With 2015 winding its way to a close, employers are putting the wraps on another year gone by and looking forward to the future to see what 2016 and beyond holds. While most of these preparations involve productivity, much of it is also relates to employee benefits, as the open enrollment season approaches.
Should employers deem it necessary, in order to save on health care expenses, companies will be allowed to increase the amount of money workers are required to pay toward their out-of-pocket health care expenses, according to a newly released statement from the U.S. Department of Health and Human Services.
Maximum out-of-pocket limit increasing
In 2016, the maximum amount that employers can use from their workers' earnings to cover out-of-pocket expenses not paid for by group benefits is $6,850 for single coverage and $13,600 for a family of four. In 2017, though, employers can charge more, as much as $7,150 for singles and $14,300 for families, Business Insurance reported from an HHS' statement issued last month.
While some may be confused as to why out-of-pocket health coverage is becoming more costly, the uptick was already scheduled when the ACA was signed into law. As noted at HealthCare.gov, the out-of-pocket limit for individual plans in 2016 is $6,850 for individuals and $13,700 for families. Once the year after next comes around, though, that maximum can be raised.
Robert Book, a health care expert and Forbes contributor, pointed out that when the ACA was passed in 2010 – followed thereafter by several reforms to the bill – provisions within it made the uptick in premiums possible as well, as those are also expected to rise.
"The well-known prohibition on charging different rates for people with higher health risks obviously makes health coverage more attractive to people with chronic conditions or a history of serious illness," Book explained.
He cautioned, however, that by making premiums independent of health status, those who have no well-being issues aren't as inclined to purchase coverage because they're paying the same rates as those who may have health complications. Those who aren't covered have to pay a penalty, but the fine is far less than what it costs to buy a health policy. Additionally, the penalty is difficult to enforce.
"Under the pre-ACA system, a patient with insurance could continue to renew existing coverage no matter how sick he or she got," Book further stated. "But an uninsured patient who got sick and then sought to obtain coverage could be charged extremely high premiums, or be denied coverage altogether."
Book had several other comments that help explain why ACA exchange premiums are increasing, which he attributes to fundamental flaws that were established when the regulations were passed.
3 in 4 say premiums now cost more
Looking back on the past 12 months, the vast majority of Americans say that their health insurance premiums have become more expensive over time. Close to 3 in 4 – 74 percent – say they are paying more for coverage today than they were in January, based on a recent survey conducted by Gallup. That's up from 67 percent who said as much last year when a similar poll was done at the same time. Only 4 percent say they're spending less than when the year began.
Though sentiment toward the ACA has made some marginal improvements, more people are still opposed to the health care law than in favor of it. In a separate poll also performed by Gallup, just over half – 52 percent – don't like it, while 44 percent approve. This past summer, satisfaction with the law was fairly evenly split at 48 percent opposed to 47 percent supporting. In January, the breakdown was 54 percent to 38 percent, respectively.
