[McClatchy DC] Insurers, regulators prepare to negotiate 2015 health coverage costs

By Tony Pugh

May 20, 2014

The risk pools in these 24 states need these healthy people, who are cheaper to insure, to help offset the cost of sicker, more costly plan members. Without them, these states might experience rate hikes next year that are 10 percent larger than those in other states, said John Bertko, a retired senior actuary for the Centers for Medicare and Medicaid Services.

“Not all of them will, because every state’s a little bit different,” Bertko said. “It all depends on the amount of enrollment they got during the open enrollment period.”

Bertko said the new hepatitis C drug cocktail, Sovaldi, might lead insurance premiums to rise up to 1.5 percent all by itself. Manufactured by Gilead, a top maker of AIDS drugs, Sovaldi has been shown to cure hepatitis C. But at $1,000 a pill, a 12-week course could run $84,000, he said.

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