As the open enrollment start date for the new health insurance exchanges gets closer, concern over how the marketplaces will affect premium rates has grown among policymakers and consumers.
Based on public insurance rate filings from 12 states — including eight state-run and four federally run or partnership exchanges — healthcare business advisory company Avalere Health has issued a report on what pricing will look like in the marketplaces established under the Patient Protection and Affordable Care Act. Here are some key findings from Avalere's analysis.
1. An estimated 80 percent of people buying coverage through the exchanges will qualify for federal subsidies to help pay for the cost of insurance.
2. Monthly premiums for the least expensive silver-level health plans range from $197 in
3. Silver plan premiums vary significantly in some states. For example, the most expensive silver plan costs $418 more than the least expensive silver coverage in
4. The average monthly premium for bronze-level plans is $274. Bronze plans cover 60 percent of medical costs, while silver plans cover 70 percent. Consumers can also choose to enroll in gold plans to get 80 percent of their costs covered or to purchase platinum plans, which cover 90 percent.
5. According to Avalere, the $62 per month difference in premium costs between bronze and silver plans could lead healthier consumers to "buy down" to bronze coverage, although bronze plans offer less generous benefits. However, people who earn between 100 percent and 250 percent of the federal poverty level can only receive cost-sharing reductions that increase the actuarial value of their plan by signing up for silver coverage. That means people earning below 250 percent of the federal poverty level would benefit more from paying higher premiums for better benefits and lower out-of-pocket costs, according to the report.
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