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ACA premiums out! "six in 10 Americans who currently lack insurance will be able to find coverage that costs less than $100 a month" says DHHS

Posted by on Sep. 25, 2013 at 8:31 AM
  • 225 Replies
1 mom liked this

Administration Touts Lower-Than-Expected Obamacare Premiums

4 min 53 sec



Department of Health and Human Services Secretary Kathleen Sebelius says "six in 10 Americans who currently lack insurance will be able to find coverage that costs less than $100 a month" in health insurance exchanges set to open next week. Here, Sebelius is shown testifying on Capitol Hill on June 4.

Department of Health and Human Services Secretary Kathleen Sebelius says "six in 10 Americans who currently lack insurance will be able to find coverage that costs less than $100 a month" in health insurance exchanges set to open next week. Here, Sebelius is shown testifying on Capitol Hill on June 4.

Jim Bourg/Reuters /Landov

Premiums in the health insurance exchanges set to open next week will be lower than anticipated, the Obama administration announced Wednesday.

According to a released by the Department of Health and Human Services, "premiums nationwide will ... be around 16 percent lower than originally expected," and 95 percent of uninsured people live in a state with average premiums that are lower than expected.

But while the premium "" that many predicted may not be materializing, there may be other things about the new health plans that consumers may not like that much.

Until now, the only premium information that's been released publicly about the Obamacare exchanges has been for states running their own, and in many, the rates have been .

Now, however, the administration has released information for the 36 states where the federal government will operate the new exchanges in full or in part.

"Six in 10 Americans who currently lack insurance will be able to find coverage that costs less than $100 a month," HHS Secretary Kathleen Sebelius told reporters in a conference call.

And in some cases, available tax credits can make health insurance really inexpensive. For example, said Sebelius, "Dallas families earning $50,000 a year will be able to buy quality coverage for as little as $26 a month."

One reason for the lower-than-expected premiums is higher-than-expected participation by insurance companies.

All year, it seemed that many , at least for this first year of the program. A few states and some counties within states will only have spotty competition. But administration officials say people in the 36 states where the feds are in charge will have an average of 56 different plans to choose from, offered by multiple insurance companies.

And competition is key to those lower rates.

"Parts of the country that have a number of insurers participating and competing for business, are coming in with lower premiums," said Larry Levitt, a senior vice president at the , who's been studying the development of the exchanges. "So the market appears to be working."

But it seems that another reason that the rates are lower — at least some of them — is that insurance companies have limited the size of their doctor and hospital networks in some of the cheaper plans.

"The lowest cost plans are coming in a lot lower than people were predicting, because the networks are coming in with a lot fewer doctors and hospitals than people were predicting," said Robert Laszewski. He's an and longtime observer of the health care system.

Because the law requires all insurers to basically offer , varying the size of the network was about the only tool they had left to try to create a less expensive plan.

"For example in California, the lowest cost Silver plan is one that has only about half the doctors and hospitals that particular health plan has in their standard employer network," Laszewski said.

Silver being the among bronze, silver, gold and platinum. Laszewski says that for people who are currently uninsured, these more limited network plans will probably be just fine. But for people who have been buying their own insurance, or if they've had employer-provided insurance, they're likely used to having a freer choice of doctors and hospitals. And they're going to find that comes with a price.

"You're going to have to pay $100, $150 a month more than that to be able to get access to those kinds of networks," he said.

Administration officials, however, dispute the idea that consumers will rebel against the plans with the narrower networks. Gary Cohen, the official at HHS who is , told reporters that state insurance officials have a long history of regulating insurers — making sure that their networks have enough doctors and hospitals to provide adequate care.

"They certainly don't want to get a bunch of phone calls from people who have health coverage but can't get health care," he said.

Still, the data released by the administration likely won't settle the premium fight once and for all. The numbers are all averages. The premium individual consumers will pay will depend on where they live, how old they are, number of family members, household income, and other variables.

National Woman's Party


by on Sep. 25, 2013 at 8:31 AM
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Replies (1-10):
NWP
by guerrilla girl on Sep. 25, 2013 at 8:32 AM

"Dallas families earning $50,000 a year will be able to buy quality coverage for as little as $26 a month."

