State grudgingly OKs insurance rates for exchange

Print Friendly and PDF By: Andy Miller Published: Aug 1, 2013
Ralph Hudgens

Ralph Hudgens

Insurance Commissioner Ralph Hudgens said Thursday that federal officials did not respond to his request for an extension in the deadline for approving rates in the upcoming state insurance exchange.

Wednesday was the deadline. Because he didn’t get a response in his request for more time, Hudgens said, he was left “with no viable option’’ but to approve the premiums submitted by health insurers.

Hudgens said the insurer filings contain “massive rate hikes.’’

The exchange, also known as a marketplace, will begin enrolling consumers Oct. 1 as part of the health reform law.

Georgia was the only state that asked for a 30-day extension to continue to analyze the rate increases. Hudgens said he wanted Health and Human Services Secretary Kathleen Sebelius to review the Georgia premiums as well.

“Although not surprised, I am disappointed in the unresponsiveness of the Obama administration,’’ Hudgens said in a statement. “Obamacare will inflict substantially higher health insurance costs on Georgia consumers.’’

But a consumer advocacy group said Hudgens was making an “apples to oranges’’ comparison on the affordability of insurance.

Cindy Zeldin of the group Georgians for a Healthy Future told GHN on Thursday that the current insurance rates in the state don’t reflect coverage for unhealthy people, who are now denied insurance or are given prices that are unaffordable.

Those currently insured on the individual market, she said, “are only the ones the insurance companies want to cover.’’

The exchange rates also don’t reflect the subsidies that many people will receive so they can afford coverage, Zeldin said. The subsidies could be as high as thousands of dollars annually for many individuals, she added.

On Wednesday, Aetna and Coventry said they were pulling out of Georgia’s exchange. Their decision has left just five insurers to offer coverage in the online marketplace.

Hudgens, in an appearance on Fox News Channel’s “On the Record with Greta Van Susteren’’ on Wednesday night, said two of the five remaining insurers have expressed concern that they would be hit with more new members than they could handle.

He did not identify the two companies, nor did he elaborate on that situation Thursday.

Nationally, premiums in the health exchanges have been reported higher than current rates in some states but lower in others. The insurance commissioner in Florida said the individual market will see rate increases of 30 percent to 40 percent for next year.

New York state recently announced insurance premiums would drop 50 percent next year for individuals buying their own coverage in the new online marketplaces. But that’s because New York already bars insurers from rejecting people with health problems — a rule that the ACA will be instituting nationwide.

In Maryland, meanwhile, the insurance commissioner reduced the premium rates proposed by every insurance carrier in the individual market, some by more than 50 percent, according to an analysis by Maryland officials.

The preliminary filings of exchange rates in May showed that companies are offering rates comparable to or even below current employer premiums, said Bill Custer, a health insurance expert at Georgia State University, who was asked to evaluate the filings for GHN.

Custer compared the filings to large employers’ average premiums, which include unhealthy as well as healthy workers, and whose coverage is comparable to that in an exchange.

A federal official indicated Wednesday that the Georgia rates were under review.

Graham Thompson, executive director of the Georgia Association of Health Plans, said Thursday that questions about the affordability and effectiveness of the exchange will be answered as events unfold. “Every [insurance] environment is unique,’’ he said.

Hudgens said this week that under the new rates, people under 35 will see increases of more than 100 percent. Middle-aged people will see hikes of up to 100 percent, and older residents will face increases of up to 40 percent, he said.

He predicted that many young people will skip the required coverage and instead pay the penalty for not having it, which is $95 or 1 percent of household income, whichever is greater.

Hudgens added Thursday in his statement, “President Obama has repeatedly assured Americans that his health care law would not increase cost on the American people. However, those assurances are not holding true in Georgia.

“I urge Congress and the White House to repeal, or at a minimum, delay implementation for a year so that Georgians could be spared from the certain consequences of this federal law.”

Zeldin said that Hudgens’ remarks might deter people from getting information about the exchange just when they need it most.

“We’re two months away,’’ she said. “This is the time we should be shifting out of political rhetoric… and we should be providing the full picture to consumers.’’

 

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  • Guest

    Hudgens is playing games. Another disgraceful politician in Georgia who only cares about his own political future. Of course he ran to FOX to get some national coverage.

    • RickB_GA

      Do you know a politician who does not place his own political future ahead of the needs of their constituents? From any state? My guess is there are about 650 in Washington which fit your description.

      • guest

        And that makes it OK? I think we should still call them out and make people aware.

