, or have no similarities to the mainland until they, too, find that they, or a dear one is in need and they don’t have the resources themselves to fix it.
    As someone in the healthcare field, I can tell you that statistically it is impossible for anyone to not suffer the effects of a moderate to major health malady whether it be to themselves, to a family member, friend, co-worker, or somebody in our “inner circle”. Shame on them for not thinking of them for tomorrow’s sake, if not realizing what they may be struggling, or maybe traumatized by today.

  10. Loving the ACA says:

    We here in FL are the loving the ACA. Its doing so much good for all off our sick. Not just FL but the whole country is benefiting.

  11. Dwferg says:

    This is my last word on topic. My health insurance was $. 600 / month with a $ 250 annual Deductible. Due to changes imposed by the ACA, my old policy has been discontinued by Florida Blue ( blue cross/ shield), my ” new ” plan will be $ 1975 / month with a $ 6500 annual Deductible. How you like them apples all you ACA supporters. And to think you assume, I am in a position to ” just. Pay It “, sure. What a JOKE !

    • Dave says:

      Welcome to Obamacare. He did say “change was coming” and to trust him one more time… My healthcare is not as high as yours but its a lot higher than my employer insurance which was stopped when Obamacare came along.

      It was actually cheaper to pay the once a year fine at tax time and you still get health care at the hospital emergency room. .

  12. Dwferg says:

    ” If you like your health care plan, you can keep your health care plan ” Who said that ?

  13. Donna Heiss says:

    Dwferg, we already pay 1975.000 a month with a 6500.00 deductible. If that goes up, we go down. I agree with you, we “just can’t pay it”.

    What was really needed was insurance reform. Where does it stop?

  14. Yellowstone says:

    Dw – You can keep it! If you have the cash, just pay for it!

    Don’t want financial aid or support extended to the public, generally with the aim of promoting economic and social policy? Go out on your own in the free (pay for it) market and find what you are looking for. That’s what the free (pay for it) market is all about. Don’t cry later about those of us who are getting better deal.

    Or, better yet, move to any modern country in the world, and get better care for less – try Sweden. They are compassionate, conservative, and even speak English over there.

    • Michael Chaplin says:

      The Health & the Healthcare of the individuals in Europe are generally much better than the US.
      The US ranks the highest in health expenditure, yet the health of the individuals is near the bottom of the list.
      Nancy N what does this tell you about The US Health Care? Let everyone know as you are the most informed.

      • Nancy N says:

        Thank you for the lovely compliment Michael.

        In January I traveled to Germany for a trade show. Over dinner with fellow members of the show’s international press corps, I began describing the American health care system and the challenges my daughter and I (who both have serious medical issues) face with getting and keeping insurance and medical treatment to my Dutch seat mate. My new Dutch friend was literally aghast at the things that I was telling her. After a lifetime of living in a society where she was guaranteed by the government to have health care, she could not comprehend that in the U.S. the political structure is to allow millions of people to suffer and even die for lack of health care in the world’s richest country.

        And yes, it is true that while we spend the most money on healthcare in this country, we get the worst outcomes overall. Our average life expectancy is lower than many many other countries – 33 in fact, according to the World Health Organization. One of the other commenters called the ACA law Communist. At 34th ranking on the global life expectancy list, in 2013 before the major ACA provisions went into effect, we were in fact tied with communist Cuba – one of the world’s poorest countries and one that is under embargo from U.S. trade. We should be very embarrassed by that.

  15. groot says:

    Thanks for finally addressing this. The ACA is not a panacea and frankly, it’s ruining us financially. Try having minimal health insurance without an employer sponsored plan, it is totally financially impossible.

    • Nancy N says:

      What ruined me financially – sent me into bankruptcy, actually – was the system before the ACA. Denied access to health insurance by my serious medical condition, but in desperate need of medical care because of it, I was spending hundreds of dollars a month just on prescription drugs. Not to mention the doctor’s appointments (which could cost hundreds of dollars each), and blood work that cost $250-$500 each time. And that was just my routine treatment and monitoring. If I had a problem that was out of the ordinary, the bills piled up quickly.

  16. Anonymous says:

    Single payer system. it’s inevitable.

  17. stan says:

    obamacare is a living hell i have been in the insurance industry 30 yrs
    and this only helps people who make minimum wage. the middle
    income person is crippled costs are out os sight high deductibles
    people who want to buy health insurance any other time under than
    the enrollment cannot, people who cannot afford it are penalized
    this is not america this communisim plus agents commissions are
    about a whopping 3 percent how disgusting this was pushed
    down americas throat with a ruthless leader and his cronies
    and it will continue to get worse. thats right if you like your coverage
    you can keep it another of many lies that will continue if america
    makes it in ayear

    • Nancy N says:

      I don’t think that word “communism” means what you think it means.

      Perhaps you should try learning a bit about political ideologies from someplace besides Fox News before you start throwing words like that around.

      • Michael Chaplin says:

        Nancy N .. You are the most informed person on this dialogue. Even more than the agent.
        People can’t judge our country by Fox news. I watched this man Greg Gutfeld on Fox.
        A loser and joke to our society. Apparently, most of the conservatives can easily be brainwashed,
        and lead in stupidity about out country. Keep up the good work Nancy and mow these
        idiots down.. MAC

  18. Sherry E says:

    How soon we forget, or prefer to ignore the fact that our horrific governor, Rick Scott, took away the power of Florida’s insurance commissioner to negotiate rates! The problem of rates going up are certainly at least partially and directly Rick Scott’s fault!!! This is part of his political effort to tear apart the ACA and take health care away from millions of hard working people!!

