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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.

Comments (37) Add comment
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my.voice
4824
Points
my.voice 09/25/13 - 02:16 pm
14
8
Perfect, from the geniuses

Perfect....... From the geniuses who brought you CASH FOR CLUNKERS is your new HEALTHCARE SYSTEM. This should work out nicely.

EDIT: What's up with all the thumbs down? I tell you what, print this article and check back in a year or three when you cant get into see your Dr and let me know how you feel. The GOVT cant manage themselves, much less healthcare!

nocnoc
42682
Points
nocnoc 09/25/13 - 12:03 pm
8
7
OK we now know what the healthist ones pay.

Now tell us the price for a 50-65+ y/o in average health?
and those living on Social Security.

The President said it and has been video quoted ...
Old people should get Pain Pills not corrective surgery.
1:40 into the video.

My Comment is based on Wednesday, Sept. 25, 2013 with NO Updates.

dichotomy
33005
Points
dichotomy 09/25/13 - 12:53 pm
10
3
Notice there is not much info

Notice there is not much info on copays and deductibles. Most who sign up for the bronze and the silver will be surprised what "their share" is if they need any more than their annual checkup.

allhans
23663
Points
allhans 09/25/13 - 01:01 pm
7
3
I notice the deductible was

I notice the deductible was conveniently left out of the article.

allhans
23663
Points
allhans 09/25/13 - 01:27 pm
5
3
A friend called me yesterday

A friend (who is employed)called me yesterday to say that her share in the group health insurance had changed and her cost will now be $215.00 a month with a $10,000
deductible.

happychimer
17659
Points
happychimer 09/25/13 - 01:10 pm
6
4
You can go to the link and

You can go to the link and get more info. If you are on social security you get medicare.

Common.sense
465
Points
Common.sense 09/25/13 - 01:21 pm
5
3
Most people aren't going to

Most people aren't going to qualify for this until their workplace stops carrying insurance because its too expensive. Even fast food restaurants offer health insurance benefits.

happychimer
17659
Points
happychimer 09/25/13 - 01:25 pm
4
5
Most fast food places don't

Most fast food places don't offer insurance to part time workers under 32 or 28 hrs.

allhans
23663
Points
allhans 09/25/13 - 01:30 pm
4
4
By the time a person pays the

By the time a person pays the premiums, the high co-pay, the high deductible....I wonder if they will still say its a good deal.

Graymare
3210
Points
Graymare 09/25/13 - 01:47 pm
4
3
"check carefully that your

"check carefully that your doctors and nearby hospitals are in the plan’s network." If it's a national healthcare plan, then shouldn't all doctors and hospitals be in the network?

happychimer
17659
Points
happychimer 09/25/13 - 01:49 pm
7
4
If their income is low, then

If their income is low, then premiums will be low. I know if I did not have medicare, I would be getting a plan. Many say they can't afford health insurance, but I can't afford not to. I know some who have nice cars, nice phones, internet, big screen tv, and still say they can't afford insurance. They can afford it. They have their priorities wrong.

OJP
6634
Points
OJP 09/25/13 - 01:57 pm
4
10
Those are some pretty good premiums.

Here's to hoping millions more Americans can afford health insurance now via Obamacare.

OJP
6634
Points
OJP 09/25/13 - 02:03 pm
5
9
@nocnoc:

Most Americans on Social Security will be eligible for Medicare (single-payer, universal health care - the kind of health care that we've been told is scary socialism). They will only need supplemental if they so choose.

OJP
6634
Points
OJP 09/25/13 - 02:39 pm
6
6
@my.voice:

Obamacare isn't government-managed healthcare. It is about forcing everyone to enter the PRIVATE health insurance market.

It's been almost four years since it was passed (and more since it was proposed/debated). There shouldn't still be this level of misunderstanding about what Obamacare actually is.

happychimer
17659
Points
happychimer 09/25/13 - 02:40 pm
4
3
I have had plain medicare

I have had plain medicare since Jan. 1st and a prescription plan part D. I am pleased, but will be looking at supplement plans with medicare soon to compare premiums with out of pocket money I put out this year. I might keep it like it is, or I might get the extra.

Humble Angela
41338
Points
Humble Angela 09/25/13 - 03:42 pm
5
4
How much would I have to pay
Unpublished

How much would I have to pay to have the coverage I currently have....you know....like the President promised I could. Will it go up? Yes it will!

OJP
6634
Points
OJP 09/25/13 - 03:58 pm
5
5
@Humble Angela

"Will it go up? Yes it will!"

Source?

Edit: I'm only aware of it being a potential problem if your insurance is employer-based, and your employer switches plans.

nocnoc
42682
Points
nocnoc 09/25/13 - 03:59 pm
7
3
just went to the Gov website to check price

Nothing available to the public until Oct. 1st for the general public in our older age group.

