Thread: New Yorkers to see 50% drop in health insurance costs in Obamacare exchange

Great JohnDoe2! I live in California and in the past two years our Insurance has doubled with loss of benefits. We worked and saved to retire. We had a great plan through our Union (private not public union) now we no longer have Vision or a good Dental Plan and our Medical Plan through Kaiser has been stripped to what is covered and what we have to pay. An additional $5,000plus out of pocket for premiums is a big deal and we have no idea if it will continue to go up. You should know $45,960 in California is a joke. We have to pay all the taxes plus be penalized on our Health Insurance by getting no subsidies.

Here’s what Washingtonians will pay under Obamacare

By Sarah Kliff, Published: June 7 at 12:42 pm
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Wonkblog readers, meet Vince. He’s a 27-year-old who lives right here in Washington, D.C. He has, from what I can tell, some pretty rocking hair. And, according to new data out Friday morning, Vince will spend $124 a month to buy health insurance under Obamacare.



Vince, as you’ve probably gathered by now, is not a real person. He’s an example drawn up by the D.C. Department of Insurance, Securities and Banking to explain how much insurance will cost under the Affordable Care Act.

According to rates submitted to the DISB, health insurers will charge a 27-year-old in the District of Columbia from $124 to $341 to purchase his or her own health insurance policy.

For a 40-year-old, prices range from $166 to $457. And in the 55-year-old demographic, the range spans from $295 to $813.

These are the rates that the DISB released Friday, the first look at how much health coverage in the nation’s capital will cost city residents under the Affordable Care Act.

While D.C.. officials described the rates as similar to those now offered in the individual market, they declined to say by what percent premiums will change between 2013 and 2014.

“We wouldn’t put a percentage on it,” DISB director Bill White told reporters.

“We’re saying there’s not a significant difference in terms of the premium rates.”

“You can go onto HealthCare.Gov, put in your information, and try and see the standard rates,” Mila Kofman, director of the District of Columbia Health Benefits Exchange, said. “But just remember the standard rate is only available to healthy people. About one-third of people applying don’t get that low rate.”

I did just that, and found that as a 28-year-old female Washington resident I could purchase coverage for a monthly premium for $90 to $1,032.

As Kofman pointed out, those rates aren’t accessible to everyone. HealthCare.Gov says that, for the $90-per-month plan sold by CareFirst, 54 percent of applicants are either rejected or charged a higher rate.

There will be three health insurance plans selling in the District’s exchange, the same number that currently participate in the individual market. You can see the rates they want to charge consumers in this table provided by DISB. These rates are not final, as the District must review and approve the insurers’ proposals.



While Kofman had told me she might be able to woo some Maryland carriers, that doesn’t appear to have happened. Washington is a tough sell for insurance carriers because it has one of the smallest insurance markets in the country.

Another thing to keep in mind: These rates do not include the premium tax credits, which will go to lower- and middle-income D.C. residents who purchase on the health exchange. Never fear, though, the District has created Joyce, a 55-year-old woman who earns $28,750 and qualifies for federal help in purchasing health insurance.



You can read more from the District on the rates here.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/06/07/heres-what-washingtonians-will-pay-under-obamacare/

All of these incomes are based on single individuals. What about married couples. Take a married couple who both individually earn $28,725 and all of a sudden they are above the limit to receive any subsidy. So I guess no one should get married or run out and get a divorce in order to afford Obamacare.

Originally Posted by MontereySherry

All of these incomes are based on single individuals. What about married couples. Take a married couple who both individually earn $28,725 and all of a sudden they are above the limit to receive any subsidy. So I guess no one should get married or run out and get a divorce in order to afford Obamacare.

I'm just posting articles of interest.
This is one of the few articles that is getting multiple comments.

Since you live in CA. you can go to http://www.coveredca.com/calculating_the_cost.html
and get the info you want.

Just fill in the forms and get the info.

SAMPLE
How Much Will You Save Under the New Federal Health Law?

Complete all applicable fields for results.

Household Information
Number of people in the household
Annual household income The total amount of income for a family in a calendar year.
Enrollee Information
Only enter members of your household who would enroll in Exchange coverage.

Age of the first adult
Age of spouse
Number of children under age 21
Number of children age 21-25

Breaking Down The Monthly Cost
Estimated monthly silver plan premium (without subsidy)
Estimated tax credit from the government

