Policies may be free after subsidy
Some Ohioans eligible for tax-subsidized health insurance purchased through Affordable Care Act marketplaces could ultimately pay no premiums for coverage next year.
You heard that right: It would be free after applying income-related tax credits.
“Coverage may be more affordable than people think,” said Emily Fisher, access-to-care coordinator for Columbus Public Health, which is helping people find plans on the exchange. “Premium assistance for consumers increased,
causing some people to find no-cost plans.”
A recent analysis by the Kaiser Family Foundation found about 4.5 million people nationwide, or 42 percent of the 10.7 million eligible to purchase coverage on the exchange, could get a bronzelevel plan at no cost. Bronze plans typically carry lower premiums than silver and gold plans offered on the exchange. State data on how many could be eligible was not available.
The Affordable Care Act, also known as Obamacare, offers subsidized private insurance to low- and middle-income people who don’t have coverage through their employer and don’t qualify for government health care like Medicaid.
In Ohio, about 239,000 have marketplace healthinsurance plans this year.
No-premium plans appear to be the result of President
Donald Trump altering the health-care bill by eliminating cost-sharing subsidies to insurers to reimburse them for offering lower co-pays and deductibles to consumers.
As a result, insurers in many states, including Ohio, hiked the premiums they charge primarily for silver plans, which have been the most popular. And that caused government subsidies to consumers in the form of tax credits to go up since the aid is calculated based on premium costs of silver plans.
The bottom line: Bigger subsidies for qualified consumers are allowing many to get coverage — particularly the cheaper bronze plans — at no cost.
A recent analysis from Avalere, a Washingtonbased health care consultant, found that nearly 98 percent of counties with federally operated exchanges on HealthCare.gov have free bronze plan options for consumers aged 50 with annual incomes up to 150 percent of poverty. That’s about $18,090 for an individual or $36,900 for a family of four. No- or lower-cost silver and gold plans also may be available to some low-income consumers.
Steven Wagner, executive director of Universal Health Care Action Network of Ohio, said bronze plans for a 40-year-old making up to $20,000 a year cost nothing in at least 10 counties, including Marion, Crawford and Richland counties.
Larry Levitt, senior vice president at the Kaiser Family Foundation, said consumers should shop around to see what’s available because higher subsidies can mean better deals.
“Even people who looked into coverage in the past but found it too expensive should look again because a lot has changed,” he said.
That said, the less-expensive bronze plans also come with the highest deductibles and out-of-pocket expenses, and for some people, silver or gold plans may be more
“It’s such fun to see them grow up and learn the passion, including conservation,” Dan Heyne said. “When they see a deer, to watch the glow in
desirable and could cost less.
A spokeswoman for CareSource, which offers exchange plans in Franklin County and elsewhere in Ohio, cautioned consumers that the availability of free plans are dependent on many variables and doesn’t necessarily mean no cost at all.
“The language ‘zero’ or ‘free’ omits the key part of the equation which includes a consumer’s financials, family size and ... financial support. Also, it could lead one to believe that the entire plan is free. We don’t want consumers to forget about deductibles and co-pays as a part of their coverage,” said CareSource spokeswoman Francine Robinson.
Open enrollment, which started Nov. 1, is ahead of last year, with about 2.3 million people signed up through Nov. 18, including nearly 49,000 in Ohio, according to data released Wednesday by the Centers for Medicare and Medicaid Services. Information is not available to show how many consumers selected no-cost plans or whether more were buying bronze plans this year.
The deadline for open enrollment is Dec. 15, as the sign-up period was cut in half by the Trump administration to 45 days. Last year enrollment ran through January.
The Affordable Care Act’s individual mandate requires that people have health coverage or be subject to a tax penalty, with some exceptions. The mandate is still in effect although Congress is considering repealing it as part of the Republican tax bill.