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Some Affordable Care Act Participants Seeing 100% Premium Increase

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Obamacare is back in the headlines. President-elect Trump has been talking about what parts he wants to keep and what parts he wants to scrap.  This as we're now learning of Oklahomans who are facing premium increases even larger than the 76% News 9 first reported.

Insurance experts say no matter what President-elect Trump does with the Affordable Care Act, what you sign up for during the current will remain in place at least for the next year. But those who are seeing their premiums skyrocket are looking at personally abandoning the Affordable Care Act right now. 

Denis Bootenhoff is a small business owner in Edmond, he has owned Rain Guard gutters in Edmond and Norman for 34 years. He's also a father and husband. But this year he learned buying insurance for his family is going to get a lot more expensive.

“From $1,700 to $3,400,” he told News 9. “A 100% increase. I just couldn’t believe it.”

And for less coverage. His share of expenses has climbed from 20% to 40% after he meets his $5000 deductible. The rates are quoted through the only ACA compliant insurance in Oklahoma: Blue Cross Blue Shield.

“I think I’ll probably just do without, pay the penalty,” said Bootenhoff.

That's actually close to what Insurance agent Brett Casey is recommending to many of his clients.

“I’ve gotten more calls asking about that then all the other years combined,” said Casey.

He says in many cases clients find much cheaper insurance through a non-ACA compliant plan which means the company doesn't have to abide by ACA mandates which drive up costs.

“The people who wouldn't use the insurance aren't signing up and the people who use it every month are signing up,” explains Casey.

Casey says there are a long list of hardship exceptions that he checks to see if his clients actually have to pay the penalty for not complying with the ACA.  But says even with the penalty many of his clients are still saving money.

Casey says it's probably what he will do . His insurance premium doubled as well this year.

About 9 in 10 Oklahomans receive a government subsidy that will cover some of those premium increases but only if those customers stay in an ACA compliant plan.

According to a BCBSOK Statement, "In 2016, 85 percent of on-exchange BCBSOK members received a subsidy to offset the total premium they pay, which is above the national average.  In 2017, the subsidies will be adjusted to cover the majority of the rate increases, so people on those plans will see a much lower increase in their out of pocket costs, if they have not had significant changes in their income or household size.

We encourage members to visit our Mobile Assistance Center to see if there is a lower cost option on a different plan that would work better for them. Our customer advocates can also help them see if they qualify for a premium subsidy, in a one-on-one setting. They can also call our customer service number on the back of their ID card."

Upcoming dates for our Mobile Assistance Center can be found here.

BCBSOK issued the following statement in regards to the rate increase:

Our rates reflect strong actuarial assumptions that have been vetted by multiple internal and external reviews using the most current data available. Rates for individuals who purchase their own plans are based on several factors, including anticipated medical care costs for a region, pharmaceutical cost and utilization, and whether or not they smoke,  among other variables. There is no incentive to overprice our plans. Consumers have layers of protections at the state and Federal levels to ensure appropriate pricing.

We recognize that consumers across Oklahoma have different needs, and we have found that no one size fits all, which is why BCBSOK offers a variety of plan choices. BCBSOK encourages people to choose the best option for themselves and their family, and to contact us to make sure they are choosing the right plan.

Since the implementation of the Affordable Care Act in 2014, BCBSOK has been the only health insurer to offer plans in all 77 Oklahoma counties, while other insurers have left the market, which shows our dedication to the health and wellness of Oklahomans.  We offer the most policy choices, the largest selection of doctors and hospitals and have helped to insure the most people.

The impact on premiums and out-of-pocket costs to members varies depending on the health coverage options members choose. However, if customers choose to go without health insurance, they could face a penalty. As of 2016, the penalty increased to $695 or 2.5 percent of their household income.

We will continue to work with state and federal regulators and legislators to establish market rules that will encourage broad participation and continuous coverage and help to create a stable and competitive marketplace for the long term.

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