So the amounts quoted and we see above are nothing more than carefully worded pre-released PR data to help sell Obamacare.

Riverman1
84078
Points
Riverman1 09/25/13 - 03:59 pm
3
3
HappyChimer, I'm asking and

HappyChimer, I'm asking and not stating for a fact, my friend, but supplemental policies to Medicare won't have anything to do with Obamacare will they?

nocnoc
42682
Points
nocnoc 09/25/13 - 04:19 pm
2
3
 

 

carcraft
25904
Points
carcraft 09/25/13 - 04:03 pm
5
3
Gee, just look to congress.

Gee, just look to congress. They make over $ 100,000.00 to $ 150,000.00 per year and need a 75% cost subsidy from the tax payer to help cover the cost of their plan. Now if this is so cheap and affordable why did Obama buckle and give the subsidy to them? Don't forget many of them are already millionaires.

nocnoc
42682
Points
nocnoc 09/25/13 - 04:22 pm
4
2
OJP Speaking of Medicare & trust

How many $$$Billions $$$ did the Lberal/Socialists take from it to fund Obamacare?

We documented and actually reviewed the promises made from 2008-2011.
A few like :
Keep our own insurance,
Keep our own doctors,
get the same level of Care we have in the past,
Cheaper,
Will cover the 15 to 20 million not covered.

We now know many of the promises were outright lies and/or they just did not know, because they never read what they signed into law.

-------------------------------------------

While I listen to My Doctor telling me he is handling 3 other practices now because those doctors bailed (retired OCONUS) dumping them.

While I listen to my 3 doctors talking about Medicare payments cut to between $11 and $15 per office a visit.

While I listen to my doctors thinking about dropping all insurance coverages (Private and Public)to avoid the mountain of forms and legal junk imposed, so they can focus on the delivering medical care.

While I am listen to a 2 of my 3 doctors considering only treating a selected number of viable patients in 2014.

So who am I supposed to trust,
My doctors or the Government? Mind you a Government known for stalling and lying repeatedly to the voters and been caught doing so?

Well, I trust my doctors with my life.
Something the Government has proven time and time again it will waste on a whim.

Humble Angela
41338
Points
Humble Angela 09/25/13 - 04:35 pm
7
3
OJP...I will be forced to be
Unpublished

OJP...I will be forced to be dropped from my husband's plan and get my own at my employer...which will cost me more. Source: The ACA.

allhans
23663
Points
allhans 09/25/13 - 08:21 pm
5
2
A medical provider now waits

A medical provider now waits around 6 weeks to get reimbursed by Medicare. The fear is now the wait will be even longer.

I would not think of having only Medicare. A supplement is expensive, a good plan is almost $200.00 a month but for those over 65 it is a necessary expense. The 20-30 percent left unpaid by Medicare can add up ....

Red Headed Step Child
4062
Points
Red Headed Step Child 09/25/13 - 06:02 pm
6
2
fine print

Good premiums? Depends on your definition of good. The proof's in the pudding - as in the coverage. Getting a good deal on a premium is worthless if the coverage sucks. Low monthly premium is great - until you have to go into the hospital for anything. Be ready for those high deductibles, etc. Not to mention who knows if your physician will accept your insurance?

I hope I'm wrong and the ACA ends up working...let's just say I won't be holding my breath.

fedex227
11187
Points
fedex227 09/25/13 - 06:20 pm
3
7
"I don't think there's a soul ...
Unpublished

out there that wouldn't want this "Affordable Care Act" to (be) successful."

I think this would be accurate if you excluded most of the Republican party.

KSL
129825
Points
KSL 09/25/13 - 06:27 pm
5
3
Evidently there are a number

Evidently there are a number of Democrats who want no part of this fiasco. Unless you think union members tend to vote Republican.

KSL
129825
Points
KSL 09/25/13 - 06:41 pm
6
2
This morning I received an

This morning I received an aotomated call from some tea party group. It stated that Lindsey was prepared to vote in favor of the ACA. Well, we all know that. The recording urged that if you did not agree with the way he is going to vote, press 1 and you would be connected to his office. I pressed 1. Guess what. I got that annoying screech of a fax machine.

South Carolina voters take note. Do you think his stsffers may have done some switcherooing to avoid bombardment?

KSL
129825
Points
KSL 09/25/13 - 06:44 pm
4
2
Oops. Double post. But maybe

Oops. Double post. But maybe I should have left both up.

KSL
129825
Points
KSL 09/25/13 - 07:04 pm
4
2
To drive the point home.

To drive the point home.

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