---

Your estimated monthly silver plan premium <p>This interactive calculator determines Medicaid eligibility and estimates maximum contributions towards premiums and out-of-pocket spending for individuals and families who purchase coverage through Covered California, based on family size, income level and age of the youngest adult. The calculator reflects the Medicaid expansion, premium and cost sharing subsidies, and age rating limitations included in the health reform law signed in March 2010. Most of the major provisions will not be effective until 2014, but the calculator reflects premium levels and incomes in 2012 dollars.</p>< p>The calculator indicates whether an individual may be eligible for Medicaid under the law. Medicaid eligibility will be expanded to 133 percent of the Federal Poverty Level (FPL) with a 5 percentage point income disregard under the law for U.S. citizens and individuals who have lawfully resided in the U.S. for at least five years. The calculator does not account for state-specific Medicaid or Children's Health Insurance Program eligibility standards.</p>< p>Individuals and families who are U.S. citizens or lawful residents will be eligible to purchase coverage through Covered California if they are not enrolled in a federal program such as Medicare, Medicaid or the Children's Health Insurance Program, and do not have an offer of affordable coverage through their employer. Employer-sponsored plans will be considered unaffordable if the employee contribution is more than 9.5 percent of family income or if the plan has an actuarial value of less than 60 percent.</p>< p>For individuals with family income above 400 percent FPL, the calculator estimates the full premium that the individual will pay, assuming they purchase a health plan with a 70 percent actuarial value. Premiums are based on Congressional Budget Office (CBO) estimates (March 2012) of 2016 premiums for second lowest-cost "Silver" family plan, deflated by 5.7 percent annually to estimate 2012 premiums. Individual premium is estimated based on CBO ratio of single to family premiums (November 30, 2009). Premiums are adjusted for age (rounded to the nearest 10-year interval) based on three-to-one age rating scaled linearly.</p>< p>For individuals with family income below 400 percent FPL who purchase coverage through Covered California, the law limits individuals' premium contributions to a set percentage of family income. The calculator returns the maximum contribution towards the premium and the estimated unsubsidized age-adjusted premium for a plan with a 70 percent actuarial value. If the monthly premium is less than the maximum premium contribution, the estimated monthly premium cost to the family is equal to the premium without subsidy. The premium caps range from 3.0 percent of income at 133 percent FPL to 9.5 percent of income at 300 through 400 percent FPL. The premium percentage cap will be 2.0 percent between 100 and 133 percent FPL, applicable to legal immigrants who are not eligible for Medicaid. This cap is not shown in the calculator, as most individuals in the 100 and 133 percent FPL range will be eligible for Medicaid.</p>< p>The calculator also estimates the maximum out-of-pocket spending for each family. The law sets out-of-pocket spending limits based on a percentage of the IRS limits for High Deductible Health Plans (HDHPs), depending on income level. The limits in the calculator are based on 2012 HDHP limits. Most individuals and families will not meet the out-of-pocket spending limits and actual spending will depend on the amount and type of services used and the cost sharing design of the plan, such as copayment and deductible amounts.</p>
Based on the information you provided, you can determine your estimated monthly premium payments and also see how much you will receive in federal assistance. Please remember this is just an estimate.
Note: This calculator shows expected spending for families and individuals eligible to purchase coverage through Covered California under the Affordable Care Act. Under the law, maximum contributions to premiums will be based on modified adjusted gross income, while estimates in this calculator are based on the annual income entered by the user. The premiums in this calculator reflect estimates for Covered California silver plans.
The software that powers this calculator was developed by the Center for Labor Research and Education and the Institute for Research on Labor and Employment Library, at the University of California, Berkeley. © 2012-13, The Regents of the University of California. All rights reserved. For more information on the methodology and assumptions, visit here.

http://www.coveredca.com/calculating_the_cost.html

. . . Eligibility for tax credits is based on a standard, called the federal poverty level Federal Poverty Level A measure of income level issued annually by the Department of Health and Human Services. Federal poverty levels are used to determine your eligibility for certain programs and benefits. In 2012, the federal poverty level for an individual was $11,170 per year and $23,050 for a family of four. To see a chart with more information on federal poverty levels, please visit http://www.familiesusa.org/resources...uidelines.html, that looks at the family income and the number of people in the family. The size of the tax credit is based on a sliding scale, with those who make less money getting a larger financial assistance to lower the cost of their insurance coverage. Individuals and families who make between 138 percent and 400 percent of the federal poverty level may be eligible for a tax credit. This means that an individual making up to $44,680 and a family of four earning up to $92,200 may be eligible for a tax credit.

There are some key facts about tax credits.

• Tax credits lower the cost of your premium. Tax credits reduce the amount of the premiumPremiumThe amount that must be paid for your health insurance or plan. You and/or your employer usually pay(s) it monthly, quarterly or yearly. you will pay for insurance.
• Tax credits help low- and middle-income individuals and families. Tax credits are available to individuals and families who meet certain income requirements.
• Tax credits can be used when you enroll. Tax credits can be applied to the cost of your health plan when you enroll – you do not need to wait until you file a tax return at the end of the year.
• Tax credits are only available through Covered California. You must enroll in a health plan through Covered California if you want to use your tax credits.
• Tax credits are paid directly to your health plan. These tax credits are paid by Covered California to your health plan to keep your costs low.
• Tax credits will be adjusted at the end of the year based on your actual income. At the end of the year, the tax credits may be adjusted if your income is different than you anticipated. This means that you will want to notify Covered California if your income changes.
• http://www.coveredca.com/frequently_asked_questions.html#faq-7

Most states won't see N.Y.'s drop in insurance rates

Julie Appleby, Kaiser Health News 2:14 p.m. EDT July 20, 2013

Individual New Yorkers buying their health coverage in new online marketplaces may see a 50% drop in premiums, but consumers elsewhere are unlikely to see similar savings from Obamacare.

