The Affordable Care Act
6:00 am
Tue October 1, 2013

Explaining the Health Insurance Exchanges

On Oct. 1 the health insurance exchanges under the Affordable Care Act start the 6-month enrollment period. This means the uninsured or people who buy their own health insurance can now go to one place online and compare plans side-by-side.

If you don’t understand a lot about the health insurance exchanges, you’re not alone. In fact, a recent Wall Street Journal/NBC poll found 76 percent of uninsured respondents don’t understand how they’ll work. Conveniently people called “navigators”, funded by the Department of Health and Human Services, will be available to answer your questions.

Brian Burton is in charge of the Louisiana Area Health Education Center’s Navigator Program, one of four organizations in the state providing navigators.

"We’re not here to tell you what you need. We’re here to show you what your options are," said Burton. "Our role is to make sure that they have the most accurate information so they can make the most accurate decision for their family."

Burton said navigators will be deployed across the state to community meetings, hospitals, health fairs and faith-based organizations to talk about buying insurance off the exchanges.

So how much will purchasing health insurance off the exchange cost? The answer: no one really knows. Plans will range from high-deductible bronze plans to more expensive platinum plans. And all of them will cover a comprehensive set of services such as hospital and doctor visits, maternity and mental health care, and medicine.

The cost will depend on variables such as age, household income, place of residence and whether you qualify for tax credits or subsidies.

Most low-to-moderate income individuals are expected to qualify for subsidies. Insurance Commissioner Jim Donelon said subsidies are available for people who earn up to 400 percent of the poverty level.

"And for an individual that’s right under $50,000 in income and for a family of four, it’s right under $100,000," said Donelon.

The Rand Corps recently released a study that said, with subsidies, premiums in Louisiana are projected to be about 20 percent less.

And last week a report by the Obama Administration said after tax credits, a 27-year-old living in Louisiana making $25,000 a year will pay, on average, $71 per month for the lowest cost bronze plan. While a family of four in Louisiana with an annual income of $50,000, will pay $15 per month on average for the lowest cost bronze plan after subsidies.

Carter Price with the Rand Corps says the population at-large will generally pay a lower premium but some people may even wind up paying more, specifically young men may wind up having slightly higher premiums.

Price said pulling more young, healthy people into the market will cause premiums to go down but critics say shifting more costs onto young people could drive them away. And lower premium prices may come at another cost. NPR reported last week that since all insurers are required to offer basic coverage, varying - in some cases narrowing - the size of doctor and hospital networks was about the only way to create less expensive plans.

But Price said, in the end, the trust cost of buy health insurance off the exchange will vary from person to person.