What to Expect When the Obamacare Insurance Exchanges Open on Oct. 1

Three likely outcomes from the launch of state-based health-insurance exchanges

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In less than a week, new insurance marketplaces will launch in most states, marketing and selling Obamacare-compliant plans and distributing subsidies to help low- and middle-income Americans afford coverage. Although some details are forthcoming, like additional price information from insurers, new data released by the Department of Health and Human Services indicates that insurance sold in the exchanges will be less expensive, in many cases, than predicted.

Only those without affordable employer-based insurance will be able to shop in the exchanges, meaning federal officials expect only 3% of the those who will have insurance in 2014, or 7 million people, will get it via a state exchange. Despite their relatively small size, the exchanges will signify the first real opportunity for many uninsured Americans to access comprehensive, affordable insurance coverage that won’t discriminate against those with pre-existing conditions. The open-enrollment period that starts on Oct. 1 will last until March 31. Anyone who purchases coverage in an exchange will buy policy that goes into effect on Jan. 1.

Here are three expected outcomes for those shopping in the exchanges:

Many people will find private insurance coverage for no or very low cost.

The subsidies provided by the federal government to help low- and middle-income Americans purchase insurance under the Affordable Care Act (ACA) are generous. The government will pay all or a portion of insurance premiums for individuals earning up to 400% of the federal poverty level, or about $45,000 per year. Individuals earning less than 250% of the poverty level, or about $29,000 a year, can also receive federal money to help cover deductibles, co-payments and co-insurance costs. Because the subsidies, which will be doled out on a sliding scale, are based on the cost of midlevel insurance plans offered in the state exchanges, some individuals and families who opt for more bare-bones coverage will pay nothing out of pocket on monthly premiums.

For example, according to a calculator created by the nonpartisan Kaiser Family Foundation, a 27-year-old resident of Houston without employer-based coverage earning $15,000 per year could sign up for a bare-bones plan and pay nothing in monthly premiums. For about $300 per year, this person could sign up for a midlevel plan with a $2,250 cap on additional annual out-of-pocket spending. Without subsidies, premiums for this midlevel plan would cost about $2,400 per year.

(MORE: Calculate Your Insurance Costs Under Obamacare)

Many, if not a majority, of those who get new insurance through the exchanges will sign up for the cheapest coverage available.

Massachusetts, which launched a state version of the ACA in 2007, provides a good test case of consumer behavior in a subsidized-health-insurance marketplace where a mandate to buy insurance is in effect. In an analysis of plans purchased during the first two years of reform in Massachusetts, researchers found that 63% of people shopping in its insurance exchange opted to sign up for “bronze plans,” the cheapest coverage available. Many health economists expect similar consumer behavior nationwide under the ACA. Plans in the state exchanges will be categorized as bronze, silver, gold and platinum, with premiums increasingly more expensive for more comprehensive coverage.

The cheapest coverage will prevent bankruptcy, but individuals and families could still pay thousands of dollars in out-of-pocket costs.

In Massachusetts, a bronze plan covers 55% of all health care costs. A bronze plan in an Obamacare-regulated exchange will cover 60% of health care expenses. Out-of-pocket expenses were to be capped at $6,350 for individuals beginning in 2014, but the Obama Administration delayed this insurer requirement until 2015. Even with the limit, though, those with bronze coverage could be required to pay hundreds or thousands of dollars in deductibles or co-insurance for hospital stays or other costly medical needs. This could be an incentive to opt for silver-tier coverage, which will cost more per month, but will cover 70% of health care expenses. At the high-end, a platinum plan offered in the Obamacare exchanges will cover 90% of an individual’s health care costs, but will charge more than monthly premiums.

MORE: What Obamacare Means for Corporate Retiree Insurance Coverage

114 comments
obamamccain123
obamamccain123

I feel so sorry for you people. I am so glad I do not live in your country.

Conservative-Veteran
Conservative-Veteran

I checked my state exchange MNsure.org and the policy they recommended was 500% higher than I currently pay.

