COLUMBUS, Ohio – Ohioans who purchase insurance on HealthCare.gov will likely save money in 2020, as the state is reporting an average premium decrease of 7.7% compared to last year, according to the Ohio Department of Insurance.
It is the first decrease for Ohioans since the health insurance marketplace was unveiled seven years ago, and it could be more evidence that the controversial Affordable Care Act is working.
HealthCare.gov offers plans for people who do not get insurance through work, nor qualify for government health care programs such as Medicare and Medicaid -- including people who are self-employed. About 206,000 Ohioans obtain plans on the exchange, according to the Kaiser Family Foundation.
The average Ohio premium on the exchange was $6,161.56 in 2019. In 2020, it’ll be $5,690.26, the insurance department said.
Low- and middle-income individuals and families on the exchange receive tax credits, designed to reduce the cost of their premiums. For instance, a family of four can receive a credit if they earn up to $100,400.
The insurance department approved 10 companies to sell plans on the exchange for 2020:
- AultCare Insurance Company
- Buckeye Community Health Plan
- CareSource
- Community Insurance Company
- Medical Health Insuring Corp. of Ohio (aka Medical Mutual)
- Molina Healthcare of Ohio, Inc.
- Oscar Buckeye State Insurance Corporation
- Oscar Insurance Corporation of Ohio
- Paramount Insurance Company
- Summa Insurance Company
There will be plans available in all 88 Ohio counties in 2020.
Twenty-nine counties will have two insurers and one county will have just one insurer. All other Ohio counties will have at least three insurers selling exchange products in 2020, the insurance department said.
Cuyahoga County, for instance, will have five: Buckeye, CareSource, Medical Mutual, Molina and Oscar.
In 2017, as Ohioans were gearing up for open enrollment on the exchange, 20 counties didn’t initially have an insurer, but insurance companies stepped in and offered plans in 19 counties.
Open enrollment on the exchange, to get a plan beginning Jan. 1, runs from Nov. 1 to Dec. 15.
Although the average premium will decrease 7.7 percent, plans are up sharply from the first year of the exchange, in 2013, when the average individual plan was $2,650.17, the department said. That’s a 115 percent increase.
“From a policy perspective, it was always assumed the marketplace pricing would normalize over time,” said Loren Anthes of the Center for Community Solutions, a Cleveland health care think tank. “These insurance providers got experience to understand who they were covering.”
Seven years ago, when people signed up for health insurance, it was the first time many had received comprehensive coverage or any coverage in years, thanks to the tax credits making it affordable. People obtained expensive procedures they had put off when they were uninsured or underinsured, Anthes said.
That drove up prices on the exchange.
In 2014, Ohio expanded Medicaid, another part of the Affordable Care Act, which reduced the number of people receiving care in emergency rooms. Most ERs have to treat everyone, regardless of ability to pay, and so hospitals charged people on the private insurance market higher rates to make up for the lack of payment they received from ER visits. Medicaid expansion has helped reduce private insurance rates, too, Anthes said.
The Affordable Care Act requires insurers to refund customers for overcharges, and Anthes said that refunds had been doled out to customers for years.
Whether rates on the exchange continue to decrease is to be seen.
A number of changes in Washington have whittled away at the Affordable Care Act -- such as allowing people to obtain short-term or catastrophic health plans. If more people end up in the ER due to underinsurance, hospitals may again shift costs to the private market.
“I think it’s a good sign the policy is working," Anthes said of the 7.7% decrease. "It’s something to pay attention to as we’re debating to remove coverage options for people.”