By SCOTT ROTHSCHILD, The Lawrence Journal-World
TOPEKA, KAN. — Most Kansans will pay less than the national average for health insurance coverage offered under the Affordable Care Act’s new online marketplaces set to open next week, according to a government report released Wednesday.
The Obama administration released the new data and sought to ramp up efforts to educate the public about the ACA as critics in Congress continued to hammer the law and try to defund it.
Lt. Gov. Jeff Colyer, a leading critic of the federal health care overhaul, said that the marketplace won’t be able to provide affordable coverage without far more competition.
Kansas is one of 36 states where the federal government is setting up or supporting the online marketplace, known as an exchange, which aims to help uninsured residents find health care at reasonable prices. Data released by the U.S. Department of Health and Human Services shows Kansans will have an average of 37 qualified health plans from which to choose, compared to an average of 53 for consumers in all 36 states.
In Kansas, more than 355,000 people are uninsured.
The HHS report provided potential costs and federal subsidies in the states with federally run marketplaces. Kansans using the marketplace will have an average of 37 health plan choices, while the average for the 36 states is 53. The plans will be categorized as “gold,” “silver” or “bronze.”
The average premium for the lowest-cost silver plan in Kansas will be $260 per month, according to the report. The national average will be $328 before tax credits, or 16 percent below projections based on Congressional Budget Office estimates.
“We are excited to see that rates in the Kansas Marketplace are even lower than originally projected,” said HHS Secretary Kathleen Sebelius.
Nationally, those silver plans will range from $192 per month in Minnesota to $516 per month in Wyoming.
The overview of premiums and plan choices said that about 95 percent of uninsured people eligible for the marketplace live in a state where their average premium is lower than projections. But the report did not reveal copays and deductibles that are important considerations when considering what type of coverage to select.
The report shows that a 27-year old Kansan who makes $25,000 per year will pay $107 per month for the lowest cost bronze plan and $145 per month for the second-lowest cost silver plan, taking into account tax credits. For a family of four in Kansas with an income of $50,000 per year, the lowest bronze plan would cost $144 per month.
The new online marketplaces, opening for business Tuesday, will enable consumers to find out whether they qualify for premium assistance and compare plans side by side based on pricing, quality and benefits.
The CBO estimates the insurance marketplaces, which can be used by individuals and small businesses, will enroll 7 million people next year. Six million are expected to qualify for federal subsidies to purchase insurance. No one can be denied coverage because of a pre-existing condition.
The enrollment period runs through March 2014 and coverage starts as early as Jan. 1.
“In the past, consumers were too often denied or priced out of quality health insurance options, but thanks to the Affordable Care Act consumers will be able to choose from a number of new coverage options at a price that is affordable,” Sebelius said.
Critics say many will pay more than they would have otherwise.
Colyer, a physician, for example, said there are far cheaper rates available now from private online marketplaces. A search on one site showed 17 health plans from three companies, requiring participants to cover up to $5,000 a year in expenses, with lower premiums. One cost less than $41 a month.
“It’s pretty obvious that the exchange is very expensive for Kansas,” Colyer said.
Colyer said many Kansas consumers still will pay relatively high premiums for coverage on the exchange, particularly if they’re young and healthy. Even with dozens of plans available on the exchange, they will be offered by one of only two companies in 82 of the state’s 105 counties.
Colyer and other critics worry that mandates in the 2010 federal law overhauling health care will not only mean expensive exchange plans but boost costs in plans offered outside exchanges, in turn limiting choices everywhere.
But experts say the plans under the health care law have broader coverage and more protections for policyholders.
A key component of the ACA is expansion of Medicaid eligibility. The federal government has promised to pay the full costs of expansion for three years and then reduce that payment to 90 percent of the cost. Estimates have indicated expansion of Medicaid could cover approximately 88,000 additional low-income Kansans. Gov. Sam Brownback and the Republican-led Legislature have refused to do that in Kansas, saying they do not believe the federal government will come through with its funding promise.