JohnnyMa
JohnnyMa

Heres your FREE Obamacare!!!!!This is a post from the OBAMACARE WEB PAGE and NOT my actual experience:

"I actually made it through this morning at 8:00 A.M. I have a preexisting condition (Type 1 Diabetes) and my income base was 45K-55K annually I chose tier 2 "Silver Plan" and my monthly premiums came out to $597.00 with $13,988 yearly deductible!!! There is NO POSSIBLE way that I can afford this so I "opt-out" and chose to continue along with no insurance. I received an email tonight at 5:00 P.M. informing me that my fine would be $4,037 and could be attached to my yearly income tax return. Then you make it to the "REPERCUSSIONS PORTION" for "non-payment" of yearly fine. First, your drivers license will be suspended until paid, and if you go 24 consecutive months with "Non-Payment" and you happen to be a home owner, you will have a federal tax lien placed on your home You can agree to give your bank information so that they can easy "Automatically withdraw" your "penalties" weekly, bi-weekly or monthly! This by no means is "Free" or even "Affordable"

Please post this to local TV outlets and other media-elites

RebeccaFlynn
RebeccaFlynn

if doctors were allowed to work in a true free market without insurance companies playing the middle man, the cost of our health care would drop significantly. There would be more competition for their services dealing directly with the public. When insurance companies pool everyone's money together, they can say charge whatever they want. It's not what you call a free market if you think about it. A better plan in my opinion would have been to offer catastrophic insurance policies + health savings accounts. At least in a true free market, you could dip into your tax free health savings account to pay for small things and have your catastrophic insurance for major events. And at least your not losing your money every year as you would paying deductibles to an insurance company. http://www.youtube.com/watch?v=3WnS96NVlMI

ontheslabs
ontheslabs

  Health insurance is a casino.  They get you to bet against you not getting sick.  With today's technology, do we even need insurance companies.  No!  They are all math that is designed to make a profit from probabilities just like casinos do.  You can write numbers to make it almost impossible  to lose in the long run.  I would guess that with the math and the profit margins, you are getting scammed out of more than 35% of true healthcare value.  And yes, that even includes Obamneycare.  The cancer will always be the insurance/casino companies.  If they don't get you with the premiums they get you with a waiting list since time is part of the equation.  The premiums have no caps.

auronlu
auronlu

I've checked the cost of an Obamacare plan vs. what I'm paying now for self-employed health insurance, and my premium will be less than half of what I'm currently paying and cover slightly more than the plan I have now.

At this point, my main anxiety is that the GOP will take it away once I switch.

But if they don't, do you know where the money I save will go? Into local businesses, since I'll have more spending money! But I suppose that ExxonMobil needs government subsidies more than ordinary Americans; they're only the most profitable industry on the planet, whereas we're just trying to get by.

texastbone428
texastbone428

What if you are not working (unemployed) ? do you still get penalized.  Why not put cost cap restrictions on health costs and DRs fees.  and out of control hospital expenses. That is where the real problem starts.   This is going to hurt more working people that we can even imagine.  

All the corrupt health insurance companies and wealthy Doctors are licking their fat chops on this one.   


 

PatriotMama
PatriotMama

Someone didn't read the bill. The lowest estimate in Ga so far is 20% more than it is presently. With outrageously high deductibles and out of pocket before it kicks in.  You really should know about the bill it self instead of reporting what the political speeches are saying. It (the bill) has cost over 1/2 million jobs before it has even been implemented. This bill favors one group and that is the insurance industry, by whom the bill was authored. It is devastating to the middle class and small businesses on which the economy depends. It is like feudalism, but once you tax and steal all the workers wages, even the elite will fall. 

ITUgettgo
ITUgettgo

Without any regulatory mandate for price and cost controls, this is a (potential) blank check to big insurance.  The other cost-reduction provisions (exchange competition, luxury premium tax, ACA) that are included have no teeth and little consensus exists about how well they will work.  In 10 years, the US may well have reduced HC as a % of GDP, but it will still be less fair and more expensive than every other major developed nation.

aboutbebout
aboutbebout

Confusion and anger.  Why nothing in the mail?