        • RickB_GA

          I agree … we should be calling them out every chance we get. We also should stop reelecting them. And, need to start in our local offices, not waiting until they get to Washington. My personal opinion, our politicians do everything they can to isolate themselves from the electorate (unless we are waving a check). They do not really want to hear from us.

          I recently wrote Saxy Chambliss and asked a simple question requiring only a one word answer (yes of no). Six weeks later I received a five paragraph lecture on the issue … and he never answered my yes or no question. I hope the Democrats offer up a good candidate because this latest action has cost him my vote in the next election he campaigns. I may not vote for the Democrat but I will definitely not vote for Mr. Chambliss. If I remember correctly he had a runoff last time he campaigned.

  • Guest

    I’d like to know what Hudgens wasn’t concerned with me paying $2200 a month in premiums with a $5500 out of pocket? Oh, and btw…Cigna paid out less than $4000 for my insurance needs. Nice little profit they had there.

    • RickB_GA

      That is a lot of premium unless it covers a family perhaps. And what is your health history? Is there a problem or pre-ex you are neglecting to mention?

      • guest

        Nope, it is only for me. What happened was that I was on Cobra for 3 years. I have “pre-existing” conditions, like most 55 year old women that don’t cause any issues….just the “possibility”. As I said, Cigna paid out less then $4000 in claims for 2013 and even less in 2012 and 2011, and before that never any expensive treatments. Georgia law was written that if an insurance company offered “conversion” coverage after Cobra ended, then people were ineligible for the state mandated pool, which would have been the only viable option for me before the ACA to get insurance because of my “pre-existing” conditions. I happen to think there was a back door deal between GA. and the insurance companies saying that if you provide the “conversion” insurance and keep people out of the state mandated pool, GA. would approve any rate the insurers wanted. If I hadn’t taken the conversion rate, I would not have been able to get insurance. To have qualified for the benefits under the ACA I would have had to gone without insurance for 6 months, a gamble I was not willing to take. As for the “pre-existing” conditions….we’re talking about having things such as osteoporosis, osteoarthritis, and migraines….something most women develop as they age. I have never had cancer, or any expensive diseases…but if you have “three strikes” you are out in the insurance game.

        • GraceD

          Well said. Most people do not understand this.

        • George

          Poster child… errr… poster lady for universal health insurance of which ObamaCare is a GOP start.

          And we know how well GOP social programs work – there are so many… No child left behind, privatization of education, suppression of abortion rights, trickle down economics, tax breaks for the wealthy so they can increase their wealth exponentially, corporate subsidies for corporate personages (just because), and the grand daddy of all GOP modern social programs, the war on drugs and privatization of the penal system. Should be interesting to see how long the ‘compromise’ health insurance program holds up. ;-)

          • guest

            So what’s your proposal?

          • jlfliberty

            George, what’s wrong? You got your way and can live off others sweat, so what’s your gripe?

        • RickB_GA

          GA does not have a high risk pool. To get in the Federal High Risk Plan you are correct, no insurance for six months and originally you had to be turned down by two carriers for coverage though I think that requirement was dropped. They had to shut it down early because the claims broke the bank. Your pre-ex’s are the reason for your rate. You may not have had much in the way of problems yet but the possibility is there for the insurance company. You say you have a $5500 deductible and the insurance company paid out $4000 … that is a total of $9500 for the year. I know some people with your pre-ex’s and their claims are quite high.

          A lot of people do not understand the insurance company has to document the reasons for their rates in GA. It is not a rubber stamp process.

          I don’t especially care for Obamacare and I think the public is going to be very disappointed also. I do like the idea all the rates are community rated, meaning all are thrown into one big pot and rates are based on the combined risk exposure. I think they are allowing for three or four age bands but the highest rate (us older folks) cannot be more than three or four times the rate for the youngest. I hope it will help your specific situation. On the other hand, that 25 year old healthy male is not going to be too happy when he learns he is paying for maternity coverage.

          Obamacare is going to fail; I think it was designed to do so from the beginning. Its purpose is to pave the way for a single payer universal system which I think we will see within the next ten years. Everyone will be on Medicare (or something like it), womb to tomb.

          • guest

            RickB….actually Georgia DID have a high risk pool when my coverage ended but because of the reason I stated, I could not enter it. When you “assume” it really doesn’t help your cause. It was almost exactly like the federal plan which you are wrong about “shutting it down early.” I guess you heard that on your right wing sponsored hate talk radio. I’m sure the 25 year old healthy male you mention was probably more relieved to find himself eligible to stay on his parents insurance due to the ACA then the bogey man argument of having his rates jacked up to pay for maternity care….and I am guessing that you are silently deeming that maternity care for the same people you think wrongly got an “Obama phone.” I’d suggest you read Steven Brill’s article “The Bitter Pill” which was printed originally in Time Magazine as far as the Medicare you so fear. Try staying informed, rather than opinionated.

