Insurance changes force some into health exchange for coverage

Blue Cross Blue Shield of North Carolina, the state's largest insurer, expects two-thirds of its individual customers will see rate increases next year similar to those of recent years. The remaining third will see larger increases because of changes associated with the Affordable Care Act, spokesman Lew Borman said.

Under the law, most health plans must cover so-called "essential health benefits," such as maternity coverage and pediatric dental coverage. Some of these items were previously optional, and Borman said more than 200,000 individual and small-group customers must upgrade their coverage to meet the new requirements.

"Some of these essential health benefits, I wasn't paying for those because I didn't need them. But now, I'm required to pay for them in this new plan. I'm never going to use them," Amy Williamson said Tuesday.

Williamson, the controller for a small Web design company, has purchased her own insurance. She said her monthly premiums have been $192, but Blue Cross recently told her she would have to start paying $314 a month for coverage in January.

"I, honestly, was absolutely shocked. I wanted to go on all social media sites and post how mad I was about it," she said.

Borman said the health care law also required various taxes and fees, such as for pharmaceuticals and medical devices, that Blue Cross is passing on to consumers.

Company health plans in place before the law was enacted in March 2010 can be grandfathered in and provide less than the "essential health benefits" as long as no changes are made to benefits or the percentage of premiums paid for by employees.

Because of the premium increase, Williamson turned to North Carolina's online marketplace to shop for insurance.

"I'm keeping my fingers and toes crossed that I'll be able to find something on the marketplace or maybe with another provider besides Blue Cross Blue Shield," she said.

The Affordable Care Act requires each state to have an online "health exchange" where people can compare coverage and cost options from various plans and sign up for coverage.

Angela Caraway, who has a lung condition that has meant expensive premiums, was enthusiastic about being able to shop for insurance through the exchange.

"I've been uninsured for four years," Caraway said. "(The exchange) means an opportunity to feel like I'm part of everyone else who is receiving health care coverage."