Health insurance premiums may as much as double for some smallbusinesses and individual buyers in the U.S. when the AffordableCare Act's major provisions start in 2014, Aetna Inc.'s chiefexecutive officer said.

While subsidies in the law will shield some people, otherconsumers who make too much for assistance are in for “premium rateshock,” Mark Bertolini, who runs the third-biggest U.S.health-insurance company, told analysts yesterday at a conferencein New York. The prospect has spurred discussion of having Congressdelay or phase in parts of the law, he said.

“We've shared it all with the people in Washington and I thinkit's a big concern,” the CEO said. “We're going to see some marketsgo up as much as 100 percent.”

Bertolini's prediction is at odds with Congressional BudgetOffice estimates that the law will have little effect on small andlarge-employer plans and the Obama administration's projectionsthat middle-class families will actually save money. The 2010 lawis expected to extend health care to about 30 million people whootherwise couldn't get insurance, paid for by new taxes and fees oncompanies and wealthier individuals.

Those taxes will make coverage more expensive for insurers, aswill other provisions such as a ban on discriminating againstpeople with pre-existing medical conditions, Bertolini said.Premiums are likely to increase 25 percent to 50 percent on averagein the small-group and individual markets, he said, citingprojections by his Hartford, Connecticut-based company.

High Estimate

The one-time jump in rates also includes increases in costs thatwould come even without the law, Bertolini said.

“That just seems silly,” said Gary Claxton, a vice president atKaiser Family Foundation, a Menlo Park, California-based nonprofitthat studies health issues. “I can't imagine anything going on inthe small-group market that would change the average premium thatmuch. On the individual market, there's arguments for thingschanging, but those magnitudes seem high.”

The Obama administration said last year that “middle-classfamilies” buying insurance through the law's new online exchangesmay save as much as $2,300 a year starting in 2014. Nick Papas, aWhite House spokesman, declined to comment on Bertolini'spredictions.

The CBO estimated in 2009 that the law will increase premiums 10percent to 13 percent for individuals and have little effect onsmall and large-employer plans. After the subsidies are factoredin, individual bills will go down by about 60 percent, the agencypredicted.

About 43 percent of people who buy on the exchanges, orindividual markets outside of them, won't be eligible forsubsidies, according to the report. They would see premiumincreases “somewhat less” than 10 percent to 13 percent, CBOpredicted.

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