SAN DIEGO (KGTV) – Open enrollment for medical insurance is right around the corner.
“Health insurance premiums are going up for a variety of factors,” Glenn Melnick, a professor at USC Price School of Public Policy, said. “One of the biggest factors is rising hospital prices in California.”
But, paying for it is going to get more expensive.
“It's happening really across the board. Employer plans, premiums are increasing as well as in the Healthcare.gov and the non-group marketplaces,” said Naomi Zewde, an assistant professor for UCLA Fielding School of Public Health.
ABC 10News spoke to these two health policy experts from their respective universities on the rise in premiums with the upcoming open enrollment.
Outside of hospital care, both experts mentioned the new weight loss drugs are impacting the cost to get care.
For those who are covered under the Affordable Care Act, there’s another direct impact to premiums.
There’s looming fallout of ACA subsides with the "Big, Beautiful Bill” passed by President Donald Trump as Democrats in Congress are trying to extend those subsides which is a part of the reason for the government shutdown.
“If that law stays in place then those folks are facing huge increases in their premiums, not just incremental, but actually huge increases because of the loss of those subsidies,” Melnick said.
KFF, a nonprofit health policy research, polling, and news organization, is reporting ACA insurers are raising premiums by roughly 26 percent.
“My assumption would be that when people are opening that website and checking what the premiums are, that there might be a little bit of sticker shock reflecting the fact that they're no longer getting these heightened subsidies,” Zewde said.
So with these rising costs, how do you make sure you aren’t breaking the bank when you need help fixing a broken bone, a common cold or something much worse?
“Most people, basically they put open enrollment on autopilot,” Melnick said.
Melnick said don’t do that but rather, spend some time researching a health care plan that’s curated to you and your family’s needs.
“But basically, they should figure out what is the total cost to our family next year under these three options, and that includes, out of pocket costs, cost sharing for the premium, out of network, so kind of projected utilization,” Melnick said.
It’s very similar stance for those who are using ACA as well.
“They should do the same thing, which is go through the options that are available to them in their zip code and figure out how much did they use last year, them and their family, and are there other options that are going to be less expensive,” Melnick said.
