Studies show that up to 15 million Americans (6%) have a personal health insurance plan (also called an individual or family health insurance plan). This includes the self-employed, small business owners, employees with a pure defined contribution health plan, and employees without access to employer-sponsored health insurance.
With major provisions of health reform taking effect in 2014, many experts agree the landscape of health insurance is rapidly changing for both employers and employees. One of the most significant changes is a shift toward the individual health insurance market. For example, of the 48 million currently uninsured, it's expected that 19 million individuals will be eligible for the new health insurance premium subsidies available through the state health insurance marketplaces.
Starting in 2014, insurers will no longer be able to use gender and health status to set personal health insurance plan premium rates and will be restricted in the amount they can vary premiums based on age, tobacco use, and location.
To provide a baseline of premium rates in 2013, the Government Accountability Office (GAO) examined base premium rates for health insurance on the individual market.
The GAO used individual market rates displayed on healthcare.gov "Plan Finder" in January 2013. Here are their findings.
Personal Health Insurance Base Rates - 2013
GAO reported the range of base premiums prior to underwriting for health insurance in the individual market that were displayed on the HealthCare.gov "Plan Finder" in the month of January 2013 for each of the 50 states and the District of Columbia.
The study provided state by state rates, by age of consumer, and type of plan.
30-Year Old Single Female Base Premium Rates
For a 30-year old single female, nonsmoker, the national average is $222/month. Here is the breakdown for this demographic, by state. These average monthly rates represent plans with median premiums.
|
State |
State |
State |
|||
|
Alabama |
$163 |
Kentucky |
$140 |
North Dakota |
$112 |
|
Alaska |
$186 |
Louisiana |
$163 |
Ohio |
$166 |
|
Arizona |
$119 |
Maine |
$774 |
Oklahoma |
$183 |
|
Arkansas |
$103 |
Maryland |
$223 |
Oregon |
$139 |
|
California |
$186 |
Massachusetts |
$287 |
Pennsylvania |
$201 |
|
Colorado |
$202 |
Michigan |
$118 |
Rhode Island |
$291 |
|
Connecticut |
$198 |
Minnesota |
$128 |
South Carolina |
$227 |
|
Delaware |
$145 |
Mississippi |
$172 |
South Dakota |
$228 |
|
District of Columbia |
$176 |
Missouri |
$171 |
Tennessee |
$182 |
|
Florida |
$129 |
Montana |
$119 |
Texas |
$153 |
|
Georgia |
$143 |
Nebraska |
$178 |
Utah |
$141 |
|
Hawaii |
$441 |
Nevada |
$160 |
Vermont |
$208 |
|
Idaho |
$164 |
New Hampshire |
$176 |
Virginia |
$154 |
|
Illinois |
$181 |
New Jersey |
$1,436 |
Washington |
$168 |
|
Indiana |
$180 |
New Mexico |
$135 |
West Virginia |
$152 |
|
Iowa |
$138 |
New York |
$479 |
Wisconsin |
$144 |
|
Kansas |
$158 |
North Carolina |
$161 |
Wyoming |
$208 |
55-Year Old Couple Base Premium Rates
For a 55-year old couple (two non-smoking adults), the national average is $815/month. Here is the breakdown for this demographic, by state. These average monthly rates represent plans with median premiums.
|
State |
State |
State |
|||
|
Alabama |
$629 |
Kentucky |
$524 |
North Dakota |
$553 |
|
Alaska |
$890 |
Louisiana |
$657 |
Ohio |
$703 |
|
Arizona |
$465 |
Maine |
$2,138 |
Oklahoma |
$832 |
|
Arkansas |
$386 |
Maryland |
$679 |
Oregon |
$624 |
|
California |
$835 |
Massachusetts |
$1,103 |
Pennsylvania |
$856 |
|
Colorado |
$794 |
Michigan |
$463 |
Rhode Island |
$871 |
|
Connecticut |
$871 |
Minnesota |
$547 |
South Carolina |
$954 |
|
Delaware |
$604 |
Mississippi |
$693 |
South Dakota |
$1,031 |
|
District of Columbia |
$799 |
Missouri |
$655 |
Tennessee |
$785 |
|
Florida |
$697 |
Montana |
$521 |
Texas |
$612 |
|
Georgia |
$581 |
Nebraska |
$841 |
Utah |
$571 |
|
Hawaii |
$1,734 |
Nevada |
$675 |
Vermont |
$565 |
|
Idaho |
$704 |
New Hampshire |
$842 |
Virginia |
$635 |
|
Illinois |
$627 |
New Jersey |
$2,926 |
Washington |
$794 |
|
Indiana |
$747 |
New Mexico |
$567 |
West Virginia |
$702 |
|
Iowa |
$642 |
New York |
$828 |
Wisconsin |
$586 |
|
Kansas |
$660 |
North Carolina |
$702 |
Wyoming |
$1,021 |
Study Methodology
The GAO examined the range of premiums for the individual market that were displayed on the HealthCare.gov "Plan Finder", which reflected insurers' base premiums prior to underwriting.
The data included insurers’ base premiums for health plans that were publicly available to consumers through the Plan Finder in the month of January 2013. The base premium amounts and supporting plan information were self-reported by each insurance company, and each company was required to comply with a data validation and attestation process. However, the analysis may not reflect the entire universe of insurers’ base premiums because roughly 20 percent of all insurance companies did not submit data.
The base premiums displayed on the HealthCare.gov Plan Finder reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS).
Read the full GAO study and methodology notes here.
What do you think? Are these rates found in the GAO study reflective of personal health insurance rates in the individual market? Let us know in the comments below.
