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Taming ACA. Premiums

Make adjustments of Health Care Law

Special to The Chronicle

The Affordable Care Act has improved and expanded health insurance to cover millions more Americans. But it is far from perfect, and the sharp increase in premiums for plans sold under the program shows some of the problems that the next president and Congress need to fix.

Premiums will increase by 25 percent on average for midlevel plans next year, according to the Department of Health and Human Services, but most Americans will be largely insulated from price increases by federal subsidies. About 85 percent of the 10.5 million people who bought insurance through the online health exchanges this year received subsidies; that proportion is likely to increase in 2017 as premiums rise.

Premiums are going up because many insurers underpriced plans when they started selling policies in 2013; not enough healthy, younger people signed up; and those who did used more medical care than the insurers had anticipated. As a result, companies like UnitedHealth and Aetna have stopped selling health plans in many parts of the country and the providers that remain have raised prices. Premiums have gone up most in states like Alabama, Arizona, Oklahoma and Tennessee that have three or fewer insurers selling Affordable Care Act plans.

Premiums are rising much more modestly in states where there is more robust competition among

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