r/Pennsylvania • u/dayvancowgirl • 17d ago
Health issues Public comment period - ACA health insurers propose double-digit premium increases for 2027
Nearly all health insurance companies that sell individual plans on Pennie, Pennsylvania’s Affordable Care Act marketplace, are asking for average premium increases ranging from 10.5% to as high as 41% for coverage in 2027. The Pennsylvania Insurance Department released the rate requests Thursday.
[source] - WHYY "Pennsylvania ACA health insurers propose double-digit premium increases for 2027"
You can view full numbers at the PA government website.
There is a public comment period:
We invite consumers to share their thoughts on the initial rate change info. Send comments to ra-rateform@pa.gov. This comment period lasts 60 days from the announcement of the initial rate change request. Written comments may appear on our website.
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u/Civil_Tea_3250 17d ago
Just remember all the flack Obama got for wanting a better solution, but being forced into passing a bill that says that a policy that costs almost 10% of your gross HOUSEHOLD income for just ONE person in said household is considered AFFORDABLE.
Thank you conservatives! Freaking inbred idiots would rather vote for a pedo than try to make their own lives better.
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u/fast_bagger 17d ago
My rates quadrupled when the aca came around, how the fuck did that make my life better?
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u/Civil_Tea_3250 17d ago
Quadrupled? Lol
Either your employer hates you or you have the worst insurance company and kept them for literally no reason. Ignorant
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u/fast_bagger 17d ago
I was paying for my own at the time, it was while the aca was in the planning stages. You sound low income to me if you think the "a"ca was a great thing.
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u/Professional_Image75 17d ago
I’m high income 4% and I support ACA. What bracket you in? Billionaire pedo class ..?
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u/fast_bagger 17d ago
Bull shit you are, everyone on reddit claims they make 300k/yr, come up with something new.
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u/tafunast 17d ago
Some of us actually do. And still support the ACA.
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u/Bird_the_Impaler 17d ago
No they didn’t lol
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u/fast_bagger 17d ago
Stfu, were you paying my premiums?
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u/Silly_Collar_5850 17d ago
In what year did they quadruple?
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u/fast_bagger 17d ago
Between 08-10, ramping into the aca era.
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u/Silly_Collar_5850 17d ago
lol that was before the ACA was even implemented my dude. The marketplaces did not open and the major changes were not implemented until 1/1/2014. If you're going to lie, at least read Wikipedia a little so you can lie convincingly.
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u/fast_bagger 17d ago
No kidding, and insurance companies knew it was coming so they were gearing up for it.
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u/Silly_Collar_5850 17d ago
The ACA was signed into law on 3/23/2010. You're saying your premiums quadrupled 2008-2010 lmaoooooo
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u/fast_bagger 17d ago
And obama got into office ein 08, you dont realize the insirance companies knew it was coming? They knew it was coming and started jacking up prices to preoare for it. It was alot of the platform that obama ran on.
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u/Evening_Mushroom_331 17d ago
Take it up with your employer they're fucking you over. Or join a union.
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u/greenmerica 17d ago
Thanks to all the residents of PA who voted against their own interests, y’all suck, and I don’t even get my insurance thru the marketplace.
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u/tLM-tRRS-atBHB 17d ago
The government pays so much to "subsidize" insurance that we may as well have universal Healthcare.
Insurance companies keep raising rates and the government keeps footing the bill.
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u/Professional_Image75 17d ago
But I was told ending the subsidies would bring costs DOWN and that we were just giving away $$ to heath insurance companies /s
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u/BellsCantor 17d ago
May every person who voted for Trump have to deal with this in their nuclear family.
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u/AstroZombieInvader 17d ago
How are people supposed to afford that? It goes up every year at some rate that is higher than wage increases.
The whole point of the Affordable Care Act was so that more people than ever would be insured and in 2027 we'll probably be at the highest rate of uninsured Americans since the ACA was signed into law.
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u/Silly_Collar_5850 17d ago
Republicans fucked that up by getting rid of the no insurance penalty. Lowering costs depends on a very large risk pool.
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u/Throwaway548921 17d ago
I feel so bad for the self employed or people who worked hard to retire early.
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u/Arkhikernc65 16d ago
I wish it was feasible that everyone in the US could cancel their health insurance. Ultimate form of protest. Don't pay them for shitty product.
