With SCOTUS Case Looming, Missourians Worry About Affording Health Insurance | KBIA

With SCOTUS Case Looming, Missourians Worry About Affording Health Insurance

Jun 17, 2015

Like many consumers, Melinda Staley relies on a marketplace subsidy to help her pay for health insurance.
Credit Hope Kirwan / KBIA

Several months remain until the next open enrollment period for health insurance, but any insurance company looking to raise the cost of their plans next year had to submit their proposed increase by June 1.

In Missouri, seven insurance companies submitted rate increases for 11 different plans, with proposed raises ranging between 11 and 28 percent. Almost every company who submitted a rate increase cited the rising cost of healthcare as a reason for the change.


 

“The rates that we are filing simply reflect the cost of healthcare," said Rohan Hutchings, Director of Communications for Aetna, Inc.

"That is the cost of services that they get from providers, the amount of services that people are getting and an increase in pharmaceutical drugs. For 2016 we expect the medical costs will grow from 8-10 percent in the individual market.”

 

This isn't the first time insurance companies have increased their rates. Back in 2014, many insurance plans raised their rates after the first open enrollment period as well.

Melinda Staley’s insurance plan was one of them, but for her the solution was simple: just switch plans.

 

“One stopped on the 31st of December and the other picked up on January 1st and it was very easy,” Staley said.

 

Staley, who works as a receptionist, receives a federal subsidy through the marketplace which makes buying health insurance more financially feasible for her. Because of the assistance, she doesn’t worry about rates so much as her bottom line.

 

“I'm looking at what I'm actually paying," Staley said. "I'm looking at how high is the deductible and what do I have to contribute and whether the care that I need is really covered.”

 

But this year could be different.

 

Fred Travis, Director of the Risk Management and Insurance Program at the University of Missouri, said insurance companies are probably considering more than just the cost of treatment when they increase their rates.

 

“Well I only think that the insurance companies are trying to protect themselves against actions the state might take in case it's determined that the subsidies no longer apply,” Travis said.

 

With a decision expected this month, King v. Burwell is a US Supreme Court case that will determine whether consumers in states like Missouri that use the federal marketplace are eligible to receive tax subsidies for their insurance.

 

If the Court decides against their eligibility, almost 200,000 Missourians could lose their subsidies according to the Kaiser Family Foundation. The cost of the average premium would increase by over 300 percent.

 

For Melinda Staley, it would likely mean she would have to go without health insurance again, like she did before the Affordable Care Act.

 

“I'd be back without any insurance. I don't make a sustainable living wage," Staley said. "You know I have a college education and I have over 35 years of experience in the working world but I still don't make a living wage."