Premiums will go up sharply next year under President Barack Obama’s health care law, and many consumers will be down to just one insurer, the administration confirmed Monday. That will stoke another “Obamacare” controversy days before a presidential election.
Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25 percent across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. Some states will see much bigger jumps, others less.
Moreover, about 1 in 5 consumers will only have plans from a single insurer to pick from, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their roles.A big problem is that young, healthy people are not signing up. And the rate increases may make things worse. Robert Pear explains at The New York Times that the drafters of the Affordable Care Act were counting on tax penalties to force them to buy insurance.
It has not worked all that well, and that is at least partly to blame for soaring premiums next year on some of the health law’s insurance exchanges.
The full weight of the penalty will not be felt until April, when those who have avoided buying insurance will face penalties of around $700 a person or more. But even then that might not be enough: For the young and healthy who are badly needed to make the exchanges work, it is sometimes cheaper to pay the Internal Revenue Service than an insurance company charging large premiums, with huge deductibles.
Some consumers who buy insurance on the exchanges still feel vulnerable. Deductibles are so high, they say, that the insurance seems useless. So some think that whether they send hundreds of dollars to the I.R.S. or thousands to an insurance company, they are essentially paying something for nothing.
“The penalty for violating the individual mandate has not been very effective,” said Joseph J. Thorndike, the director of the tax history project at Tax Analysts, a nonprofit publisher of tax information. “If it were effective, we would have higher enrollment, and the population buying policies in the insurance exchange would be healthier and younger.”
Americans have decades of experience with tax deductions and other tax breaks aimed at encouraging various types of behavior, as well as “sin taxes” intended to discourage other kinds of behavior, Mr. Thorndike said. But, he said: “It is highly unusual for the federal government to use tax penalties to encourage affirmative behavior. That’s a hard sell.”