Over the last five years, with movement from non-managed care to almost all managed care plans exclusively, there was a downward force that reduced rates. But now the rates have stabilized and they are starting to go up again. The problem is the fact that the legislature was concerned about complete access but did not factor for overall affordability. There is no denying that the modified community rating has worked better than the strict community rating for individual plans, but work has to be done so that plan affordability can work for everyone. In all of the above experiments certain similarities in approach as well as result should give us pause before embarking on changes of national proportion.
Community rating causes premiums of the younger and healthier population to dramatically increase.
Older less healthy people may experience rate reductions, but only in the short term. It is not long before the young and healthy drop out and what is left is a less healthy older population. In every real world case, community rating has increased the number of uninsured and increased the cost for those remaining in the pool. State mandates have also dramatically reduced the numbers of insureds by increasing the cost of insurance. Many people have been forced to drop coverage that they desperately need but simply cannot afford.