Health insurance provider Optima announced that it will increase health insurance costs for Hampton Roads-area residents next year by hundreds of dollars a month.
Earlier this year, Anthem pulled out of all but a few Virginia county health insurance exchanges. The result is that people living in the Hampton Roads area will only have one health insurance provider -- Optima -- to choose from next year in the private health insurance marketplace. Last week, Optima announced that it will be increasing health insurance prices next year by 81 percent for residents of Hampton Roads.
The most basic laws of economics are supply and demand. When supply for something is low and demand is high, prices tend to skyrocket. Under the Affordable Care Act, Hampton Roads residents -- like the rest of the country -- are legally required to have health insurance. For many, that requires them to go into the marketplace and purchase a plan, either out-of-pocket or with federal subsidies. Since there will be only one provider in the Hampton Roads area next year to offer private health insurance, they get to freely set their pricing. Optima knows that if people refuse to purchase insurance, they will face fines from the federal government.
The result is that many in the Hampton Roads area will end up paying a lot more for health insurance next year. While the price differences will vary, Optima says that a 40-year-old Hampton Roads resident should expect to pay an additional $266 each month for a silver plan. Since silver plans tend to carry the highest deductibles, these people will now have to pay an additional $3,192 next year for health insurance that -- short of getting hit by a bus -- they will likely not even use.
The same is not true for people who purchase private health insurance plans subsidized by the federal government. Lower-income families who qualify for these subsidies should only expect to see their out-of-pocket bills increase by around $4 a month.
"It’s not what we would have loved to have as the outcome," admitted Vicky Gray, the Senior Vice President of System Development for Sentara Healthcare
This price difference is what has made the Affordable Care Act, also known as Obamacare, such a hotly debated issue, both in Southern Virginia and across the nation. While many continue to receive access to lifesaving medical insurance for next to nothing, those forced to pay wholly out-of-pocket are seeing their costs skyrocket. Optima estimates that 30 percent of their members do not receive government subsidies.
This year, Optima signed up 17,000 people onto its health insurance plans. With the vacuum being left by Anthem's departure, Optima expects next year's enrollment to top 70,000. In addition to Hampton Roads, Optima expects to expand coverage to people living in Harrisonburg, Mecklenburg, and Halifax counties, as well as the Charlottesville area.
Optima is a division of Sentara Health, so the company is only expanding to areas that have Sentara hospitals and providers. The company has chosen not to expand to Northern Virginia or Richmond, even though there are Sentara hospitals in those areas. The reason given is that there are already insurance providers in those marketplaces. Then, Optima would be forced to keep their prices competitive.
The rising health insurance costs are not a phenomenon limited to Southern Virginia. Communities across the country are seeing prices jump as fewer companies choose to participate in the Affordable Care Act's individual market exchanges.
This year, Congress came close to repealing the Affordable Care Act, falling one vote short in the United States Senate. President Donald Trump and Congressional Republicans have promised to continue exploring strategies to repeal the law. Congressman Bobby Scott (D), who represents Virginia's 3rd Congressional District, voted against the repeal legislation and has urged his colleagues to fix the broken healthcare law, not scrap it all together.