Experts: Wait to get new health plan prices

Sep. 27, 2013 @ 10:30 AM

Although North Carolina residents could pay more than the national average for health insurance in the state’s federally run online marketplace, it may be better just to wait until next week to find out for sure.
That’s the advice that came out of a health care forum on the Affordable Care Act this week at Morehead Recreation Center. 
Figures released Wednesday by federal health officials showed that average premiums in North Carolina for a mid-range health insurance plan under the Affordable Care Act will be $369 a month before income-based tax breaks are applied, according to federal figures released Wednesday.  In the metro area that includes Greensboro, High Point and Winston-Salem, the lowest-cost mid-range plan would be $224 a month without a subsidy.
The marketplace, or exchange, is aimed at helping uninsured people find coverage they can afford. People who have employer-paid insurance, Medicaid, full-coverage VA or Medicare do not qualify.
There was talk at the forum that Blue Cross & Blue Shield of North Carolina may have posted rates ahead of the Tuesday opening of the exchange.
“You really won’t know what the rates are until Oct. 1,” said William Dixon, a program navigator for Southside United Health of Winston-Salem, “because that is when they have to post them.”
The average monthly cost for mid-range coverage across 48 states will be $328, the U.S. Department of Health and Human Services said. Costs will vary widely across the state, depending on age, income, county of residence, and deductibles.
“Each case is different,” Dixon said. “It depends on what you have put on your tax forms about your income and family.”
Some North Carolinians with low incomes will pay no monthly insurance premiums after the federal subsidies are applied, according to experts. Individuals making less than about $46,000 a year and families of four earning less than $94,000 a year would qualify for subsidies.
Anyone making below the poverty line of $11,490 for an individual and $23,550 for a family of four won’t be eligible for subsidies. They are among 500,000 people who were supposed to be covered by an expanded Medicaid program North Carolina lawmakers rejected.
States with lower premiums tend to have more competition, the federal report found. The average is eight companies offering coverage for the 36 states studied where the federal government will operate the online marketplace.
“If there is more competition in North Carolina, the rates should go down,” said Sylvia Collins, director of Triad Economic Development Corp. 
Only Blue Cross and Blue Shield of North Carolina will offer insurance plans statewide. The only other company selling coverage is Coventry Health Care of the Carolinas in 39 counties, including rural ones and those that include Raleigh, Charlotte, Greensboro, Asheville and Fayetteville. Aetna acquired Coventry in May.
Other report details:
—North Carolina shoppers also will have fewer than half the policies to choose from than the average of 53 plans across the 36 states.
—The statewide average cost for a mid-range health insurance plan for a 27-year-old would be at least $237 monthly, falling to $145 if he or she earned just $25,000.
—A family of four with an income of $50,000 a year would pay $880 in premiums for the mid-range health insurance plan before their tax credit, dropping to $282 after the break.
—Young adults also could choose to pay lower premiums with a plan that covers prevention, some primary care, and high costs in cases of major accident or illness. The lowest cost catastrophic plan would cost $123 a month on average in North Carolina, the federal agency said.

The Associated Press contributed to this report.


Differences: The liberal advocacy group Families USA estimates 869,000 North Carolina residents, mostly uninsured people, will be eligible for federal subsidies to help purchase insurance under the federal exchange. But the amount will vary widely depending on income, location, the plan, family size, age, and even tobacco use.