Obamacare is the talk of the nation after the Department of Health and Human Services released a report detailing average premium prices for the insurance market's plans across the United States. Prices vary between Obamacare's four coverage tiers of bronze, silver, gold, and platinum, but the average mid-tier silver plan without any subsidies will cost $328 per month, according to the government report. That's a positive according to the administration, which claims that prices are around 16% lower than expected and that 95% of all purchasers live in states with lower-than-expected premiums.
Depending on what state you live in, however, you could be paying a lot more -- or less -- than average Americans. Massachusetts, Hawaii, and Kentucky have yet to release their premium prices, but some state residents will be paying a pretty penny for even the least-expensive bronze plans on the markets. Out of the47 states and the District of Columbia's cheapest bronze plans on a weighted average by state, here are the five most expensive states to live in if you're in the market for Obamacare.
No. 5: Vermont, $336 per month
If you live in Vermont, be prepared to shell out more than three Franklins per month for the state's lowest-cost bronze plan before any subsidies kick in. The state offers some benefits over others -- notably, Vermont's premiums don't differ across age groups, providing some comparative benefit to seniors. But if you want more coverage than what the bronze plan allows, you'll be paying an extra $59 per month for the state's lowest-cost silver plan at $395 per month for the next highest tier of coverage.
Vermont is a small state, so there aren't a lot of options for consumers. Cigna's (CI +0.00%) vying against Blue Cross and Blue Shield of Vermont and New York-headquartered MVP Health Care for the state's consumers, but the company's battling against negative PR in the race for the Green Mountain State's insurance dollars. Last year, the company had the most denied claims on a percentage basis out of the three biggest insurers in the state, denying 21% of claims. That'll make it tough for Cigna to win over the hearts of savvy consumers, but the company's national reach makes Vermont a minor piece of the pie.
No. 4: Connecticut, $340 per month
Speaking of Cigna's reach, the company's headquartered in Connecticut -- the state where you'll pay the fourth-highest monthly premium for the lowest-cost bronze plan in the U.S. Tack on $57 more per month if you're looking for a silver plan at $397 a month. Connecticut is the fourth-wealthiest state in the country by GDP per capita, however, making up for some of the pricing pain.
A lack of competition hasn't helped to keep the state's prices down. Cigna might be based in the Constitution State, but the company opted out of Connecticut's health insurance exchange, forgoing the chance at an estimated 200,000 state residents expected to buy insurance. It wasn't the only company to do so: Aetna (AET +0.00%), America's third-largest publicly traded insurer by membership, also skipped out on Connecticut's exchange after reportedly being unable to agree with state regulators on pricing.
UnitedHealth (UNH +0.10%) also abandoned Connecticut's individual exchange. However, the country's largest publicly traded insurer by membership has stuck around for the state's small-group exchange. However, the state's small population means that it won't be a major piece of any insurer's financial approach to health care reform, particularly among larger companies like UnitedHealth. Considering that both UnitedHealth and Aetna passed on California's individual exchange system despite a significantly larger opportunity to capture members, Connecticut's hardly a compelling opportunity for either company.
No. 3: Mississippi, $342 per month
For having the U.S.'s lowest per-capita GDP on a state-by-state basis, Mississippi's shelling out a lot for health care. The Center for Mississippi Health Policy projects 54,000 adults will pick up coverage through the state's exchange, although they'll pay significantly for a silver plan: The lowest-priced plan in the next tier of coverage will cost another $61 on top of the cheapest bronze's price for a total of $403 per month.
Mississippians will likely qualify for more subsidies than in many states due to the state's poverty levels, but don't expect a lot of competition here. Blue Cross and Blue Shield of Mississippi long has dominated the Magnolia State's insurance scene, but the only two companies planning on participating in the state's exchange system are Humana (HUM +0.13%), which will offer plans across 40 state counties, and Centene's Magnolia Health Plan. Humana plans to enter 14 different state exchanges across the country, so Mississippi's impact on the company's costs due to the state's poor health will be lessened.
The state's insurance commissioner, Mike Chaney, cited Mississippi's lack of companies offering health care, along with its lack of wealth and high prevalence of health problems such as diabetes, to contributing to its pricey premiums. For Humana and Centene, the state's combination of poverty, low wealth, and rural population don't make it a very attractive or lucrative target when compared to more heavily populated or wealthier states.
No. 2: Alaska, $385 per month
Alaska's surprisingly one of the richest states in the U.S.: The state's GDP per capita is the third-highest in the U.S. But residents will be using that wealth to pay heavily for Obamacare's premiums on even the lowest-cost bronze plan. Expect to pay even more if you're in the market for better coverage, with the state's cheapest silver plan costing a whopping $89 more at $474 per month.
With a small population and only several significant cities, Alaska's not a major target for the country's biggest health insurers. A lack of competition's likely due in part to that high cost. Only two insurers, Primera Blue Cross and Blue Shield of Alaska and Moda Health, are vying for Alaska's insurance consumers on the new exchange.
No. 1: Wyoming, $425 per month
Wyoming's the third state on this list to rank among the top five states for GDP per capita, so residents of the U.S.'s smallest state by population will be better suited on average to pay for the highest price in the country for the cheapest bronze plan offered. There is good news, however: The Department of HHS estimates that after the tax credit, a Wyoming family of four with an annual income of $50,000 will pay only $81 per month for the cheapest bronze plan.
But if you're looking for more substantial coverage, be prepared to fork over a handful of cash: Wyoming's cheapest silver plan will cost $489 on average. The state's insurance commissioner, Tom Hirsig, echoed the comments of his colleague in Mississippi, citing Wyoming's small and mostly rural population as behind the state's pricey plans. Wyoming's plan is more of a mess, however: Officials have yet to even announce the firms that will compete for the state's uninsured even as federal regulators plan to bring the exchange online by Oct. 1. Hirsig expects Blue Cross and Blue Shield of Wyoming and WINHealth, an insurer in the mountain region, to compete for the share. For Wyoming residents, however, Obamacare's still very much a situation in flux.
Big costs on the way
One theme in common among the five most expensive states for Obamacare: All have small populations that have promoted a lack of competition in insurance exchanges. For sizable health insurers, such as UnitedHealth and Aetna, states like Mississippi and Alaska aren't strong markets to compete in for the previously uninsured, particularly as many questions remain over Obamacare so close to its rollout. The top insurance companies and their investors are relying on their already sizable membership bases to carry them through the possible upheaval of health care reform's launch.
For average Americans, however, one thing's going to change: Health care reform's going to cost them one way or another, either through the individual penalty for lacking insurance or the price of premiums hitting the nationwide exchanges.
