Tuesday, December 17, 2013

Next Obamacare Crisis: Small-Group Renewal Shock

  • I expect about 80% of small-groups (sub 50 in California) will see shocking increases.  
  • Groups that are disproportionately older, with an average age in the late 40s to 50s will save money. 
  • Small-groups will be hit harder than large ones due to the enhanced requirements on them, such as: 
    • More extensive essential health benefits, 
    • maximum plan deductibles, 
    • the application of new taxes and fees, and 
    • new rating rules disadvantaging the you and those who take better care of themselves.  
This is from David Nather at Politico:

Think the canceled health policies hurt the Obamacare cause? There’s another political time bomb lurking that could explode not too long before next year’s elections: rate hikes for small businesses. 
Like the canceled individual health plans, it’s another example of a tradeoff that health care experts have long known about, as the new rules for health insurance prices create winners and losers. But most Americans won’t become aware of it until some small business employees learn that their premiums are going up because of a law called — oops — the Affordable Care Act.

Some will learn the opposite, that their premiums are going down because of the law. But as we saw with the canceled individual health plans, it’s the losers who will get most of the attention.
And the timing will be terrible for Democrats: A lot of those small businesses will have to start dealing with their new prices in October — just in time for Republicans to make it an issue in their mid-term election campaigns.

There are no widely accepted estimates for how many people could be affected, but even if it’s a relative minority, it won’t matter politically — because Democrats will once again have to defend the administration’s claims that the majority of Americans who have employer-based insurance won’t be affected by Obamacare.

“The biggest shocker for the small business community is going to hit in October, which is interesting because it will be prime time for the election,” said Jessica Waltman, a top lobbyist at the National Association of Health Underwriters.

Here’s why: Next year, small business health plans — generally those that cover less than 100 workers — will have to comply with a wide range of new rules, particularly the ones that say employees can’t be charged more if they have health problems. Their premiums will only vary based on their age, whether they have individual or family coverage, what part of the country they live in, and whether they use tobacco — and older workers won’t be able to be charged more than three times as much as younger ones.

Those changes will be helpful to small businesses with older workers and employees with health problems, but they also mean that small firms with younger, healthier workers will have to pay more than they used to. The new small business plans will also have to cover the same set of minimum benefits that individual health plans will have to provide, including pediatric care and mental health and substance abuse services.

“If you can’t use health [to set premiums] anymore, some people will move down and other people will move up,” said Gary Claxton, director of the Health Care Marketplace Project at the Kaiser Family Foundation. “If you’re a group of three 21-year-old men, you’ll pay more because a group of three 64-year-olds somewhere else will be paying less.” 

A lot of small businesses pushed off those changes this year by renewing their old, pre-Obamacare health plans early, extending them into next year. A common tactic, according to insurers and brokers, was to reset their plans with a Dec. 1 renewal date, which allowed them to hold onto the old benefits and rules as long as possible.

Next year, though, many of those small businesses will have to upgrade to health plans that comply with the new Obamacare rules. Unlike the canceled health policies which largely hit this fall, those changes will be spread throughout the year.

But there will be a cluster of December renewals, industry officials say, and those small businesses will get the first look at their new prices in October — right at the height of an election that’s increasingly being framed as a referendum on the impact of Obamacare. ...