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Health insurance costs an increasing burden on families

7 Investigates the reasons behind rising health insurance rates and how they're impacting Idaho families.
Buying health insurance coverage has grown more complicated and expensive in recent years.

BOISE – Across the Gem state, Idahoans are making important decisions for their families -- which insurance plan will cover their medical needs for next year. It's a choice that some say has grown more complicated and more expensive since the Affordable Care Act went into effect.

In fact, we heard from dozens of people on social media about the changes they've noticed in healthcare coverage recently.

A BIGGER BURDEN

One Boise resident, James McLaughlin, said he could not believe how much his costs keep going up.

"The word I could use is disheartening," said McLaughlin.

Every year, McLaughlin follows his healthcare costs closely, keeping track of every change.

He's insured through a group plan with his employer and says since 2011, the cost to cover wife and three kids has risen 53 percent.

"It's nice to have the coverage, don't get me wrong, it's actually a really good plan that we're on, it's just the fact that it's costing more and more to get a little bit less it seems like each year," said McLaughlin.

We took the concerns to long time insurance agent B.G. Davis. He says although each family his company deals with is unique, prices across the board are definitely going up.

One reason is that plans must now include the ten essential benefits.

"There is no more rate levels, there's no more qualifying for coverage, no more waiting period for pre-existing conditions, the age and rate of the plan you're looking at is what it is, no questions asked," said Davis.

REASONS FOR RISING RATES

Davis says there are many other reasons for the increase. He says the cost discrepancy has narrowed, the rates are now the same for men and women, and he says premiums will now go up about ten percent just because you're a year older.

Davis says calculating a person's rate has changed completely.

"It doesn't matter what your health is, we have a couple clients that are cancer stage four and their rate is exactly the same now, as it is for anyone in the ACA and might be an Olympic athlete running the Boston marathon, it's exactly the same," said Davis.

Davis went on to say group plans are divided into several categories -- some are grandfathered in, while there are some are new ACA options.

He says in general, he's noticed an average spike of about ten to twelve percent from 2014 to 2015.

"So what the employer is doing is cutting back the amount he's paying for the employee, and if he was paying some or all of the dependent costs, he's cutting that back as well," said Davis.

REGULATION AND MONITORING

We wanted to know how the plans are regulated and if anyone is monitoring the rise in premiums.

The Idaho Department of Insurance says there are more regulations surrounding individual plans than group policies.

They also say there is no limit in place as to how much premiums can go up each year.

"The Idaho law is pretty flexible because what our rates and forms staff look at is are those rates sufficient to pay the claims, not too high and not too low," said Bill Deal.

Director Bill Deal says they use three factors when approving plans, making sure they aren't inadequate, excessive, or discriminatory.

"What we're looking for is rate adequacies, so that would be the guide that we use," said Deal.

But for McLaughlin and his family, no matter the reason, it's a rise that he says is becoming unbearable.

"The emotional side of it is kind of hard to deal with because you're paying so much for something you may not use," said McLaughlin.

We asked the Idaho Department of Insurance the average increase in plans for next year, but were told it's something they don't track.

Nationwide, the Washington Times recently reported that a study found prices for some groups increased as much as 78 percent, since before the Affordable Care Act passed.

RELATED:Officials: Idaho's exchange a smooth launch

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