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Impact of Regulations
on Health Insurance Company Premiums

$34,300 to $47,700 per year premiums:
an example of sky-rocketing costs when tough regulations are applied … as already clearly demonstrated in the state of New York


Summary

The state of New York has regulations on insurance companies that are similar in concept to what the U.S. is now placing on all insurance companies in all states, as per the Affordable Care Act of 2010, also known as Obamacare or Obama's health care law.

A family in Allegany County, one of the poorest counties in the state of New York, can buy a health insurance plan with the range of yearly costs shown above. The variation is largely based on whether one purchases an HMO plan or a PPO plan, where the latter provides more benefits. The cost of the latter is not much different than the entire median family income for a year in the U.S.

Minimum Cost; Only the Premiums

There are some advantages to paying the higher amount via a PPO plan: the health insurance plan does not ration your care quite as much as being within an HMO. However, it does not eliminate in-network and out-of-network restrictions, co-pays, deductibles and the coinsurance for major medical bills. In other words, the higher cost per year for the more expensive plan is the MINIMUM cost per year.

Putting the numbers on a monthly basis:
     Lowest: $2,860 per month for a family plan
     Highest: $3,975 per month for a family plan
     These rates are for May of 2012, as communicated by the state of New York.

The Cause

The state of New York has special regulations on health insurance companies:

” … New York has addressed the problem of underinsurance by requiring, through regulation, that insurers provide adequate benefits. Also, they must accept anyone, regardless of health status (though they can enforce a waiting period to prevent individuals from waiting until they need care to apply for coverage). Innovative insurance products that keep premiums competitive by shifting significant costs to the insured are prohibited in New York.”

Sources and Additional Information

Comments about the regulations: PNHP article of April 28, 2009
http://www.pnhp.org/news/2009/april/new_york_hmopos_dea.php
New York health insurance rates for Allegany County:
— November 2011 (pdf file)
http://www.medicareforall.org/files/New York__Allegany County ins rates 2011 11.pdf
— current rates for Allegany County:
http://www.dfs.ny.gov/insurance/hmorates/pdf/Allegany.pdf

Insurance rates for all counties in New York state:
http://www.dfs.ny.gov/insurance/ihmoindx.htm

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