rivers
rivers

Indeed obamacare plan favor too much for the part-time job or the no-contract job employee, but also this plan will encourage the employer to take more zero-contract job, any way the labor union is there, they will consider these issue, push relative department in good position. people should have medical insurance even in worse status,with less payment, with large work. this policy main target to provide the relative poorer people to change the medical condition, this is an great work anyway. 

j45ashton
j45ashton

The GOP's political bread and butter is based on scaring people.  According to them, anything Obama proposes, anything Democrats propose will lead to Armageddon, and they try to stop change before it gets going.  Well, we'll see.  If Obamacare is successful, it will shut the coffin on the GOP.  If it fails, it will shut it for the Democrats.  Let the facts speak for themselves after Oct 1. 

vstillwell
vstillwell

It will be widespread socialist anarchy! People will be able to buy health insurance! Even part-timers! AHHHHHHHHHHHHHHHHH!

SmoothEdward1
SmoothEdward1

I think if they throw in HBO and Cinemax, more people will chose the Silver Plan.

mary.waterton
mary.waterton

It's killing jobs, I know that much. The only jobs being created are temporary, contract and part-time to avoid the Obamacare mandates. As a result, taxpayers will end up paying for the healthcare of those who can't find full-time work. In plain English that means it will be added to the national debt.

The national debt has become a joke, except that it won't be funny when it finally collapses the US economy and plunges MILLIONS into unimaginable poverty.

reallife
reallife

Shouldn't these kind of articles be labeled "Advertising"?

Send the bill to the Democratic Party please, don't expect "we the people" to pay for this too



GavinGreenwalt
GavinGreenwalt

@ontheslabs You don't seem to understand the concept of differed risk.  Yes you are absolutely correct, in all likelihood you will pay out more in insurance premiums than they will pay out in claims.  Under ACA though they are capped at a 2% profit I believe.  Which is to say that you will pay them 2% more than they pay your doctors over your life.

However what you don't seem to realize is that insurance isn't to pay for going to the doctor it's to protect you from the dice coming up cancer, or having  a traumatic burn.  I know people who have had $1,800,000 in medical expenses from a single accident.  Yes $1.8 million.   You will not pay that in insurance premiums over your entire life.   However if we all chip in a little extra then we know that if we're so unfortunate as to need huge medical payouts we are covered.   So yes, 1 in 10 won't need it but nobody knows if they'll be the one. 

RebeccaFlynn
RebeccaFlynn

@auronlu who do you think pays for your subsidy? it comes out of your tax dollars whether you realize this or not.

CarmenSepulveda
CarmenSepulveda

@rivers What?!  Did you go to the Sarah Palin school of public speaking?  I don't know what you are talking about.  Seriously!

CarmenSepulveda
CarmenSepulveda

@vstillwell How?  I am a part-time and I can't afford health insurance, even under Obamacare.  I was cut down to 29 hours a week thanks to Obamacare.  It's hard to find another part-time job because of conflicting schedules.  So tell me, how does someone like me afford Obamacare when we have rent, utilities, car payments and insurance, debt, student loans, food, clothing, and the list goes on and on.  Most Americans are at the end of their rope right now.  Obamacare just tightened the noose for people like me. 

Openminded1
Openminded1

@SmoothEdward1 My man smooth, very funny that is what we need more of humor, that is why I have fun on here .

CarmenSepulveda
CarmenSepulveda

@mary.waterton  Mary, you are right on target.  Where do liberals think money comes from anyway?  I don't have health insurance as the small firm I work for never offered it, and now, to top it all off because of the econmy, I have been cut down to part-time status. That the government is going to have to subsidize my health care.  Before that, I belonged to a small clinic that had a sliding fee scale where I made a payment I could afford.  Now I won't have that option anymore.

LarryYoumans
LarryYoumans

@mary.waterton that's when the government will come and take you and your family to the fema camps and have  complete and total control over your life and the way you live it. Good luck on your new job at the labor camp. If you survive the rebellion.

