In 2014, the oldest health plan enrollees will not pay more than three times the premium of the youngest enrollees in the same region and with the same smoking status. Some industry analysts have warned that, as a result of this requirement under the Affordable Care Act (ACA), premiums for enrollees in their 20s will go up to subsidize the premiums of enrollees in their 50s and 60s. But a study by HealthPocket reveals that these fears are unfounded.
HealthPocket looked at premium data for individual and family health plans across the United States for nonsmoking men and women ages 23, 30, and 63. Premiums increased 260% for 63 year-olds versus 23 year-olds, which is well under the 300% limit imposed by the Affordable Care Act. The new age related premium limit is not likely to cause significant premium increases in most states. Two factors are more likely to raise monthly health insurance premiums than are age-based premium increase limits:
- Plans will need to offer more benefits to enrollees under the Affordable Care Act.
- Enrollees will include individuals with health conditions who previously could not get affordable coverage in the commercial market.
The prohibition of gender-based premium differences in 2014 may benefit elderly men. Premiums for 63-year-old nonsmoking men were 317% higher than for 23 year-old nonsmoking men. Premiums for 63 year-old nonsmoking women were only 203% higher than for 23 year-old nonsmoking women. However, the 23 year-old women started with higher premiums. This curious switch in the gender gap may be due to insurers associating higher healthcare costs to women between ages 19 and age 56. For more information, visit www.HealthPocket.com.