by Ali Meyer • Washington Free Beacon
The average deductible for a silver plan through the Affordable Care Act, one of the law’s most popular health insurance plans, is projected to jump 20 percent to $3,703, according to a report from Avalere Health.
Rep. Tom Price (R., Ga.), the nominee to lead the Department of Health and Human Services, said at his confirmation hearing that while many individuals have coverage through Obamacare, some of them are not getting the care they need because they cannot afford their deductible.
“I get calls almost weekly from my former fellow physicians who tell me that their patients are making decisions about not getting the care that they need because they can’t afford the deductible,” Price said.
“If you are an individual making $40,000 and $50,000 per year, and your deductible is $6,000 or $12,000 for a family—which is not unusual on the exchanges—you may have an insurance card, it might have a wonderful name of an insurance company, but you can’t have the care because you can’t afford the deductible,” he said. “People are denying themselves the care that they need.”
The report found that out-of-pocket costs are expected to rise in other ways next year.
On average, co-insurance for specialty drugs on silver plans is set to increase from 34 percent to 37 percent. More silver plans will charge co-insurance for specialty drugs as well. In 2017, 84 percent of silver plans will charge for the drugs, up from 74 percent in 2016.
Half of silver plans will charge more than 30 percent co-insurance for specialty drugs, compared to 36 percent of silver plans in 2016.
In addition to higher deductibles and out-of-pocket costs, the Obamacare exchanges will offer fewer preferred provider organizations, which offer a wider network of providers and cover more out-of-network services.
In 2014, 52 percent of plans on the Obamacare exchanges were by preferred provider organizations. In 2017, that number is projected to decline to 31 percent.
Premiums are set to increase by 25 percent in 2017. The number of insurers participating on the exchanges is set to decline.
“After several national and regional insurers exited the exchange markets, 36 percent of all regions in the country will have only one participating health insurer in 2017,” the report stated. “By comparison, only 4 percent of regions had one participating insurer in 2016.”
Finally, the report noted that Obamacare enrollment is less than half what the Obama administration initially projected. The government estimated that 23 million people would be enrolled by 2017; only 11.5 million people were enrolled as of Dec. 24, 2016.
“Exchange enrollment continues to lag behind projections, even after accounting for 2017 open enrollment to-date,” said Caroline Pearson, senior vice president at Avalere. “Lower-than-projected enrollment makes the market less stable and less attractive to insurers and has the added effect of increasing premiums in subsequent years.”
The Department of Health and Human Services did not respond to requests for comment.