Medford, Ore. — The usual bills will always cut into profits. But for Bill Bumgardner–who owns a Rogue Valley landscaping business and privately buys health insurance–the rise in insurance premiums has him trying to prune back expenses. But it may not be enough. Bumgardner said his rate is going up 35-40%. “We’re going from a 600 to 1100, it’s pretty high. Those are on a lower end plan, there not as much coverage,” said Bumgardner. He doesn’t qualify for tax credits. “I’m not sure what the government is thinking how it’s going to work out for everybody. It just isn’t affordable. Rates have doubled and in some cases tripled, if they don’t qualify for a pretty healthy tax credit.”
Ron Morris, a health insurance agent at Reinholdt and O’harra, is fielding calls from clients. He told NBC5 News’ Jennifer Elliot insurance companies say they are bleeding cash, and as a result: “Rates have double, and in some cases close to tripled in the last three to four years.
Morris said since the implementation of the affordable care act, many companies have hemorrhaged. “Used to be that we had close to a dozen plans in this valley. Now there are only 3.”
Life Wise Health Plan and Oregon Health CCO, a coordinated care organization were unable to stay solvent and went packing. According to the Eugene Register Guard, in just months, Moda lost $33 million.
“There are a lot of sick people using coverage–the carriers are forced to increase their rates based on the claims they have to pay,” said Morris. The cost of the actual care is also a big part of the problem.
A last ditch effort by the state, raised allowable rates, preventing them from only having one carrier, the Register Guard writes the state agreed to up the rates allowed for Providence and Moda insurance, who both threatened to pull out of the area.
And while they’re now staying in Jackson and Josephine counties, Moda is still leaving 20,000 customers in the lurch in counties including Klamath and Douglas. And that is being felt in the pocketbooks.
A Jackson County 21-year-old on silver Moda, Bridgespan, or Providence insurance will see their rates go up anywhere from 26% to 60%. A 60-year-old buying insurance through the marketplace can expect their individual plan premium to near $1,000. “I’d say the individual plans as a whole are the ones that are really taking a hit,” added Morris.
According to the Henry J. Kaiser family foundation, over 270,000 Oregonians don’t get health insurance from a group provider and purchase their own.
One local beautician told NBC5 News the combined cost of her and her husband’s health insurance in 2017 will be more than their mortgage. And it’s not just individual plans seeing a price change:
Ashlander Laurel May is on her husband’s plan. She said she used to just pay cash, but added, “It costs me more to go to the doctor than it did before I had insurance.”
Dani Liles said she’s working so she can go to the doctor. Despite getting partial disability assistance for Lyme disease, Liles out of pocket costs are also rising. She said, “It’s frustrating, trying to work physically to pay for a doctor to help me is a really weird paradigm.”
Local companies, wanting to offer employees health insurance are deciding between increased premiums versus reduced benefits. And if more people pull out to face the aca penalty, as 7% of the state’s population already does? Experts said it could lead to the whole system imploding.
There is hope–for those that qualify for a tax credit. Which Morris says includes 85% of those buying privately.
The U.S. Department of Health and Human Services said tax credits are tracking up at the same rate of premiums.
According the Kaiser Foundation, in big cities, out of pocket rates will virtually remain the same, despite the higher costs.
The trouble may come in rural areas, like Southern Oregon, where there are fewer providers allowing for higher rates. And ultimately the money to fund those higher subsidies is passed on to the tax payers.
Morris Said, “I think our best shot for light at the end of the tunnel is for the affordable care act to be repealed and kind of start over.”
A House committee is demanding estimates on tax impact by November 7th. In the meantime, Bumgardner is hedging his bets. He said, “Cost is still so high, that it’s kind of getting priced out. It’s really hard right now because we’re not sure how we’re gonna pay for it.”