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Affordable Care Act: Feds unveil premiums on state exchange

Wednesday, Sept. 25, 2013 11:27 AM
Last updated Thursday, Sept. 26, 2013 1:04 AM
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A family of four in Atlanta with an income of $50,000 per year can buy the cheapest “bronze” plan in the upcoming health insurance exchange for $138 per month.

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A 27-year-old living in Georgia who makes $25,000 per year will pay $103 per month for the lowest-cost bronze plan and $145 per month for the second-lowest-cost silver plan, taking into account the subsidies, or income-based discounts, they would receive.

The average premium for the lowest-cost silver plan will be $304, and for the cheapest bronze plan it will be $265 in Georgia, lower than the national average. Those prices don’t take into account the subsidies.

On Wednesday, the U.S. Department of Health and Human Services released the prices of health insurance in the exchanges in Georgia and 35 other states where the exchanges are being run by the federal government. The exchanges are a key component of the Affordable Care Act in the Obama administration’s drive to have more uninsured gain coverage.

Nineteen percent of Georgians currently have no health insurance.

Premiums nationwide will be about 16 percent lower than originally expected, HHS said Wednesday. About 95 percent of eligible uninsured individuals are living in states with lower-than-expected premiums, before taking into account the subsidies that are based on income

Bill Custer, a health insurance expert at Georgia State University, told GHN on Wednesday that because premiums are lower, the cost to the federal government for subsidies will be lower as well. “The costs of Obamacare are less than projected,’’ Custer said.

“Nationwide, these premiums look like what large employers are paying now’’ for health insurance, Custer said.

Oct. 1 will mark the beginning of an open enrollment period that runs for six months, through March 2014. Coverage begins as early as Jan. 1, or 100 days from today.

Plans in the Georgia insurance exchange, or marketplace, are categorized as either “gold,” “silver,” or “bronze.” These vary by the amount of cost sharing — how much the customer must pay in annual deductibles and copayments.

Bronze covers 60 percent of expected costs; silver, 70 percent. Bronze plans have the lowest premiums and the highest cost sharing.

Young adults will also have the option of purchasing a “catastrophic” plan, further lowering their premiums.

The subsidies for younger adults can be substantial. Statewide, the average subsidy for an individual age 26 to 35 choosing a bronze or silver plan would be $316 per month, Custer said.

And the maximum an individual making $12,000 a year would pay for a bronze or silver plan is $20 per month, after the subsidy is counted, Custer added. For a person earning $24,000 in income, that individual would pay no more than $132 per month.

One-third of individual health insurance plans are bought by young people currently, Custer said. Many of them will end up paying a lower cost in the exchange, after the subsidy is included, he said.

Consumers can get help finding coverage through a number of different resources. They can get more information through HealthCare.gov, or in Spanish through cuidadodesalud.gov.

There will also be people in local communities who can provide in-person help with coverage choices.

An analyst told the Associated Press that the administration analysis of premiums is consistent with what the 14 states running their own insurance markets have reported.

But Dan Mendelson, president of the market analysis firm Avalere Health, said the focus on premiums is too narrow. “The analysis doesn’t account for cost sharing,” Mendelson told AP. “This is a limitation.” To get an idea of the true cost of coverage, consumers have to add up premiums and their expected out-of-pocket costs.

“Consumers are going to need to shop,” Mendelson added. “Sometimes a silver offering doesn’t cost much more than a bronze.”

He added two other caveats: Be ready for significant cost sharing, and check carefully that your doctors and nearby hospitals are in the plan’s network.

Custer noted that individuals don’t qualify for a subsidy if they are eligible for any other insurance coverage. So an individual isn’t eligible for this discount if that person’s spouse is offered family coverage through an employer, he said.

For more from Georgia Health News, go to www.georgiahealthnews.com.

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fedex227
11192
Points
fedex227 09/25/13 - 07:04 pm
4
8
One recent poll I found interesting ...
Unpublished

according to a Fox News poll conducted on 9/25/13, when republicans were asked if they supported the "Affordable Care Act", the result was 22% in favor (not very robust to be sure). But when the same people were asked if they supported "Obamacare", it dropped to 14%. Quite telling.

happychimer
22025
Points
happychimer 09/25/13 - 07:04 pm
3
5
Riverman Obama care benefits

Riverman Obama care benefits Medicare. One is the price of prescription drugs.You can find answers to your questions on healthcare.gov and medicare.gov

allhans
25528
Points
allhans 09/25/13 - 08:27 pm
5
2
Regarding prescription D, I

Regarding prescription D, I have RA and my medication is quite expensive, yet I have never reached the so-called "do-nut hole" and I wonder just how many people actually do. I this part of ACA is way over-blown.

happychimer
22025
Points
happychimer 09/25/13 - 08:44 pm
4
3
If you have name brand drugs

If you have name brand drugs they can be expensive. I have 3 that there are not generic.Istill get a big discount on those 3. My others are generic and cost very little.

