Similarly, Republican Senator Rand Paul of Kentucky during his brief cameo in Cruz’s Senate Speech: “We went through this whole debacle of giving people Obamacare and it is going to be expensive. Everybody is going to pay more. Many people still will not have insurance. The ones who do have insurance are going to pay more.” How much an individual’s insurance costs will change because of Obamacare depends on a whole host of factors. It depends on age, current health status, state of residence, and of course, whether the individual (or family) was insured before purchasing a policy via the Obamacare-mandated insurance exchanges.
For example, those who are uninsured and have a preexisting condition will likely pay less for coverage than they would in the current private market. Without accounting for subsidies, those who are uninsured but young and healthy will likely pay more; those who are insured through their employers will likely experience few changes; and some 13 million Americans who are currently uninsured will pay little to nothing because they will become eligible for Medicaid. Plus, a vast majority of those buying plans on the individual exchange — 80 percent, according to the Congressional Budget Office, will receive subsidies of varying amounts to make insurance more affordable.
In general, exchange premiums also reflect insurers’ estimates of the cost of offering the new benefits to people: the plans offered on the exchanges must meet certain regulatory requirements, surcharges based on health status will be eliminated, premium variations based on age will be limited, and the three-year long, $10-billion reinsurance pool will theoretically insulate insurance costs from the shock of offering coverage to those previously uninsured customers or those who were enrolled in high risk plans.
As for states, premium increases can vary not only because each exchange has attracted a different number of insurers, but because states have regulated the insurance market for more than one hundred years and have developed different standards. For example, insurers operating in New York were not allowed to sell so-called bare bones plans, meaning that to adjust these plans to comply with Obamacare standards, which require insurance to cover a minimum set of benefits like maternity leave and mental health, insurers had fewer changes and fewer costs to add.
Plans are no longer able to charge more based on health status or gender, but they can vary based on geography, tobacco use, and age. Still, Obamacare regulations prohibit insurers from charging an adult 64 or older more than three times the premium charged a 21-year-old for the same coverage. Younger adults, who are less risky to insure, will likely see the greatest increases because their premiums are meant to balance out the medical costs of those older and sicker insurance consumers who are more likely to use their benefits.
An August 2013 RAND study, sponsored by the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, calculated that there would be “no widespread trend toward sharply higher prices in the individual market.” Rather, rates would likely vary from state to state and based on individual circumstances.