Healthcare.gov premiums have bigger increase for 2016

About 70% of those who return to the federal insurance exchange when open enrollment starts Nov. 1 will pay less than $75 a month after they receive tax credits, a government analysis released Monday shows.

The Centers for Medicare and Medicaid Services also reported that for this third open enrollment about 80% of consumers shopping again on Healthcare.gov will be able to pay less than $100 a month after tax credits.

Healthcare.gov covers the 38 states that don't have their own exchanges selling individual policies for next year.

The new report did not address the important issue of total out-of-pocket costs, which include deductibles, co-payments and other cost sharing. Many people who shop based on premium costs alone can be alarmed when they see how much they have to contribute to their health care on top of their monthly premiums.

"Premiums are a part of the picture but not the whole picture," says Eric Gashko, assistant vice president for government affairs at the National Health Council, which represents people with chronic conditions.

For people like the council's members, cost sharing is "often times a bigger driver of the cost than the premium would be," he says.

For 2016, more than two thirds of counties will have three or more insurance companies selling plans. USA TODAY has found the plans with the highest deductibles were in areas with the least competition among insurers.

ACA plan deductibles vary wildly, challenging consumers

In more than 300 counties across 11 states on the federal exchange for 2015, USA TODAY's analysis found there were fewer choices of low deductible plans. While the minimum deductible cost inched up only a few hundred dollars in some cases, they became much higher in other areas, especially across much of Kansas and parts of Texas.

The average rate increase in 30 of the largest insurance markets — which cover about 60% of the consumers in the 38 states —  is 6.3% for second lowest-cost silver plan, which is considered the benchmark plan used to determine tax credits. Across all markets in the 37 states using Healthcare.gov for 2015, the cost of the benchmark plan will increase an average of 7.5%.

That's up from an average increase of 5% for 2015. It doesn't include tax credits, which averaged about $270 a month in 2015. Tax credits are available to consumers earning up to 400% of the federal poverty limit, which is about $95,000 for a family of four.

Those who receive tax credits can buy plans in any of categories —  platinum, gold, silver or bronze — but those who receive subsidies that reduce the amount of cost sharing they owe have to buy silver plans.

Health insurance premiums for people buying individual coverage from 2008 to 2010 — before the Affordable Care Act — grew an average of more than 10%, according to a report last year by the Commonwealth Fund.

CMS also said a new analysis based on the second open enrollment found that those returning consumers who switched plans within the same metal tier saved an average of nearly $400 on their 2015 premiums after tax credits as compared to those who stayed in their same plans.

Kevin Counihan, Healthcare.gov's CEO, says that shows it pays to shop around.

The new federal report focused on silver plans, which Gashko says can be indicative of the premium prices. He also echoed Counihan's suggestion that it pays to shop around, adding that people with chronic health conditions, such as diabetes, cancer or heart disease, tend to choose gold or platinum plans because they offer lower out-of-pocket costs.

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Tell us your plans for insurance in 2016 at healthinsurance@usatoday.com