HHS Assistant Secretary for Planning and Evaluation Issue Brief: Health Insurance Marketplace Premiums for 2014

This issue brief from the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) describes the number of competing qualified health plans and the premiums they will charge in the health insurance marketplaces opening for enrollment on October 1, 2013 to implement expansions of health insurance coverage under the Patient Protection and Affordable Care Act.  The ASPE website also has links to the number of competing health plans and the premiums they will charge in each of the 36 states that have federally-facilitated or state partnership health insurance marketplaces.   The premiums vary by region within each state, by the age of the individual(s) applying for health insurance, and the level of health care benefits (more comprehensive benefits are more expensive, using a metallic tier coding of platinum, gold, silver, and bronze levels).  While all this information is current as of September 18, there are some final, last-minute negotiations taking place between HHS and health plans that may change specifics of health plan availability and premium rates before October 1.

In the 36 states in this analysis, the number of qualified health plan choices available in a regional rating area ranges from a low of 6 to a high of 169 plans. On average, individuals and families will have 53 qualified health plans to choose from in their rating area.

Information on the premiums being charged by health plans operating in the state-based health insurance marketplaces in the remaining 14 states and the District of Columbia are available on their respective websites.  One can find each of those websites at www.healthcare.gov or en espanol at www.cuidadodesalud.gov

In terms of premiums, the average premium for the second lowest cost silver plans for 47 states and the District of Columbia (that submitted data) is $328 per month, or 16 percent below Congressional Budget Office (CBO) projections.  In 15 states, the premiums for the second lowest cost silver plan will be less than $300 per month.  Overall, 95% of the uninsured who are potentially eligible for the marketplaces live in states with average premiums below CBO projections.

The premiums are even more affordable for low-income Americans who will qualify for federal tax credit subsidies to help them pay for health insurance.   For example, with federal tax credit subsidies included, an  27-year-old with income of $25,000 living in Texas would pay $145 per month for the second lowest cost silver plan, $133 for the lowest cost silver plan, and $83 for the lowest cost bronze plan.  With available federal tax credit subsidies,  a family of four in Texas with household income of $50,000,  would pay $282 per month for the second lowest cost silver plan, $239 for the lowest silver plan, and $57 per month for the lowest bronze plan after tax credits.  With available federal tax credit subsidies included, nearly six of ten (56%) of low-income, uninsured Americans would qualify for health coverage in the health insurance marketplace for less than $100 per person per month.

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