GREENFIELD — With health insurance exchanges set to open in one week ahead of the federally mandated changes in health insurance under the Affordable Care Act, even the president of one of Indiana’s largest health insurance companies can’t say which way premiums will go.
“These numbers are all over the place,” said Robert Hillman, president of Anthem Blue Cross and Blue Shield in Indiana.
Hillman and company vice president David Lee were in Greenfield Monday to preview and field questions on how the Affordable Care Act might affect individuals and small-group policy holders after Jan. 1.
“There’s a lot going on here, and there are a broad range of possible answers,” Hillman said. “Under the law, everything moves to the center.”
According to Hillman, whether or not individuals will see their premiums go up depends primarily on who they are, and the answer, he said, is counterintuitive.
Individuals whose premiums were based on a healthy lifestyle with no significant health risks will automatically see their rates increase when the law goes into effect Jan 1.
Conversely, people who were previously considered a higher risk with health issues or conditions will find a premium decrease and windfall after the first of the year.
Hillman said there’s going to be a tremendous amount of “market disruption” when some 800,000 uninsured Hoosiers enter the insurance market in 2014.
“What really matters is where you’re at today,” he said, in predicting whether one’s health insurance costs will rise.
Small-group plans might see as much as a 120 percent overall increase or reductions of as much as 40 percent. For individuals, premiums could hike 140 percent or decrease by as much as 40 percent, he said.
“Everyone is subsidizing everyone else to a greater extent than before under the Affordable Care Act,” Hillman said.
The bottom line: Those individuals who have been doing the right things to take care of themselves will more than likely wind up paying more for their health insurance than those who have health issues.
For Kellie McBride, fitness manager at Hancock Wellness Center, there was little logic in the process.
“Aren’t you concerned that rewarding bad health habits is going to implode the entire system?” McBride asked.
“I couldn’t agree with you more,” Hillman said. “Small-group employers who’ve implemented wellness programs for the last 10 years, none of that matters anymore.”
Moreover, individuals at 250 percent of the federal poverty level, which currently is $11,000 annual income for an individual – may apply for subsidies that pay premiums, co-pays and other out-of-pocket expenses.
Unless one is already covered under an approved insurance plan or falls under certain exemptions, citizens must purchase a health plan or face a penalty that is the greater of $95 for adults and $47.50 for children or 1 percent of their annual income for the first year.
The penalties gradually increase over three years to $695 or 2.5 percent of annual income.
Policies can be purchased through insurance companies or through the federally sponsored insurance exchanges.
And though only seven days remain until the health insurance exchanges open, there’s little indication as to what they will look like, even to industry insiders.
“None of us know what it looks like yet, even though it’s supposed to open in a week,” Hillman said.
For northern Shelby County resident Linda J. Conner, the discussion was illuminating but not necessarily elucidating.
“It was helpful, but it’s still very confusing,” Conner said.
And that’s a sentiment Hillman said he expects to continue as people try to learn how the new health care law affects them.
“I think a lot of people are going to be learning on the fly,” he said.
For more information on the health insurance marketplace exchanges, go to the U.S. Department of Health and Human Services website at www.healthcare.org.