Story Highlights

• Only a handful of states have rules similar to New York's.
• Starting Jan. 1, the federal health law will require nearly everyone to carry insurance.
• President Obama mentioned New York's lower rates during a speech touting the benefits of the 2010 health law.

New York's announcement this week that insurance premiums would drop 50% next year for individuals buying their own coverage in new online marketplaces made good talking points for proponents of the Affordable Care Act, but consumers in most states are unlikely to see similar savings.

That's because only a handful have New York's rules, which — like the federal law — bar insurers from rejecting people with health problems. Unlike the federal law, however, New York does not require consumers to purchase coverage, so over time, mainly older, sicker people, have purchased coverage. That drove up prices and discouraged younger, healthier people from buying policies, as did a requirement that insurers charge the same rates regardless of age or health status.

As a result, premium prices listed for individuals often top $1,000 a month for some New Yorkers buying their own coverage, making the state's rates among most expensive in the nation.

"New York with such extreme rules sets the stage for a larger drop in rates than you'd expect to see in many other states," said Paul Ginsburg, president of the Center for Studying Health System Change, a non-partisan think tank in Washington D.C. "It's clearly in the minority."

A handful of other states — including Maine, Massachusetts, New Jersey and Vermont — have similar rules barring insurers from rejecting applicants with health conditions when selling coverage directly to individuals.

Only Massachusetts currently requires the flip side of that equation: that consumers also purchase coverage or face a fine.

Starting Jan. 1, the federal health law will require nearly everyone to carry insurance, with the aim of expanding the markets to include the young and healthy, who can be charged less than older people. At the same time, subsidies become available to help people earning up to about $44,680, helping offset the costs of those premiums. Those changes could moderate costs not just in New York, but in those other states that currently require insurers to sell to all comers — if it works to bring more young and healthy people into the market, according to the Society of Actuaries and other experts.

In New Jersey, benefit firm Milliman projects up to a 25% reduction in premiums for some consumers who buy their own insurance as a result of the health law, for similar reasons.

Individual coverage costs about 60% more in that state than the national average. New Jersey officials have not yet disclosed proposed or final premium prices for the new online market.

In Vermont, the actuary group predicted a more substantial drop, but when the state released its proposed premium rates for next year, the rates were largely unchanged.

Vermont, however, is a small, rural state with only two insurers offering to sell policies in the marketplace; only about 9% of the state's residents lack insurance, compared with a 16% average nationwide.

That contrasts with New York, where 17 insurers have been approved to sell coverage, and fewer than 26,500 people out of 2.6 million uninsured buy their own coverage currently, according to state data analyzed by the United Hospital Fund.

"Competition helps drive down health insurance costs for consumers and businesses," said Gov. Andrew Cuomo, a Democrat.

Another factor contributing to lower-than-expected premiums in some places is how the policies are structured. Many insurers nationally are creating smaller networks of doctors and hospitals, or limiting the range of prescription drugs they will cover as a way to lower premiums, said Dan Mendelson, CEO of Avalere Health, a private research firm in Washington, which recently released a study showing that premium prices may be lower than expected in some states.

President Obama mentioned New York's lower rates during a speech touting the benefits of the 2010 health law on Thursday, saying "the progress we're seeing in California and Washington and Oregon and now New York – that's progress that we want to see across the country."

He was seeking to rebut Republican criticism of the health law, and the largely symbolic vote by the Republican-led House of Representatives to postpone the requirement that everyone buy insurance. The so-called individual mandate is at the heart of the law and without it, the exchanges could lose the business of the younger and healthier people needed to balance out the higher costs of older, sicker people.

The administration released its own analysis showing that individual premiums in the online marketplaces will be 10% to 18% less than projected next year, based on an average of rates in 10 states and the District of Columbia. While the rates insurers will charge in most states won't be known until closer to the time enrollment begins, Oct. 1, the administration was able to analyze proposed and final premium prices from California, Colorado, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia, Washington state and D.C.

Although the administration said the figures show the health law is working, the premiums cited may not reflect what individual consumers will actually pay next year, because the numbers are averaged within and across states. As a result, some consumers in those states are likely to pay more than they do now, while others will see savings.

"The impact of the ACA will vary considerably depending on a person's age, gender, health status, and where they live," said Robert Zirkelbach, spokesman for the America's Health Insurance Plans. "Simply looking at averages doesn't tell you what these reforms are going to mean for a particular person in a particular state."

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

http://www.usatoday.com/story/news/politics/2013/07/20/kaiser-new-york-insurance-premiums/2570873/