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Debate Over Health Care Costs Continues

With the federal health insurance plan taking effect soon, there are a lot of cost projections being tossed around by state officials. And there's a lot of confusion about how much the changes will cost consumers and companies. Ohio Public Radio's Karen Kasler reports.

Lt. Gov. Mary Taylor has been an outspoken critic of the Affordable Care Act, which she calls Obamacare. But she says that doesn’t change a study her office did of the costs submitted for the statewide health insurance exchange, which will be operated by the federal government. Taylor is the state’s insurance commissioner, and says she used an independent actuary group’s report to look at the average costs of 214 health insurance plans filed by 14 companies in Ohio in 2013 – that number came out to $223.
“We compared that to the average cost to again cover these essential health benefits beginning in 2014, and that number that was based on the plans that have filed was $420, which represents an 88% increase.”

That’s a shocking increase. Taylor says those essential health benefits, which are required in all plans, are driving up those costs.  And though her study relates to the amount it will cost insurance companies to provide those essential health benefits, not premiums paid by individuals and companies, Taylor says she expects premiums to rise significantly as well. And she says this study backs up a projection in 2011 saying premiums would rise with the ACA. But that’s not how a non-partisan group that studies health related issues sees it. Amy Roling McGee is with the Health Policy Institute of Ohio, and she says Taylor’s study provided only a partial look at what may be the cost of insurance coverage in 2014.
“But that it didn’t equate to the premiums that would be charged as market competition might influence rates and subsidies will be provided under 400% of the federal poverty level, which is approximately $78,000 a year for a family of three.”

The Lt. Gov.’s report made supporters of the ACA angry. Kathleen Gmeiner is with the Universal Health Care Network of Ohio.
“Unfortunately the Lt. Gov., insurance commissioner Mary Taylor, is making the wrong comparisons and is making people in Ohio more concerned than they need to be by not explaining this properly.”

Gmeiner agrees with Roling McGee that subsidies need to be included in comparisons for them to be fair. But Gmeiner and Roling McGee admit that younger, healthier people may pay higher premiums, but people with pre-existing conditions and serious illnesses such as cancer will have access to insurance when it was too expensive or completely unavailable before the ACA. But Taylor says her main concern is that the exchange created by the ACA won’t make for a competitive insurance market in Ohio.
“We didn’t need a market to be generated or created in Ohio. That market already existed. In fact, we’re seeing a bit of a shrinking of the market after the Obamacare mandates take effect.”

Roling McGee agrees with the first part of that statement, but disagrees with the last part.
“We’ve been known to have a competitive insurance market, and it looks like we’ll continue to have a competitive insurance market.”

But Gmeiner has a very different opinion.
“I would say that it certain is, if not the weakest, one of the weakest and that – the reason is that Ohio has done a very good job of keeping people out of insurance because of their pre-existing conditions. We’ve kept so many people out that rates are artificially low.”

People who don’t have health insurance coverage through their employers can enroll to purchase insurance on the exchange starting October 1.

Jim has been with WCBE since 1996. Before that he worked as a reporter at another Columbus radio station, and for three newspapers in Southwest Florida.