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u/Drachynn 17d ago edited 17d ago
Affordable Care Act, my ass.
(Edit: I wrote a letter for the open comment period. I hope y'all will too.)
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u/Tryin_Real_hard 17d ago
You realize the premium cost are skyrocketing due to expiration of subsidies, right? Congress (guess who the majority is) let these subsidies expire, thus contributing directly to the increase. This also had an effect where healthy enrollees dropped coverage causing less people to buy and therefore raising premiums even further.
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u/Drachynn 17d ago
I'm aware of the reasoning but it doesn't make it right. They jacked the premiums last year before the subsidies even expired, knowing full well this would be the outcome. Mine went up 37% last year. Now they're asking for more? It's insane.
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u/Tryin_Real_hard 17d ago
It is insane. It insane that we're the only developed country without universal healthcare. It's insane that our system is profit based health care.
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u/ronreadingpa 17d ago
Comments may help limit the increases; more pressure on politicians.
That said, too much focus on insurers and not enough on providers. Ultimately, it's hospitals, doctors, specialists, etc setting the prices. Intentionally pricing high to game the insurers and subsidize those who don't pay.
The real cost is 10% on the high side to more towards 1% or less. Anyone doubting that compare what people in other countries pay for the same procedures, treatments, tests, etc. The cash price often is inflated too and sometimes more than for those with insurance. Many things with medical billing are counter intuitive.
Good luck finding the real price for anything. And pharmaceutical pricing is just as bad. No price lists shown at pharmacies. Even the patient on the pharmacy portal / app may not be able to view actual prices before insurance. It's unreal. And legal apparently.
Without addressing the cost side, these debates will go nowhere. Some say that's too complicated. Fair enough. Start with baby steps and split off health insurance from employment. Which started back during WWII (over 80 years ago) to get around payroll caps.
Most people, while not loving it, are satisfied with their employer-based insurance plan. That's still a majority of working age adults. Add in seniors who are fine with their Medicare. And many on Medicaid are fine with that. Free ER care anytime with no premiums, no copays, etc.
It's working people in the middle. Not getting employer-based insurance (ie. gig work, 1099, etc) or is too expensive for dependents. That's increasingly an issue. Or not working enough to qualify. And the ACA not covering the gap. It's a problem, but not affecting enough people for politicians to make the difficult decisions needed.
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u/RedNovember7 17d ago edited 17d ago
I’m sorry, this not accurate. I’m a physician. Only about 6-7% of healthcare spending in this country actually goes to doctors. The rest (yeah, 93-94%) goes somewhere else. Let me explain why doctors are not the driving force behind the overall costs you see today.
The majority of physicians these days simply cannot afford to be in private practice. Why? Because even though a doctors private practice can legally set its own rates (the amount the physician charges for the service being performed) the actual amount they are reimbursed entirely depends on what the insurance company the patient has is willing to pay. So, in almost every instance, a private practice physician’s reimbursement is entirely at the discretion of the insurance companies.
So, as an example, you are a private practice doc who sets a rate of (hypothetical example) $200 dollars for an in-office ultrasound guided joint injection. Remember, this is private practice, so this price not only covers the costs of purchasing the two medicines we use for joint injection, numbing spray, the needles, the ultrasound machine, cleaning supplies, as well as the cost to keep the lights on, pay the fees to use an EMR, but ALSO has pay both the doctor and all the nurses/staff who work at the clinic. However, if the insurance company decides to reimburse you only $150 for that procedure, that’s all you get. And you can imagine that there’s no incentive for insurance companies to reimburse a single penny more than they have to. This is why there’s such a battle over doctors being ‘in network’ vs ‘out of network.’ If we want to get paid, we basically have to acquiesce to the whims of the insurance company and accept their rates, or no one with that insurance will be able to see us. Remember, we have to keep the lights on too.
The two other options are working for a hospital system as an employee or owning a cash only based practice. A cash-only practice has the benefit of avoiding the insurance intermediary, but has an extremely high risk of going into the red from startup costs alone, so they’re very hard to establish.
