What’s happening right now is that people who have bought policies in the individual market are beginning to get letters from insurance companies advising them of rate increases. Policyholders pinched by these increases are not likely to listen to White House messaging about the ACA reducing healthcare costs or making insurance more affordable.

Before Christmas, Blue Cross Blue Shield of Nebraska warned 80,000 customers in the individual market that their rates were increasing about 10 percent on average, but they could avoid the increase if they increased their deductibles or coinsurance and co-payments. In neighboring Iowa, Susan Voss, the insurance commissioner, approved a 12 to 13 percent increase for Wellmark Blue Cross and Blue Shield earlier this year, affecting 150,000 residents. Voss said the rate hikes were justified and would continue until healthcare costs were under control. Aetna just sent a letter to its individual market customers announcing higher premiums because “costs for services provided by hospitals, doctors, and drug companies have gone up significantly.” The company also cited new fees and taxes imposed on health insurance to help pay for subsidies for the uninsured. “Aetna began adding these taxes and fees to premiums in select states in the first quarter of this year,” the letter said.

In her remarks admitting rate increases would be coming, Sebelius said she is “a believer in the market strategies that will minimize the rate impact.”

Just what are those strategies and what do they mean for people receiving “Dear Customer” letters from their insurers? How do we step back and untangle Insurance company spin, White House spin, and the spin of all the interested parties to help ordinary people find their way to affordable healthcare in a new geography. They need help, and that’s where journalists come in. In subsequent posts, I will try to help sort all this out.


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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.