RamonRoman
RamonRoman

@mary.waterton Hey, mary waterton, has somebody told by any chance to stop reading the bible? Tell me, Mary waterton, where are the untold millions Canadians starving to dead and the the untold millions in poverty? Do you know mary waterton that I lost a kidney to cancer, that I had prostate cancer and they put it in remission with a brachytherapy, that I had a heart attack and  to open an artery after the heart attack they put a stent to open it? And do you know, mary waterton, how much I paid in this country, Canada, including my stay in the hospitals?  NADA, RIEN, ZERO. And you know why, mary waterton? Because this country values the dignity of human beings and health is not a commodity to trade in the market. That''s why. Finally, Canada is not a communist, or a socialist country.

vstillwell
vstillwell

@mary.waterton Actually, where I work, it could be helpful. My employer has been getting nailed with high insurance premiums for several years now--which means that it kills any hope of a raise we might get. Also, our deductibles go up about every year too. Now, we have options. Options are good. 

I wish people like you would stop watching cable news. 

SmoothEdward1
SmoothEdward1

@mary.waterton Nonsense. The trend toward temporary, contract, and part-time jobs to avoid paying benefits has been in happening since the 80s. 

RamonRoman
RamonRoman

@LarryYoumans @mary.waterton YEAH, YEAH, YEAH, Larry, Canada is a big labor camp. We are all slaves because we have a working health care paid by the people's taxes. The situation in Canada is so effervescent that at any moment the revolution is going to take place so the people can enjoy the private insurers, living and becoming rich with the result of the ignorance of the majority. YEAH, YEAH, YEAH, LONG LIVE THE LEECHES, LONG LIVE THE PRIVATE INSURERS.

Openminded1
Openminded1

@RamonRoman @mary.waterton Well lets see what we learned from that rant, #1 you told Mary waterton off. # 2 you have been one sick SOB. #3 You are living in Canada are friends to the north. #4 You seem to really dislike the USA, thus the reason you live in Canada. #5 You paid not a f-ing thing for all that medical help.#6Canada cares about there people, #7Canada is not a communist or socialist country. So the only thing you enlightened be about is you were or are a very sick man and you do not care for Mary. In closing I say to you hope you have fully recovered, glad canada is not a commie country and that Canada is not apples for apples in this matter with the USA. 34 million no comparison to over 366 million. What may work there may not here. Plus your system has been in place along time under different conditions and the way it is done.

fabfusion1
fabfusion1

@RamonRoman @mary.waterton  So why do over 75% of Canadians come to the US for their healthcare?  Ask my mom who has worked in one of the top 10 best hospitals in the US.  She and many Canadians will tell you, Canada rations and puts you on a waiting list.  Which is why they come here.  Canada doesn't have the facilities nor the equipment that the US has, which again is why more and more Canadians come here to the US for their healthcare.  You do pay for it, you just don't know it.

realtruth
realtruth

@vstillwell @mary.waterton I think the bigger effect comes in 2017 when large employers are able to enter the exchange.  Can you imagine the competitive group plans that will be offered driven by business' desire to save on the bottom line? Competition will kill cost every time.

realtruth
realtruth

@SmoothEdward1 @mary.waterton True, that trend has escalated the healthcare problem for many. This is a reasonable solution for now. The law still need to be tweaked tho.

Openminded1
Openminded1

@RamonRoman @Openminded1 @LarryYoumans @mary.waterton Caps ramon? You are not only long winded, you are a holy roller too. keep your hands together for yourself and your family. I am proud of my life and my loved ones and do not care about Canada pride your religious bleeding heart bs and anyone else issues with THe U. S> or its politics. again I say to you if you are not American as you claim why do you care what and how we as a country deal with our politics? Stick to the politics of your little country and let us Americans that live and can vote here worry about The USA. We seem to have many of your countrymen buying up a lot of real estate here and vacationing here, I wonder why?

RamonRoman
RamonRoman

@Openminded1 @RamonRoman @LarryYoumans @mary.waterton Openminded, I put my palms together, I look at you and I feel such compassion for people like you and with a great sadness, looking to the heavens I tell the inexistent all powerful entity that rules the whole universe, including you, " FORGIVE THEM, FOR THEY KNOW NOT HOW TO LIVE AS MEN OF PRIDE, THEY WILL ALWAYS GIVE THE PRODUCT OF THEIR SWEAT TO PEOPLE THAT REALLY DESERVE TO LIVE THE GOOD LIFE WITHOUT WORKING, THE PRIVATE INSURERS, THE CHOSEN BY THE PRIVATE ENTERPRISE TO PLAY WITH THE LIVES OF OTHER PEOPLE FOR THE RIGHT PRICE."

