Incomplete Reporting of Marketplace “Premium Increases” Misleads, Harms Consumers

Despite an array of reports to the contrary, most consumers purchasing health coverage in the Marketplace for 2015 can pay about the same – or lower – in monthly premiums for the same level of coverage as they did in 2014.

Underlying the confusion is the fact that the amount each consumer using Premium Tax Credits in the Marketplace will pay for coverage is different. This makes it extremely difficult to boil down a wide range of individual amounts to one single statistic. As a result, most reports have ignored or misstated the impact of Premium Tax Credits, although 91% of Florida’s Marketplace customers received this financial help in 2014.

The fact is, the amount of financial help a consumer can get in the Marketplace depends mainly on their income and the Federal Poverty Level. If those two numbers don’t change much, the amount of Premium Tax Credits for which they qualify won’t change much either.

It is important to note that in order to keep premiums level, a consumer may need to switch plans, and that raises other considerations. For this reason, Florida CHAIN is urging all Marketplace customers to compare their particular plan options during Open Enrollment. Consider the example of 50-year old Hillsborough County consumers who purchase the benchmark* Silver Plan in both 2014 and 2015 (see chart). Reports have stated that this group faces a 13 percent premium increase in 2015. The fact is, a typical such consumer would pay the same amount in 2015, and the average change across the entire group would be a premium decrease. Furthermore, not a single consumer using Premium Tax Credits would see a 13% increase. Consumers deserve the full story.