Insurance companies trying to get even LOWER actuarial values for ACA exchanges approved

[bornskeptic]

11. Deductibles are a major factor in figuring actuarial value of a plan.

Calculating actuarial value takes into account the size of seductibles, copayments, coinsurance, and any limit on out of pocket expenditures. There are many quite different ways a 50% actuarial value plan could be structured. It could have a low deductible with high coinsurance and copays, or it could have a high deductible with all expenses beyond the deductible covered. Even if plans with a lower actuarial value were allowed, though, the maximum out of pocket cost would still be set at the same level, which is about $6000 annually, except that that is reduced somewhat for people in lower income brackets. For young healthy piople with good incomes, a policy with a lower actuarial value may make economic sense. The advantage to insurance companies of having such policies included is not that they make more money on a low actuarial value plan, which they don't, but that it would lead to fwer people efusing to buy conforming insurance, and thus to more policies being sold.