WASHINGTON -- Millions of people who pay the full cost of their health insurance will face rising premiums next year with no financial help from government subsidies.
Renewal notices bearing the news will go out this fall.
"I don't know if I could swallow another 30 or 40 percent without severely cutting into other things I'm trying to do, like retirement savings or reducing debt," said Bob Byrnes of Blaine, Minn., a Twin Cities suburb. His monthly premium of $524 is already about 50 percent more than he was paying in 2015, and he has a higher deductible.
President Barack Obama's health law provides income-based subsidies for consumers who buy individual policies on healthcare.gov and state insurance markets. About 10 million people get assistance, helping reduce the uninsured rate to 9 percent.
But there's no subsidy for those making more than $47,520 for an individual and $97,200 for a family of four -- cutoffs that represent four times the federal poverty level. Also, subsidies are not available for consumers at any income level who purchase outside of HealthCare.gov or a state marketplace. Those who remain uninsured risk fines.
Premiums are expected to climb next year in many areas as insurers report financial losses under the health law. Enrollment has been lower than anticipated, new customers were sicker than expected, and a government system to stabilize the markets had problems.
"People receiving subsidies can protect themselves from premium increases, but others who buy their own coverage don't have that option," said Larry Levitt, who tracks the health law for the nonpartisan Kaiser Family Foundation. He estimated 5 million to 7 million consumers nationally may be paying full freight.
Byrnes, a manager for a medical courier service, says he supports the law's goal of expanded coverage, but he hasn't found his policy particularly affordable.
In the small East Texas city of Lufkin, Kirk Smith buys his policy from the only insurer available, which also happens to be the state's largest.
Blue Cross Blue Shield of Texas seeks an average premium increase of nearly 60 percent for 2017, and Smith says his monthly bill of about $350 is already as much as a car payment. Moreover, he's had to drive to a neighboring county for medical care because he couldn't get an appointment close to home.
"I've got a problem when you can't see somebody in the county, and they want an increase?" said Smith, who works for a contractor installing telecommunications equipment. He said the government should subsidize everyone in rural communities with no insurer competition.
Michelle Scarola of Queens, a borough of New York City, said she has received notice that her 2017 premiums will be going up in a range of 8 percent to 25 percent. Scarola, who's in the midst of a career transition from advertising to interior design, isn't happy that her insurer dropped the hospital network she wanted.
"For people like me who are in the middle, there is very limited choice, and now that limited choice is going to get more expensive," she said.
Insurance broker Liz Gallops in Raleigh, N.C., said she tries to let customers vent about premium increases. Some see insurance bills that surpass their mortgage payments. The state's biggest insurer is proposing average increases of nearly 19 percent.
"I've had people yell on the phone," she said. "I've had people curse."
In 2010, the Obama administration used public anger about premium increases as leverage to help win passage of the health law. It now says worries about next year's premiums are premature because final rates have not been approved.
Officials said some people buying directly from an insurer might find that they qualify for subsidies if they go through HealthCare.gov. Those who make too much for a subsidy still can shop for lower premiums. Under the health law, insurers have to accept consumers with health problems. People are no longer locked into a plan indefinitely.
Another wrinkle is that people who pay their own premiums may be able to deduct the cost on their income taxes. But the rules are complex, and it's not the same as getting an upfront subsidy.
The law created one big insurance pool in each state for consumers buying individual coverage, whether or not they go through markets such as HealthCare.gov. That has led to premium increases even for people who get no financial assistance.
People trying to save money have few options. Those who switch to skimpier coverage to save on their premiums risk bigger medical bills if they need treatment. Some insurance brokers encourage customers to get plans linked to a health savings account, but rising premiums can cut into how much customers stash away.
Information for this article was contributed by Eric Carvin of The Associated Press.
A Section on 06/13/2016