We know thousands of Nevadans — some estimates run as high as 100,000 — are seeing steep premium increases as they move into Affordable Care Act-compliant plans for the first time in 2015.
The question is how businesses and individuals are adjusting to the higher costs. Are they simply paying the bigger premiums, are they tweaking coverage or are they dropping insurance altogether?
The answers are trickling in.
Consider Las Vegas trucking company HR Transportation, which lost its coverage through the now-canceled Las Vegas Metro Chamber of Commerce’s group plan. The company’s chamber plan had no deductible and covered 100 percent of medical costs, HR principal Art Bernier said. Keeping something similar, with all of the new benefits mandates in the federal law, would have doubled premiums.
Going without a plan wasn’t an option.
“In order to be attractive to employees, we need to provide some kind of medical benefit,” Bernier said.
So HR Transportation switched to a health maintenance organization plan with a limited network and a $5,000 deductible. The plan also covers just 70 percent of medical costs. But premiums for the company’s 28 employees will stay about the same, Bernier said.
“They’re still covering the same things, but they’re paying less,” he said. “There’s going to be way more out-of-pocket expense. All we have now is catastrophic insurance. It’s only good if you have something really major.”
The company will handle some new costs by raising its prices, although Bernier said ACA-related changes won’t add more than 1 percent to what it charges. Other costs, including rising workers’ compensation expenses and pay raises, will actually add more — 3 percent to 5 percent, Bernier said.
Still, even 1 percent hurts, because trucking “is a very competitive business,” he said. “It’s not a high-profit industry.”
Las Vegas insurance broker Chris Carothers, who worked with HR Transportation to find a plan, said 80 percent of clients he works with are reducing benefits to keep premiums lower. Options include offering a lower-tier bronze plan, which covers just 60 percent of medical costs, and asking employees to pay the difference to upgrade to a silver or platinum plan, which cover 70 percent to 90 percent of costs.
For individuals, the math — and the decisions — can be tougher. They’re purchasing on their own without the buying clout of even a small group.
Local poker player and freelance writer John Mehaffey’s October renewal letter said the monthly premium on his 2015 plan would more than double from $360 to $688. His plan benefits haven’t increased along with those higher premiums, though.
So Mehaffey and his wife, Kristina, are going to gamble. He and his wife will go without coverage for the next year, while she finishes her education degree. They plan to enroll their kids, who are 15 and 8, in coverage through Nevada Checkup, a public plan for the children of families who have trouble affording a private policy.
Mehaffey, who said the idea of going without coverage for a year makes him “nervous,” acknowledged that Affordable Care Act does have advantages: No one can be denied a plan because of a pre-existing condition. Nor can insurers rescind coverage after members get sick. But he’s questioning whether it’s worth it.
“I don’t mind subsidizing that (care for pre-existing conditions), but when we double down for coverage over the course of two years, it’s not worth it.
“I thought it (the law) wouldn’t affect me because I already had insurance I wish I had spoken up earlier. I’m in a tough situation, and I didn’t think I’d ever be here.”