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Average 2021 Health Insurance Plan Premium for Single Coverage (MEPS)

The average single coverage premium for each private sector employee enrolled in a health insurance plan was $7,380 in 2021. This was up 3.2% from the prior year MEPS data. Table I.C.1 (page 91) shows average premium by size of company, industry, for-profit vs nonprofit, union establishments vs nonunion, and other breakouts. For companies of less than 10 employees, the average single premium was $7,707 per month, up 6.5% from 2020. Report on private-sector establishments, from the Medical Expenditure Panel Survey (MEPS) Insurance Component summary tables.

Average 2022 Premium on the Health Insurance Exchanges

On average, 2022 individual premiums were under $600 per month for a plan on last year’s health insurance exchanges. Data are shown in the “2022 Open Enrollment Report”. Across all states, the average premium was $585 for the plans selected by individuals, up 1% from the prior year. About 89% of people received the Advance Premium Tax Credit (APTC) (which is based on income) to bring the net cost to individuals, down to about $133 per month. For those who qualify for the APTC, the difference (about $505 per month) is covered by the government (“Obamacare” and the American Rescue Plan). Average monthly premium net cost for those who qualified for the APTC was $111 per month on the federal Healthcare.gov exchange, and $188 on the state-based marketplaces. The national average premium of $585 per month works out to $7,020 premium cost per year. Source report from CMS, undated.

In an older report, “Early 2021 Effectuated Enrollment Snapshot“, details by state are provided for the prior year’s 2021 enrollment.

Citizens’ Health Care Working Group: Final Recommendations 9-25-06 Editor's Pick

Citizens’ Health Care Working Group: Final Recommendations, September 25, 2006. After input from more than 14,000 engaged citizens, the national working group delivered its recommendations to the President. Six recommendations called for immediate action and public policy that all Americans have affordable health care; that quality and efficiency be improved, and end-of-life-care be reformed. In recommending that core health care benefits and services be defined, it shares data that the people think consumers and medical professionals should define these benefits, rather than insurance companies. The group calls for affordable access to health care to be achieved by 2012. Summary and Appendix C (poll results) should be required reading for Congress and White House staff. Unfortunately the survey left out the question of how to encourage personal responsibility for exercising, eating right, and other healthy behaviors. Still, Editor’s Pick. It’s a classic.

Fact Sheet: Underpayment by Medicare & Medicaid (2022)

Analysis by the American Hospital Association shows that Medicare and Medicaid under-pay the true cost of hospital care by about $100 billion. This cost ends up being borne by other payers and commercial insurance. Using 2020 data, it is estimated Medicare paid 84 cents on the dollar, and Medicaid paid 88. February 2022 report.

Federal Exchange Marketplace Average Rate Changes for 2022 (CMS)

CMS reported average rate changes in health insurance premiums for 2022 on the federal exchange marketplace for two types of sample consumers – a 27 year old, and a family of four. The premium cost for the second-lowest cost silver plan (benchmark) is reported to be reduced by 3%, on average, for the 2022 enrollment starting Nov. 1. According to CMS, the average benchmark silver plan premium for a 27 year old is expected to be $368 in 2022. The average benchmark plan (after the American Rescue Plan implementation) was estimated to be $379 per month in 2021. After subsidies, a 27 year old with income at 150% of federal poverty level (i.e., $19,320 per year) would pay $0 for the lowest cost silver plan in 2022. For the Family of Four example, the benchmark silver plan cost $1,440 per month on average. The lowest cost plan (probably a Bronze plan) will cost $1,061 per month for incomes at 250% of the federal poverty level ($66,250 household income). However, after qualifying subsidies, the family cost was just $3 per month.

The healthcare.gov exchange will open on November 1, 2021. Open enrollment closes January 15, 2022. However, if you want coverage to start January 1, 2022, you must enroll by December 15, 2021.

No information about average price hikes or reductions was presented for older consumers. Older enrollees pay more, but costs for older consumers in 2022 were not disclosed in the press release. Also not disclosed in the CMS press release, Oct. 25, 2021, is the size of deductibles. The report accompanying the news release is one of the most confusing written.

For reference, the average 2020 total monthly premium for Marketplace enrollees was $573, before Advance Premium Tax Credits and before adjustment credits due to the pandemic. This was down 3% from 2019. The average enrollee is older than 27 years of age. AARP noted that a 2019 Kaiser Family Foundation report found that a 60-year-old not eligible for subsidies paid $708 a month for the lowest-cost bronze plan and $943 a month for the lowest-cost silver plan.

Impact of Covid on Insurance Rate Increases for 2022

What impact will COVID-19 have on health insurance rate increases for 2022? According to the American Academy of Actuaries, the COVID-19 pandemic continues to bring uncertainties into developing premium rates for 2022. Among the factors are regional vaccination rates that affect both Covid illness and non-Covid care; increased future illness (or higher severity of illness) as a result of delaying preventive, vaccinations and early screening for cancer; higher alcohol use during the pandemic; PTSD from being on a ventilator for a long time; mental health and telemedicine usage. The actuaries did not hazard a guess about rate hikes. Gains and profits made in 2020 and/or 2021 or 2022 may be rebated to consumers, if necessary, based on the 3-year formula, instead of lowering health insurance rates. The report suggests that conservative insurance companies will play it safe and increase premiums as they deem prudent for 2022. Nine page Issue Brief: Drivers of 2022 Health Insurance Premium Changes was published September 2021 at actuary.org.

Medical Bills Survey (Medical Debt) KFF-NYTimes

The Burden of Medical Debt in the United States is an analysis by the Kaiser Family Foundation (KFF). Data from 2020 show that about 1 in 10 adults owed at least $250 in medical debt. This level of debt was deemed “significant”. About 6% of adults owed more than $1000; 1% owed more than $10,000. Data are from the Survey of Income and Program Participation (SIPP). Published March 2022.

Other Helpful Listings

CEO PayWatch Database

CEO PayWatch database web site by the AFL-CIO permits searches to find CEO compensation in publicly traded companies. Can search by industry sector. Select View CEO Pay Data, then Health Care. Transparency of CEO pay. Many pharmaceutical company and other healthcare CEOs received over $20 million in 2020 compensation. Easy to use.

Medical Cost Advocate Editor's Pick

If you need help negotiating your medical bills, Medical Cost Advocate, a commercial company, will help get the price down. They take 35% of the savings. In addition, they have a prospective negotiation service that may get you a lower price before you have the service.

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