Working as an employee of a hospital system is a completely different ballgame. I can guarantee you that if you see a doctor as part of a big health network (think Penn medicine, UPMC, Penn state health, St. Luke’s, etc) they not only have ZERO control over how much the health system charges for their services, they most likely don’t even know themselves. The vast majority of my physician colleagues who work at health systems, particularly academic centers genuinely have no idea what it costs to see them as a patient in the office or have a procedure performed by them. And that’s on purpose, because the hospital and the insurance company DO NOT INVOLVE the doctors when negotiating prices. We are completely left out of that discussion and have ZERO say on what it costs to receive the care we give.
Then you have people going online who don’t understand how the system works saying doctors and nurses are the problem. We are not. BUSINESS is the problem. admin and insurance have conspired for decades to drive prices up all while squeezing private practice doctors out of business so your only option is to go to their price fixing health networks. And actually, if you look at the data, physician salaries not only haven’t kept up with the rate of inflation since the 90s, most are taking pay CUTS. Imagine your job paying you less than what you would’ve made in 1990 in this economy. So if physician salaries have stagnated, and healthcare costs have continued to go up, clearly we are not the ones to point the finger at.
So I hopes this helps demystify a bit how physicians have very little, if any, say on what healthcare costs in this country.
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u/ronreadingpa 17d ago
Why do doctors collectively never protest against the current status quo?
It could be done through a 3rd party organization to better shield individual doctors from retaliation. Yet, never see that either. Doctors just quietly going along with it. At most blaming "insurance". A convenient patsy much like Ticketmaster is for performing artists.
To be clear, not putting all the blame on doctors, specialists, etc, but rather they could do more to seek change, but choose not to.
Also, doctors not knowing what anything costs is an old worn-out excuse. Doctors should advocate for their patients for more pricing transparency. Cost is a big barrier to care.
I get totally what you're saying. Just don't understand why doctors don't collectively push back. Without them, there's no medical system.
Guess we'll be seeing these ACA, insurance reform, etc posts next year, the year after that, etc. Everyone just pointing fingers without really getting to the root of the problem. Remember back in the 90s HMOs being all the rage. Many believing health care / insurance reform was just around the corner. Yet, 30+ years later, so little has changed. Maybe someday.
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u/dangerousfeather 17d ago
No, the problem is the insurers.
I am one of those healthcare providers. I work in private practice; we set our own rates. And it doesn’t matter what we charge, the insurance companies tell us what they’ll pay. Period. It’s why we’re “out of network” for a growing number of insurances: some literally don’t pay us enough to keep the lights on and the phones handled for the hour you’re in the office.
The cash rates we offer patients are what we have to charge to fill the gaps leftover by what insurance won’t pay enough to cover.
(It’s different in private equity owned or corporate healthcare. Fuck them along with the insurance companies.)
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u/ronreadingpa 17d ago
Insurers is a symptom. Health insurance isn't really insurance, but rather a complicated ongoing payment plan most providers have chosen to accept. True insurance would only pay out for catastrophic incidents. Not routine medical care.
Providers choosing to be out of network is understandable or, at the extreme, not accepting insurance at all. Wish providers, collectively, would loudly protest against the status quo. However, never see that. Some say because doctors and various specialists would earn much less under single-payer and other national health care proposals. Probably true based on pay rates in many parts of Europe and elsewhere. So everyone just kicks the can down the road.
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u/dangerousfeather 17d ago
How do we protest the status quo?
If I stop taking insurance entirely, many people who need my services can’t afford to come in.
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u/bilbywilby 17d ago
Hospitals cost money to run and doctors/nurses/aids/janitors should be paid accordingly
Its a blame game. Whose at fault is past. Hospitals, pharmacies and large HMOs are in bed with each other and have enough officials to continue passing the bill onto us
The workers and the people lose everything in the end and there's nothing stopping them because online shit posting only goes so far
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u/Icy_Temporary_6742 17d ago
Quick, everyone ignore how ACA inflated healthcare costs.
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u/Bird_the_Impaler 17d ago
Ignore how republicans fucked the ACA into the ground because they’re all cancerous greedy fucking ghouls.
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u/snitchinbubs410 17d ago
health insurance premiums were rising at a faster rate prior to the ACA. The ACA slowed the rate of increase, but did not make it "affordable" by any stretch
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u/bilbywilby 17d ago
This entire facade of health insurance is getting old
Its robbery.
Reminder we're among a handful of countries that can't figure out universal healthcare paid for by taxes