          • RickB_GA

            Georgia had a system where some people with specific issues or circumstances could be assigned to Insurance Companies on a rotating basis by the health insurance commissioner’s office. The high risk pool coming out of the ACA was closed to new enrollees about 6 – 8 months ago because it ran out of money. The payout surpassed the premiums plus the amount of seed money supplied by Congress to start it. The rules of the ACA legislation required it to be self supporting. Those enrolled in the plan are still covered but it was closed to new enrollees = “shut down”. Regarding the 25 year old male, change the age to 27 or 30, I picked 25 at random. Actually, in Georgia, students 25 or under could stay on their parents plan before Obamacare. Maintaining coverage for a “child” to age 26 is/was to get coverage for those young invincibles who will not buy it for themselves, moma and daddy could continue to foot the bill if they chose to do so, or they had a pre-ex which would preclude them from getting coverage other than group. Also, in GA, most of the wellness benefits touted by Obamacare were already mandated into coverage, so since they were being paid for anyway, it will help modify the probable rate increases. Rates are not “jacked”, they will just be higher because of the way community rating works. One will not be able to opt out because they do not feel they want/need certain coverages. I favor community rating and including maternity coverage as it helps everyone and after all, somewhere there is a guy responsible for at least half the cost of maternity care. And it will certainly help with newborn wellness if mom can get the care she needs during pregnancy. Maternity care for those with Obamaphones (actually the program was started under Bush) is probably already covered under the state Medicaid program. Obamacare will especially help those who are just a little to “wealthy” for Medicaid.

            Medicare is great, I know, I am on it. My opinion is we should have done Medicare for all, absolutely zero exceptions, from the get go and we will be there in about ten years. Our whole health care system needs to change, not just the means of paying.

            Thank you for the literary suggestion. I will find the article and read it. I do not listen to radio talk shows, not left, right or about sports and I rarely watch Fox or MSNBC news.

            I have been where you are, granted for a shorter period of time, only about three months between cobra and Medicare. Good luck to you, I hope all works out and Obamacare treats you well.

          • guest

            RickB…sorry my previous reply was written quickly and came off as disdainful of you and with a misunderstanding of some of your previous statements. You are right about the PCIP being discontinued, I was speaking of when it could have been of use to me. I was also speaking in general of kids getting kicked off of their parents policies and am unaware of what the guideline was in Georgia. In many states if a child was no longer a student, etc. the child could get kicked off as early as 19 years old from a parents policy. I do not think the ACA went as far as it needed to, and I too think Medicare for everyone would be a great idea, or a single payee system. I do think you would find that article really beneficial though and hope you will read it. I am just hoping that I can find something more affordable than the $2200 a month I am paying for a crappy, bare bones insurance policy and that others in my situation are better off. Also, I am not unique as far as the pre-existing conditions….many parents of kids who have been diagnosed with ADHD and ADA and given out medications like candy would be in for a very rude awakening if they had to shop for insurance for their child even after they turned 26 if the ACA had not been enacted. MANY insurance companies will not underwrite kids who have taken those prescriptions that have “helped” their kids. That’s a ticking time bomb that no one is aware of until they are in that situation.

          • guest
          • RickB_GA

            Found it via Forbes and downloaded a copy. Very interesting reading. Obama and crew successfully demonized the health insurance industry to get Obamacare through. The are already working on the second leg of the three legged health care stool, the hugely profitable pharmaceutical industry and the providers will be last. Most of us know our doctors and nurses … going to be harder to demonize. Thanks for the article.

          • RickB_GA

            The GA program for the 19 – 25 year olds required student status and it was monitored closely by the insurance companies to assure the qualification was met. You are also correct about the ADHD, etc. and the Rx drugs associated with it. I wrote some health coverage for a while and gave up in desperation as I was lucky to get one in ten applications approved. I still deal with health plans but only for Medicare eligible persons. Though I am opposed to the politics of Obamacare, there are some things it will help, the biggest being access to health insurance. Face it, health insurance, even Medicare, is nothing more than a prepaid health payment plan. The insurance companies, in order to attract members, had to keep their premiums as low as possible by avoiding “adverse selection”, the risky situations. Contrary to popular beliefs, insurance companies do not generate the profit margin many attribute to them, most working on a 1 – 2% net profit … but they handle a lot of dollars, so that small profit is still a lot of money. Nearly everyone complains about their insurance company not covering something they wanted so they are easy to demonize. A lot of people do not look for coverage because they wait until they get an unfavorable diagnosis then they complain about not being able to get coverage, again easy to demonize. The insurance company dropped me after I got sick … and stopped paying the premium, but frequently the second part of the statement is omitted by the politicians in their demonizing.