Humble Angela
41338
Points
Humble Angela 09/26/13 - 06:22 am
5
2
fedex.....the average
Unpublished

fedex.....the average democrat polled isn't exactly a rocket scientist either....just listen to them supporting Obama just because it's Obama....also quite telling.....Let's be fair and balaned now.

http://www.youtube.com/watch?v=gpv0lPz-pd4

ColdBeerBoiledPeanuts
14902
Points
ColdBeerBoiledPeanuts 09/26/13 - 07:01 am
4
2
Charts

Why don't they just publish a chart, showing plans, incomes and costs.
That way you can look at the different plans, your income level and the costs and benefits to see just how screwed you'll be! A lot of businesses are telling people to remove their spouse from coverage because the company their spouse works for offers a minimal amount of coverage. Let's say you have a company sponsored insurance plan that pays 95% and have you and your working spouse on it. Their plan covers 50% but costs the same as yours. Is this starting to sink in?

GnipGnop
13079
Points
GnipGnop 09/26/13 - 07:37 am
5
2
Why doesn't congress fall under the same plan they want me to

fall under? Because they know it stinks and they want no part of it. More reason to switch to Libertarian!!!!

Humble Angela
41338
Points
Humble Angela 09/26/13 - 07:48 am
5
2
CBBP, it sank in long ago to
Unpublished

CBBP, it sank in long ago to people who read the law....those who support it no matter what are a little slow on the uptake.

nocnoc
57174
Points
nocnoc 09/26/13 - 07:55 am
6
2
BREAK IT OUT

Show us the costs for different Age Groups BEFORE it becomes LAW.

All we are seeing are the projected costs of the Healthist age group.

Humble Angela
41338
Points
Humble Angela 09/26/13 - 07:57 am
6
2
nocnoc....not to mention they
Unpublished

nocnoc....not to mention they are only showing the rates for the cheapest plan, and show NONE of the benefits, deductibles or copays.

Bizkit
42003
Points
Bizkit 09/26/13 - 10:10 am
4
2
Why are the younger folks

Why are the younger folks premiums lower than imagined-I thought the whole idea is to get lots of young folks who will pay higher than normal premiums to offset the aged. And what's with the subsidies and offsets-that costs will be paid by the taxpayer. Seems this plan is the hide the bean under the three cups scenario. Over 50 percent of our young don't support Obamacare- I guess they don't want to pay their fair share.

GnipGnop
13079
Points
GnipGnop 09/26/13 - 01:09 pm
2
1
Lots of Koolaid drinkers....

Anything the giverment "REGULATES" gets worse. The phone company, gas company, cablevision. Ever had any dealings with SSI, Tag Office, Driver's License Office or the IRS? You really want these people deciding your healthcare? I bet within 5 years you will be sorry.....

Bizkit
42003
Points
Bizkit 09/26/13 - 03:50 pm
2
1
It's amazing what can change

It's amazing what can change in a generation 1960 gas 30 cents now over 3 dollars. I think the govt wants young folks to get use to paying higher taxes and more to the govt-you know start em off right. Pay for health care they don't really need (as most are healthy) so what next to pay for that they don't really need, and taxes start em at 35% so you can move em up to 45-50% of their income with more dependence on the govt. Wow its going to be great to have Obama's dream come true. We can redistribute everything for some social justice -hey maybe ship the white folks back to England and give all their wealth to all the african-americans so that the white man can be saved and go to heaven without the sin of slavery over their heads. Isn't that what Reverend Wright preached?

Bizkit
42003
Points
Bizkit 09/26/13 - 04:00 pm
1
1
Dang that was a pretty

Dang that was a pretty inflammatory rhetoric post and nada. Tough crowd. I'm offended by it.

chascushman
6653
Points
chascushman 09/29/13 - 09:02 am
1
0
"Riverman Obama care benefits
Unpublished

"Riverman Obama care benefits Medicare."
happy, not according to all 3 of my doctors. One of them has already stopped taking any new Medicare patients and one of them is thinking about retiring because of Obamacare. They said the amount Medicare pays is being cut by Obamacare and the paper pretty much doubled.

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