  You see, mr openminded, when you have pride in your culture, as the Quebecois, they want to keep that culture and protect it. You see, openminded, we, as Canadians, take great pride in the culture that formed, with blood and hard work, the basis of Canada. The time will  come for Canada to abandon the monarchic past of it. Personally I don't give a damn about the Queen.

  When anyone doesn't have the arguments to continue a discussion, the last and only resort left is the personal attack against a culture and to its people. I understand it, the ignorance has this as its only argument.

Openminded1
Openminded1

@RamonRoman @LarryYoumans @mary.waterton And long live the queen you guys love so much. She does not care about the UK.s cousin country. canada is a wanna be country, wannabe the USa, wannabe the UK and the moron's in Quebec  want to be there own country because they are wannabe France,  What a Joke.                                                                                                                              

Openminded1
Openminded1

@RamonRoman @Openminded1 @mary.waterton I better learn, are you kidding I know about capitalist and how the system works. What makes me fall asleep is some of your long winded rants. As i said before what is your interest in American politics? You need need to stick to the queens Canada and worry about politics there.

RamonRoman
RamonRoman

@Openminded1 @RamonRoman @mary.waterton You'd better learn, during the waning years of your life, how the capitalist system works. Now, if you really want to know the way your present system works, totalitarian, take your time, go to the library, get " Negations" written by Herbert Marcuse and open your eyes. Maybe the problem with you is that if you see something that is written in more than two pages, you fall asleep.

RamonRoman
RamonRoman

@fabfusion1 @RamonRoman @mary.waterton I forgot, fabfusion, why do you think the propaganda against the health Canada is so enormous? There is A BIG TEAT CALLED HEALTH INSURERS that don't want to lose their billions, appealing to the ugly euphemism, " SOCIALISM". Why don't you eliminate Medicaid, medicare, social programs, food stamps, etc, etc,etc, and revive what AYN RAND wanted for America? THE LAW OF THE JUNGLE.

RamonRoman
RamonRoman

@fabfusion1 @RamonRoman @mary.waterton Poor you! The propaganda is really enormous. So your mother told you. 75% of Canadians go to the states for treatments, wow, that means the Canadian Hospitals are empty. Why don't you come here and see with your own eyes? But you prefer to believe your mom, that I am pretty sure is one of the thousands of tea party baggers. Waiting lists?  That sounds a lot like Sarah Palin's death panels. Look, mister, what do you think Canada is? A third world country? Why don't you visit a Canadian Hospital and see if the technology is not the same as Americans?  Instead on relying on your MOM, come and visit CANADA. We are not starving, we are not dressed in rags and of course are hospitals are always full and nobody is kicked out for not having MONEY TO PAY FOR THE COMMODITY OF HEALTH.

RamonRoman
RamonRoman

@reallife @RamonRoman @mary.waterton Hey, reallife, you know nothing about life. I know is a little late to give you an answer, but is worth a try. Nothing in this life is free. we pay taxes for our way of health care, but we pay it knowing that our taxes are not lining up the pockets of leeches. By the way, reallife, read Article I section 8 clause 1 of your constitution. Taxes are embedded in it for many cause, one is the welfare of the United States of America. So please, if you pay your taxes and those taxes are for your welfare and not for leeches, I think is worth while doing it.

RamonRoman
RamonRoman

@reallife @RamonRoman @mary.waterton Are  you for real? I think  I am pretty sure that you live in the surreal life of the American dream. I have nothing to do with the D. Party. I just get involved invoking the so much handled freedom of opinion. I am just a Canadian and I look at you in  disbelief when I see the distortions and lies that the big insurers tell you to be able to make billions with your so called freedom to make a buck with the naivete of the Americans at large. Health is not a commodity to be traded in the market. Health is a right of everyone and not only for those that can afford it. You will never understand it, but is worth a try from abroad to open your eyes a little bit. If this is propaganda, then, I am a propagandist, it is worth a try for my American brothers.