            You were caught in a bad place at a bad time with some “what if’s” and you are someone Obamacare will benefit; good for you. But, the costs of the program are going to make it unsustainable. I think the Democrats knew that from the start when they forced it through and it is merely a step in the direction of Universal Health Care. People better start liking HMO network model plans, that is what is coming within the next couple of years.

            It was good discussing with you, I hope your issues work out. I did try the link you posted but I am not a subscriber (and not willing to pay to read). I will see if I can find a back door through google.

          • guest

            You should know this….I don’t receive the discounted doctor discount or any negotiated rates on prescriptions….so the $9500 would have been much less if I didn’t have the special “conversion” policy. And don’t forget the $26,000 in premiums.

      • jlfliberty

        @RickB_GA – My premiums are very close to the guests, with a 5000.00 deductible. I am self employed and yes it is a family plan with just a few doctor office visits over the year. One emergency room to sew up a finger. Funny how you leaches that voted for Obama care keep on displaying ignorance as you wait for the producers to pay your way.

        • RickB_GA

          First … I am not an Obama supporter and I have paid my own way all my life. Don’t ASSume anything. Your premiums are probably in line with most other premiums in your category and I fail to see your point.

  • old native Georgia white guy

    Hudgens is such an embarrassment. Neither he nor his top aides can barely make a grammatically correct complete sentence. And they were offered the opportunity to run Georgia’s health exchange! No doubt that we are much better off to have the Feds run it.

    • RickB_GA

      Actually I am not particularly fond of Hudgens myself but he has some aides who are pretty well up on things and do a very good job of explaining in grammatically correct sentences. I have more confidence in his aides than Hudgens himself. He is definitely one of the “good old boys” which us Georgians seem to continually elect.

  • WorkingGuy

    The title of this article is simply FALSE! Hudgens is intent on sabotaging the exchange and HE is now responsible for seeing rates for millions of Georgians increase by 100%

  • insurance momma

    The only reason Md. and NY rates have gone down is the state ins. comm. cut them. They do not accurately reflect the real cost to the ins. company. The Md. ins. comm said she didn’t like the rate, it needed to be cut. Insurance company sell a product. This is the government dictating the cost of that product. In Georgia, Aetna said we’re not playing that game and pulled out of the market. Good for them. Govt setting the price a of commodity, insurance is a commodity folks, is intrusion on the market place. You cant put 30 mil extra people on an insurace plan for free . . Everyone expects free insurance now. IT IS NOT FREE, IT HAS TO BE PAID FOR BY SOMEONE.

    Health Care and Insurance are two separate business. This stupid law mixed it together. insurance is a hedge against out of pocket costs. You are paying to ensure that if you have catastrophic need, insurance will be there to help. If insurers were dropping folks then that should have been addressed with laws. Overhauling the entire system to fix some serious issues was not necessary. You folks will eventually come to the same conclusions as the Republicans 3+ years ago. We just thought about the unintended consequences first. Just look at the unions, everything they are saying is what Repubs said would happen.

    They simply needed to expand Medicare, expand local access to medical care by strengthening the county medical services and reign in the horrible business practices of some of those insurace companies. Make no mistake about it, insurace is a two way street, you are paying to have covg available when you need it. As more costs were mandated to be covered fully, these costs soared and then passed along to the consumer. Yes some companies were not doing best practices but that should have been address with laws. A govt takeover of these two industries was unnecessary.

  • GraceD

    According to reports, Maryland’s insurance comm. reduced rate proposals by 50%. What rates have you refused, Hudgins? This office does not do Ga citizens right.

    States that are progressive and recessive, like our red state of Ga., are seeing Hugh discounts.
    And please note that an article in Today’s AJC, quotes Hudgins admitting that these rates are only for those people who are having to purcase private insurance. Before, many had no access at all through the private market.
    What a hypocrite.

    “in Maryland, meanwhile, the insurance commissioner reduced the premium
    rates proposed by every insurance carrier in the individual market, some
    by more than 50 percent, according to an analysis by Maryland
    officials. “- See more at:
    http://www.georgiahealthnews.com/2013/08/state-grudgingly-oks-insurance-rates-exchange/#sthash.arDV3mn0.dpuf

  • Pingback: Spin Battle Over Obamacare Premiums Continues | Health Care

  • George

    Profits before People! It’s a GOP thing… sometimes referred to loosely by the religious right as ‘family values’. (Just not YOUR family.) ;-)

  • Cary Ann Bennett

    Soooo……why doesn’t the Insurance Commissioner take immediate action to stop price gouging. Problem solved.