    How soon we forget, or prefer to ignore the fact that President Obama would have preferred that we have a single payer system, similar to Medicare. A system that would diminish the “gouging” of our “maximize profits” medical system. BUT. . . the “I’ve got mine, and to hell with you” conservatives would not allow “single payer” and FORCED health care through the same insurance companies that raised rates repeatedly for years, while those same companies cherry picked ONLY the most healthy to cover.

    How soon we forget, or prefer to ignore the fact that our medical service providers continue to charge more than most (if not all) other countries! And, that several other countries provide SUPERIOR health/medical services, at LOWER costs, because their culture and government places “people OVER profits” . . . for the common good. . . instead of the ONE PERCENT!! r

    How soon we forget or prefer to ignore the fact that the conservatives have “NO VIABLE” alternative option for health care that would cover EVERYONE and cost LESS!!!

  19. Sherry E says:

    Our insurance premiums are going up, while profits in the medical industry are soaring. . . for example, the pharmaceutical industry, on the average, is posting 18% NET profits, after paying their executives huge salaries!

    Take a look at this from the Huffington Post:

    Here’s an outrage that must be changed: Big Pharma has been systematically price-gouging the Medicare program for seniors and people with disabilities — and raking in billions in excessive profits. The 11 largest global drug companies made an astonishing $711 billion in profits over the 10 years ending in 2012, and they got a turbo-charged boost when the Medicare Part D prescription drug program started in 2006, according to an analysis of corporate filings by Health Care for America Now (HCAN).

    The drug companies hold the power to charge America’s consumers whatever they want. Worse, Medicare — the nation’s largest purchaser of drugs — is prohibited by law from seeking better prices. The result of this shortsighted policy is dramatic. In 2006, the first year of Medicare’s prescription drug program, the combined profits of the largest drug companies soared 34 percent to $76.3 billion. And unlike other industries, such as Big Oil, drug companies get something even better than a tax subsidy — they get a government program.

    There is nothing wrong with a company making profits — that’s what they’re supposed to do. But the drug industry’s profits are excessive as a result of overcharging American consumers and taxpayers. We pay significantly more than any other country for the exact same drugs. Per capita drug spending in the U.S. is about 40 percent higher than in Canada, 75 percent greater than in Japan and nearly triple the amount spent in Denmark.

    • Anonymous says:

      The rising cost of health insurance is a reflection of the rising cost of healthcare. The rising cost of healthcare is a reflection of the rising cost of healthcare provider and salaries, health care provider education, and rising drug and drug marketing costs. This is the core of the problem. The ACA solution is incorrect: allowing insurance companies to raise premiums to pay for these health and drug provider windfalls and coverage of the uninsured. The real solution: focus on increasing the numbers of care providers and drug makers significantly to add much more competition and supply to the supply and demand equation, incent providers to take on more preexisting coverage risk by lowering taxes for those who do it, require provider service menu pricing (yes, just like restaurants) to encourage shopping.

      • Nancy N says:

        Using the concept of competition to bring down rates sounds great – if you are talking about something like a general practitioner or an obstetrician that many, many people need and so there is demand and the creation of competition in a local area.

        But my 12 year old daughter has serious medical conditions that have us driving hours just to find ANY pediatric specialist that is qualified to treat her condition. There’s no possibility for competition in that market because demand is so low. She’s one of only about 5,000 pediatric Scleroderma patients in the entire United States. The same goes for the juvenile arthritis that she also has. It’s not quite as rare, but we still have to drive for hours to find the specialists she needs.

        We can’t shop around for her care. There simply are no other options and never will be because there is no need for them because there is no way for there to be competition in that market. It’s too small (thank goodness, because these are serious illnesses).

        Drug costs are definitely out of control. Every four weeks, Shands Children’s Hospital bills my daughter’s insurance company around $12,000 for a single IV bag of drugs. That doesn’t include the costs of administering that bag. It’s just the bag of drugs! Something has to be done! I understand that R&D is expensive but we have to figure out a way to not let it bankrupt the healthcare system.

        • Michael Chaplin says:

          Nancy, my pleasure to give you a compliment. You are well versed in the Law & the Stats.
          Michael Chaplin

  20. Michael Chaplin says:

    Everyone please refer to Nancy N for the most up to date info on ACA. MAC

  21. Sherry E says:

    Dear Nancy,

    Thank you so much for sharing your personal ordeals with receiving reasonable health care for hard working citizens in the USA. Too many voters are so brain washed by FOX that they label any person who is struggling with a medical condition (or needing any government assistance at all, for any reason) as lazy, lower life forms “TAKERS”! While they arrogantly call themselves as “MAKERS”.

    Challenges in life happen to us all. . . just be very careful in labeling and disparaging others in such terrible ways. What goes around, comes around! Our bodies are incredibly fragile. Each of us is a hair’s breath away from being in Nancy’s position. Hopefully, there will still be enough forgiveness, compassion and caring from your fellow citizens, when YOU need them.

  22. markingthedays says:

    A serious question though. Is a $1900 per month premium a real thing? How many people are on that policy?

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