The Daily Item, Sunbury, PA

News

October 1, 2013

Health insurance exchanges open

LEWISBURG — SUNBURY — Millions of uninsured Americans are preparing to sift through massive amounts of information about new health care options when health insurance exchanges open today as part of President Barack Obama’s Affordable Care Act.

While some states are opening their own exchanges, Pennsylvania, home to 1.3 million uninsured people, according to the Kaiser Family Foundation, is one of 36 states taking part in the Health Insurance Marketplace, run by the federal Department of Health and Human Services, which released new details of the available plans for consumers Wednesday.

The Kaiser Family Foundation estimates that 13,000 uninsured people live in the Sunbury, Shamokin and Milton areas, representing about 14 percent of the region’s population.

After providing some basic information about household size and income, the federal marketplace will list options for coverage, which will be broken up into four categories: bronze, silver, gold and platinum. Insurance plans in the marketplace are all offered and run by private companies, according to HealthCare.gov.

Plans vary in cost and may be offset by advance tax credits for qualifying individuals, which can be directly applied to health care premiums, according to HealthCare.gov. The exchange will indicate whether individuals qualify for tax credits, which depend on family size and income, after they fill out the Marketplace application.

For a Pennsylvania family of four with an income of $50,000, the lowest silver-level plan in the federal exchange will cost $675 per month, or $282 after a tax credit. A 27-year-old with an income of $25,000 will pay $187 per month — or $145 after the tax credit — for the same plan.

Coverage on plans purchased before Dec. 15 begins Jan. 1, according to an Associated Press Q&A.

All plans must cover certain “essential health benefits,” according to HealthCare.gov, which include outpatient care, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive, wellness and chronic disease management services, and pediatric services.

Some private insurance carriers also will have exchanges to provide additional options for consumers, including Geisinger Health Plan, spokeswoman Amy Bowen said recently. Geisinger’s marketplace will be available through thehealthplan.com/marketplace.

Health coverage will be required by Jan. 1, with penalties — beginning in 2014 with $95 per uninsured adult and $47.50 per uninsured child or up to 1 percent of a household’s income — in place for those who refuse to obtain coverage.

By 2016, those fines will rise to $695 per uninsured adult in the household and $347.50 per uninsured child or 2.5 percent of household income.

The Associated Press contributed to this report.

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