More states share exchange plan menus

Consumers are getting a clearer picture of how much they will pay for health insurance under PPACA as more states unveil rates and details about their public health insurance exchange plans.

California said it will offer a total of six plans in its Small Business Health Options Program small-group exchange, including Blue Shield of California -- but not including WellPoint's Anthem unit.

Managers of the state's Covered California SHOP exchange say average rates for moderately generous, "silver" level plans in San Francisco County, for example, will start at $223, and that the average cost of the three lowest-priced silver plans will be 28 percent cheaper than the average price of comparable small-group coverage in 2013.

Maine has released hundreds of documents related to the two carriers that want to sell coverage through its exchange -- Anthem and Maine Community Health Options -- but no clear summaries comparing 2014 rates with 2013 rates.

South Dakota posted a crisp summary showing just how many plans the three carriers in its individual and SHOP exchanges will offer in various categories of coverage, and how much the plans will cost.

In South Dakota, individuals will have access to only one ultra-generous "platinum" level plan, and that plan will cost a 21-year-old nonsmoker $316 per month. The same young nonsmoker could choose from a list of 24 moderately generous silver level plans, with prices ranging from $187 to $305. The young nonsmoker also could choose from a list of three high-deductible catastrophic plans, with monthly premiums ranging from $165 to $224. 

Some of the other states making major exchange "qualified health plan" announcements include New Hampshire, North Carolina, Ohio and Washington state.

In some states, the flurry of information is coming now simply because the states decided to release the information now. 

In other states, the U.S. Department of Health and Human Services will be running a "federally facilitated exchange," but the state has agreed to review the exchange QHP filings. In the states helping HHS with FFE plan management, state recommendations about the exchange QHP menus were due Wednesday.

In some of the plan management partnership states, officials have released some details because of the nature of local customs or public information laws.

Earlier this week, for example, officials in Florida, Georgia and Indiana warned that Patient Protection and Affordable Care Act insurance product requirements could lead to dramatic increases in unsubsidized rates for young, healthy men.

Insurers in most states currently can hold down rates for younger, healthier individuals by charging older, sicker consumers higher premiums and by refusing to cover people with health problems. PPACA requires insurers to sell coverage on a guaranteed basis and not discriminate against those with pre-existing conditions. The act also limits insurers' ability to charge older people more than they charge younger people.

The Ohio Department of Insurance is estimating that in part because of the new mandates, premiums for the individual exchange coverage sold in 2014 could be 41 percent higher than the comparable coverage sold in 2013. Ohio also estimates that premiums for small businesses that use the state's federally run SHOP exchange could be an average of 18 percent higher.

Officials in New Hampshire and North Carolina said they had sent their recommendations to HHS but declined to provide details.

In North Carolina, the rates filed by Blue Cross and Blue Shield of North Carolina, Coventry and FirstCarolinaCare are trade secrets, officials said.

Similarly, New Hampshire officials said they cannot make rates or plan details available at this time. Residents there may have to wait until the Centers for Medicare & Medicaid Services, the HHS arm in charge of the federally run public exchanges, releases plan details.

Washington state revealed in an announcement of its individual exchange QHP plan and rate approvals that it is taking a vigorous approach to reviewing QHP applications.

Washington state approved filings for just four of the carriers that applied to sell coverage through its individual exchange.

The carriers that made the cut include Bridgespan, Group Health Cooperative, Lifewise and Premera Blue Cross, but not Kaiser or Molina Healthcare.

Commissioner Mike Kreidler said in a statement that some carriers that applied struggled to guarantee access to some providers and hospitals.

"It's our duty to make sure that, if you buy a health plan, you can actually see the doctor or hospital that provides the service you need," Kreidler said.

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