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What Do PA’s New Insurance Rates Mean for Me?

October 16, 2017

Today, Pennsylvania released the 2018 rates for insurance plans offered through the Affordable Care Act’s individual market place.  Rates will increase by an average of 30.6 percent.  While these numbers may sound intimidating, there is still some good news.  Here are answers to common questions:

Do I have to pay 30% more for my coverage?
Not necessarily!  Financial help is still available for people who qualify based on income.  This means that, while rates are going up, financial assistance is going up too.  The amount you pay may not go up if you qualify for financial help– 4 in 5 people do.

Wait a minute… I thought ACA subsidies ended last week.  Is the government still paying for subsidies?
The President did announce he would stop paying for a certain type of subsidy – called Cost Sharing Reductions – that helps people pay out-of-pocket costs.  This decision led to these large rate increases. However, the government is still helping people get financial assistance to pay monthly premiums.

If cost sharing reductions are going away, should I even bother enrolling?
Yes! While the payments for cost sharing reductions will eventually stop, insurance plans must continue to offer this kind of assistance in 2017 and 2018 to enrollees.

What if I don’t qualify for financial assistance based on income?
Pennsylvania is taking steps to provide alternative options for the 20% of people who do not qualify for financial assistance.  Contact a trained navigator to learn more about your options.

How do I make sure I get affordable coverage this year?
This year, things might be especially confusing.  It’s important to get free help from a trained navigator to make sure you’re getting the plan that makes the most sense for you and that you get as much financial help as you can.

Is there any good news about rates?
Yes. Only Silver level plans will see the highest rate increases. These are the plans that have cost sharing reductions. Other plans– Bronze, Gold, and Platinum levels– will see much lower rate increases. If you receive financial help, your premiums on these plans might even decrease.

When do I enroll? What should I be doing now to prepare?
Open Enrollment starts November 1st and ends on December 15th.  You must get enrolled during that time as there will be no extensions this year.  Things you can do now to get prepared include: talking to a navigator to learn about your options and making sure your healthcare.gov account is set up and active.

Why are rates so high this year?
The high rate increases are directly linked to the government’s decision not to fund Cost Sharing Reductions and other actions that have created uncertainty in the market.  Since insurers still have to help people pay out-of-pocket costs by law, they increased their rates to make up for the loss.

How do I reach a PHAN navigator?
Call or Text: (877) 570-3642
On the Web: pahealthaccess.org/gethelp
Email: helpline@pahealthaccess.org