Gabeys_Mommy
by Member on Sep. 25, 2013 at 8:36 AM
2 moms liked this
Obviously I need to learn more about Obamacare because so far I don't see what all the bitching is about. It's damn near impossible to get affordable insurance if your employer doesn't offer it. I also like that it makes those employers liable in some way to pay towards employee health insurance, one way or the other.
NWP
by guerrilla girl on Sep. 25, 2013 at 8:37 AM
1 mom liked this

But it seems that another reason that the rates are lower — at least some of them — is that insurance companies have limited the size of their doctor and hospital networks in some of the cheaper plans.

The lower cost plans will be accessable to people currently without insurance. Keep in mind that less doctor choice is better than NO doctor choice which is what these folks have now:)


NWP
by guerrilla girl on Sep. 25, 2013 at 8:39 AM
2 moms liked this

$26 a month for a family making 50K seems pretty good...And that is in Texas!

WTF is wrong with those folks?

That said, I would still prefer a public option.

Quoting Gabeys_Mommy:

Obviously I need to learn more about Obamacare because so far I don't see what all the bitching is about. It's damn near impossible to get affordable insurance if your employer doesn't offer it. I also like that it makes those employers liable in some way to pay towards employee health insurance, one way or the other.


National Woman's Party


stacymomof2
by Ruby Member on Sep. 25, 2013 at 9:10 AM
Restricted access to docs outside your network doesn't sound that bad either for people like me who pay out of pocket for health care. I am restricted right now to sliding fee clinics. Never get the same doc twice anyway. And when I did have coverage it wasn't unlimited choice anyway.

Quoting NWP:

$26 a month for a family making 50K seems pretty good...And that is in Texas!

WTF is wrong with those folks?

That said, I would still prefer a public option.

Quoting Gabeys_Mommy:

Obviously I need to learn more about Obamacare because so far I don't see what all the bitching is about. It's damn near impossible to get affordable insurance if your employer doesn't offer it. I also like that it makes those employers liable in some way to pay towards employee health insurance, one way or the other.


NWP
by guerrilla girl on Sep. 25, 2013 at 9:11 AM

Yes, I see this as a good thing. We have employer based healthcare and nothing has changed for us except lower co-pays and more services covered for free.

Quoting stacymomof2:

Restricted access to docs outside your network doesn't sound that bad either for people like me who pay out of pocket for health care. I am restricted right now to sliding fee clinics. Never get the same doc twice anyway. And when I did have coverage it wasn't unlimited choice anyway.

Quoting NWP:

$26 a month for a family making 50K seems pretty good...And that is in Texas!

WTF is wrong with those folks?

That said, I would still prefer a public option.

Quoting Gabeys_Mommy:

Obviously I need to learn more about Obamacare because so far I don't see what all the bitching is about. It's damn near impossible to get affordable insurance if your employer doesn't offer it. I also like that it makes those employers liable in some way to pay towards employee health insurance, one way or the other.



National Woman's Party


Fairywings1223
by Member on Sep. 25, 2013 at 9:12 AM

But what about copays? How much are those going to cost. No one is mentioning any of that. A lot of times the cospays are still too high to go to the doctor.

NWP
by guerrilla girl on Sep. 25, 2013 at 9:15 AM

I believe that co-pays are part of the standardization in the requirements for plans to participate..but I'm not sure how much that is.

Our co-pays went from $25 to $15 after the first roll out of the ACA and we have no co-pay for our annual well-check visits.

Quoting Fairywings1223:

But what about copays? How much are those going to cost. No one is mentioning any of that. A lot of times the cospays are still too high to go to the doctor.


National Woman's Party


AtiFreeFalls
by Silver Member on Sep. 25, 2013 at 9:16 AM
We live in Texas... And earn less than $50,000. If we really can get insurance for $26 per month that will be amazing. Even $100. I've been thinking $200-300 and hoping NOT, because that will put us in a really tight spot. Like... Really tight lol.
mesfilles
by Member on Sep. 25, 2013 at 9:17 AM
I just calculated the same demographic in MI and it's 65/week with 10,000 out of pocket.


Quoting NWP:

"Dallas families earning $50,000 a year will be able to
buy quality coverage for as little as $26 a month."


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