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Government


Ohio groups debate costs of Affordable Care Act
Lt. Gov. Taylor says costs will go up, others say her calculations are off
by WKSU's STATEHOUSE BUREAU CHIEF KAREN KASLER


Reporter
Karen Kasler
 
President Barack Obama signed the Affordable Care Act in March 2010.
Courtesy of Keith Ellison
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In The Region:
The Affordable Care Act has sparked a lot of debate since it was proposed. And with the federal health insurance plan taking effect soon, there are a lot of numbers being tossed around. There also is a lot of confusion about how much the changes will cost consumers and companies.
LISTEN: KASLER ON ACA

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Lt. Gov. Mary Taylor has been an outspoken critic of the Affordable Care Act. But she says that does not influence a study her office did of the costs submitted for the statewide health insurance exchanges, which will be operated by the federal government.

Rising prices
Taylor is the state’s insurance commissioner, and says she used an independent actuary group’s report to look at the average costs of 214 health insurance plans filed by 14 companies in Ohio in 2013, which came out to $223.

“We compared that to the average cost to again cover these essential health benefits beginning in 2014, and that number that was based on the plans that have filed was $420, which represents an 88 percent increase,” Taylor says.

Taylor says those essential health benefits, which are required in all plans, are driving up those costs. Though her study relates to the amount it will cost insurance companies to provide those essential health benefits, not premiums paid by individuals and companies, Taylor says she expects premiums to rise significantly as well. And she says this study backs up a projection in 2011 saying premiums would rise with the Affordable Care Act.

Or maybe not
But that is not how a non-partisan group that studies health related issues sees it. Amy Roling McGee is with the Health Policy Institute of Ohio, and she says Taylor’s study provided only a partial look at what may be the cost of insurance coverage in 2014.

“But that it didn’t equate to the premiums that would be charged as market competition might influence rates and subsidies will be provided under 400 percent of the federal poverty level, which is approximately $78,000 a year for a family of three,” Roling McGee says.

The Taylor's report made supporters of the ACA, such as Kathleen Gmeiner of the Universal Health Care Network of Ohio, angry.

“Unfortunately the lieutenant governor ... is making the wrong comparisons and is making people in Ohio more concerned than they need to be by not explaining this properly,” Gmeiner says.

Gmeiner agrees with Roling McGee that subsidies need to be included in comparisons for them to be fair. Gmeiner and Roling McGee acknowledge that younger, healthier people may pay higher premiums, but people with pre-existing conditions and serious illnesses such as cancer will have access to insurance when it was too expensive or completely unavailable before the the federal health-care overhaul. 

Still, or ever, competitive?
But Taylor says her main concern is that the exchange created by the act will not make for a competitive insurance market in Ohio.

“We didn’t need a market to be generated or created in Ohio," Taylor says. "That market already existed. In fact, we’re seeing a bit of a shrinking of the market after the Obamacare mandates take effect.”

Roling McGee agrees with the first part of that statement, but disagrees with the last part.

“We’ve been known to have a competitive insurance market, and it looks like we’ll continue to have a competitive insurance market,” Roling McGee says.

But Gmeiner has a very different opinion of the historical state of Ohio's insurance market.

“I would say that it certainly is, if not the weakest, one of the weakest. And the reason is that Ohio has done a very good job of keeping people out of insurance because of their pre-existing conditions," Gmeiner says. "We’ve kept so many people out that rates are artificially low.”

People who do not have health insurance coverage through their employers can enroll to purchase insurance on the exchange starting Oct. 1.

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