    • guest

      Because then he won’t get an interview with Greta on FOX.

  • Cary Ann Bennett

    This seems to me to be a no-brainer. You tell the insurers in the state that effective immediately, price gouging (ie. rate hikes >10% will be illegal as of Oct. 1, 2013.)

  • insurance momma

    The Md. ins. comm. stepped in and determined the rates not the market…that is govt intervention at it’s finest. This is wrong at it’s core and they are being sued for the trouble. The insurance commissioner is not responsible for pricing insurance plans. He approves the fair market value for the plans based on the evidence the companies present. He simply agrees or not. But he does not price it. The company sets the rate based on a thousand things and we pay it OR NOT. OBOZOCARE has made a giant step into the marketplace. It will fail. Why would they need to spend $$$800M to get folks to sign up…maybe the Kardashians should hawk it…then maybe those who dont pay attention to the real game would listen up. What they will hear is the sound of dollars being sucked out of their pockets. You cant get Medical care for free and the ability to pay for it isn’t free either. This is govt intrusion on the commerce of our country.

  • Defund Obamacare

    I came here to ask a question to the author but after reading the comments I’ve changed my mind.

    It’s clear to me that the prior commentators know nothing about the free-market and/or capitalism. A business is in business to make money. Insurance companies are no different. Why would a business stay in business where they would lose money? They won’t.

    I don’t fault Aetna, I fault the horrible law that put them in this situation. Call your congressmen and senators and tell them to defund Obamacare! This is the only thing that can save the state and country.

  • Eric

    This article, along with most other articles, is woefully incomplete and the comments reflect a lack of information — even from “experts”. In a very short time, you will all be able to login to the exchanges and see the rates. If you believe that forcing an insurance company to provide unlimited coverage to a person who is already sick will result in anything but dramatically increased cost, you’ll soon be able to prove yourself incorrect. The only thing that will make buying insurance in the exchanges affordable is the federal subsidy that some will receive. In other words, the government will be use your tax dollars to pay for the health insurance of others. Agree or disagree with this principle but those are the facts.

    • RickB_GA

      Increased risks are going to cause increased premiums; insuring those with pre-ex conditions is going to cost and the young and healthy are going to bear the brunt of that costs, especially in the individual markets. Groups will not see a big difference because most of the mandates for new individual coverage A reduced premium due to a subsidy is not a reduced premium … the premium is still the premium which the insurance companies will get, only part of the premium (and copays and deductibles) is going to be paid by the taxpayers, as few as we are becoming, again, the insurance companies will get their whole premium. If you get a subsidy, someone else is footing your bill, no one is getting a deal. Insurance rates in the individual market are going to increase or insurers are going to pull out of the exchanges. I also suspect plans issued through the exchanges are going to be short on networks and long on wait periods to see a PCP. The wait period for an average non emergency appointment with a PCP in GA is about 11 days. The same wait period in MA, the Obamacare model, is about 49 days. I agree with your observations Eric.

  • RickB_GA

    Like it or not, Obamacare is the law of the land. It is a piece of legislation which was forced down the throats of the taxpayers at the behest of the Democratic party without adequate study or forethought. They made their point with the biggest fraud ever perpetrated on the American taxpayer. The original 2000 page legislation is now over 27,000 pages of rules and regulations, enabled by the politicians and allowing the lining of pockets of lawyers and MBA’s trying to carve out their personal niches in government to better feed off taxpayers, what few of us are left. It is going to be a financial disaster and worse yet, it is rapidly turning into a management disaster. We are less than 60 days from doomsday and the training for the exchanges is still not readily available.

    But, it is here, and we need to be spending time trying to get the monster under control rather than spending time on meaningless repeal votes which will never go anywhere. Obamacare is going to self destruct, it was planned that way by the Democrats … within 10 years we will all be on single payer, universal health care because it is going to be impossible to undo the disaster of Obamacare; and I have found Medicare works pretty good.

    The Republicans will hopefully get their minds on responsible fiscal leadership and stop worrying about who is marrying who, women’s rights and sending immigrants who have grown up in this country back to a home many of them have never known. They need to stop worrying about what is on the shelves at the Starship Adult Novelty stores too, total waste of taxpayer dollars in Coweta County this week.

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