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Report: Most Individual Health Plans Cover Less Than Health Care Law Requires Report: Most Individual Health Plans Cover Less Than Health Care ... Report: Most Individual Health Plans Cover Less Than Health Care Law R... Report: Most Individual H...

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Health Care / HEALTH CARE

Report: Most Individual Health Plans Cover Less Than Health Care Law Requires

Most individual polices currently on the market could not be sold on state exchanges in 2014, a new report concludes.

The report, published Wednesday in Health Affairs and funded by the Commonwealth Fund, analyzed individual plans from several states and concluded that 51 percent of the plans would fail to meet the minimum requirements established under the 2010 health care reform law.

The law says that plans sold on public exchanges must cover at least 60 percent of the costs of treating a typical patient, a figure known as “actuarial value.” Most of the policies the researchers analyzed covered less than that, meaning the possibility of high out-of-pocket costs for patients.

 

In order to meet the actuarial value targets for "bronze plans," the lowest category, current plans would have to pay for more care. That likely means they would be more expensive to consumers.

“The individual market of the future will sharply contrast with the market of the past decades,” John Gabel of the University of Chicago and colleagues reported.

They do not say whether changes to the market will be good or bad for consumers, but they are likely to be a mixed bag. Champions of the law say that new regulation of insurance products provide key consumer protections. Critics say that they will drive up the cost of insurance.

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