The following is not an endorsement or condemnation of any
particular policy - this is simply my experience.
As my firm provides health insurance to
full-time employees, we met with our insurance adviser to discuss our annual renewal . The result - a
32% increase in the bill. I've been both
anticipating and dreading this meeting, but I have been primarily interested in what
would happen to our premiums due to the insurer's response to the Affordable
Care Act.
This is where it gets interesting - our insurer, a major
carrier, uses individual rates for all enrollees rather than leveling the
premiums after a certain number of enrollees. So, I can see how it breaks down. Here's what happened:
The rate for our youngest male enrolled employee more than doubled. The rates for the rest of our male enrolled employees
under 40 increased markedly, although not quite doubling. In contrast, the rates for our oldest enrolled
male employees stayed pretty flat. The rates for the female enrolled employees stayed pretty flat too.
So what happened? Did some of our staff members suddenly get
way more likely to get sick? No, it
would seem that the culprit is the ACA mandate that gender can't be considered.
And, it's pretty well-settled that females use
more healthcare dollars than males. So, rates for the younger males go up, but
the rates for the females do not come down by a corresponding amount - they
stay flat. This means that the present
state of the world is as follows - the
rates are individual in the sense that we get a different one for each of our
staff members, but they are no longer individual in the sense that each rate
reflects the person's likelihood to avail themselves of medical care. The actuarial tables are out the window.
Ultimately, as the (co-)employer, I only care about the fact
that the check we have to write is 32% larger.
And, because we foot the entire bill for the premium for full-time
employees, they don't really have to care either. If, however, I was a 30 year old male who had
to pay some portion of the premium under an employer-sponsored plan, and my
share suddenly doubled, I'd be more than a little cranky, and maybe not really
be so enamored of the brave new world where political mandates override statistical
realities.
