Individuals who do not obtain health coverage, through any source, are subject to a tax penalty unless they meet certain exemptions. The penalties under the so-called individual mandate were phased in over a three-year period starting in 2014 and are scheduled to increase substantially in 2016. This analysis from the Kaiser Family Foundation provides estimates of the share of uninsured people eligible to enroll in the marketplaces who will be subject to the penalty, and how those penalties are increasing for 2016.
Private insurance plans typically require some form of cost sharing, or out-of-pocket costs, such as copayments, coinsurance, and deductibles. This brief shows the cost sharing in plans sold to individuals through Healthcare.gov for 2016, with a focus on the variation in the ways plans may set cost sharing for services, such as physician visits, prescription drugs, and hospital stays.
In most states, consumers with HIV or AIDS who buy silver-level plans on the insurance marketplaces find limited coverage of common drug regimens they may need and high out-of-pocket costs, according to a new analysis.
With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost.
The Affordable Care Act’s third open enrollment season started Nov. 1, and federal officials are hoping to reach about a million people like Thomas across the country. Newark has an estimated 112,000 uninsured people, around one-third of the city’s population. It is one of five areas – along with Houston, Dallas, Chicago and Miami – where the federal government is focusing enrollment efforts. Altogether, Washington will spend more than $100 million on marketing and enrollment.
Health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on the insurance marketplaces, according to two analyses published this week. Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, an analysis by the Robert Wood Johnson Foundation found. Those cutbacks will affect customers in 37 states, according to the foundation.
After nearly two years in operation and millions of dollars spent in development, the small business health insurance exchange created by the Affordable Care Act is struggling to catch on. Nationally, about 85,000 people, from 11,000 small businesses, have coverage through the online marketplace known as the Small Business Health Options Program, or SHOP, according to the latest federal data released in May. Those totals do not include employers that began coverage in 2014 and have not yet renewed their coverage through HealthCare.gov for 2015.
As Marketplace enrollees begin to shop for coverage starting in 2016, the number of insurance choices available to them is changing in some parts of the country. In early 2015, an average of 6.1 insurer groups offered coverage in each state, up from an average of 5.0 in 2014. Since then, some insurers have announced their exit or been required to withdraw from the Marketplaces, most notably a number of nonprofit Consumer Operated and Oriented Plans (CO-OPs) and some larger insurers like Blue Cross Blue Shield of New Mexico. Despite these withdrawals, the Department of Health and Human Services (HHS) recently announced that the average number of issuers per state is increasing slightly in 2016 and that about 9 out of 10 returning Healthcare.gov customers will have 3 or more insurers from which to choose in 2016.
About 29 million people are still without health insurance, government estimates show — down more than a third since 2013. About half are eligible for subsidized coverage through the marketplaces or can enroll in Medicaid. Signing them up won’t be easy, Obamacare navigators and advocates say. Many don’t see the need for coverage, they believe it’s too expensive or they are unaware of financial assistance to lower the costs for insurance, surveys and interviews have found.
The table below presents an update to our previous analysis of 2016 changes in premiums for the second-lowest cost (“benchmark”) silver marketplace plans in major cities in the 49 states and the District of Columbia, where we were able to find complete data on rates. Among these major cities, the percent change from last year in the benchmark premium ranges from -10.6% in Seattle, Washington to 38.4% in Nashville, TN. The simple average of these rate changes is 10.1% before accounting for the premium tax credit.