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Online Obamacare marketplaces offer ample options, report says

Most Americans will have a wide variety of choices for health insurance and young people may find plans costing $100 a month or less, the Department of Health and Human Services says.

September 24, 2013|By Noam N. Levey

WASHINGTON — Most Americans who shop for health insurance on new online marketplaces set up under President Obama's health law will have a wide variety of choices, a new report from the Department of Health and Human Services indicates.

And many young consumers will be able to select health plans that cost $100 a month or less, according to the report, which is based on a preliminary analysis of premiums that insurers will charge when the insurance becomes available Jan. 1 in 36 states.

Premiums will be even less expensive — and free in some places — for low-income consumers who qualify for government subsidies through the Affordable Care Act, commonly known as Obamacare.

Obama administration officials did not release exact figures for each health plan being sold, explaining that rates will not be final until Tuesday, when consumers are scheduled to be able to start shopping on the marketplaces.

The report also includes specific data only from the 36 states that have elected to have the federal government run their marketplaces. Premium information from the 14 states operating their own insurance marketplaces — including California, Maryland and Connecticut — in most cases is available through state websites.

Despite that missing data, the new report provides an important overview of the kind of options that millions of consumers will have. The report also demonstrates that many consumers will probably find an affordable option, though some may face higher premiums, as critics are quick to point out.

"We are seeing, across the board, fairly competitive prices," said Caroline Pearson, vice president of Avalere Health, a consulting firm that has been closely following the rollout of the marketplaces. "The health plans are convinced that people will buy based on price, and they are working very hard to put low-cost products in the markets."

Under Obamacare, most Americans will continue to get health insurance through an employer. The marketplaces will enable consumers who don't get benefits at work to comparison shop for health plans, much as they buy airline tickets.

Insurers selling on these marketplaces will be prohibited from denying coverage to consumers, even if they are already sick. The insurers also cannot put annual or lifetime limits on what they cover. And for the first time, all plans will have to provide a standardized set of health benefits.

"There have been a lot of products on the market where people would find out that they thought they had health insurance, but then they would find out that it wouldn't cover hospital visits, for example," said Gary Cohen, the Health and Human Services official who oversees the online marketplaces. "It's important to understand that, because of the Affordable Care Act, the health insurance that people will be buying will actually cover them in the case of them getting sick."

Millions of low- and moderate-income Americans who make less than four times the federal poverty level — about $46,000 for an individual — will qualify for government subsidies.

Because insurance markets vary considerably, consumers will see widely varying options and prices depending on where they live, their age and the size of their household.

Consumers in Miami, for example, will have a choice of 137 health plans. In Portland, Maine, there will be only 17 plans, based on the preliminary data in the report.

A 27-year-old looking for insurance with a high deductible in Miami could get a plan for $109 a month; a similar plan in Portland would cost $162.

In both places, a more generous plan, known as a gold plan, which covers about 80 cents of every dollar in medical expenses, could cost the same shopper at least $239 in Miami and $306 in Portland.

Older consumers would pay nearly three times as much for that kind of coverage.

Critics of the health law often note that cheaper insurance plans are available now.

But subsidies, which are expected to be available to many consumers in the marketplaces, should make premiums substantially more affordable for many.

In Indianapolis, premiums for so-called silver health plans, which cover about 70 cents of every dollar in medical expenses, exceed $1,000 a month for a family of four.

But a family making $50,000 a year — about twice the federal poverty level — would pay only about $282 a month for this coverage after subsidies. The same Indianapolis family, if it makes more than $94,000 a year, would have to pay the full cost of the premium.

noam.levey@latimes.com

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