Monday, December 22, 2014

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Healthcare Costs Explained For Uninsured Consumers Affected By Affordable Care Act

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TWC News: Healthcare Costs Explained For Uninsured Consumers Affected By Affordable Care Act
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Come October 1, people will be able to buy health insurance through the state's exchange, and many currently uninsured consumers are wondering what this means for them and their wallets. NY1's Tara Lynn Wagner filed the following report.

Health insurance can be expensive. It can also be confusing.

The Affordable Care Act aims to change both.

Starting in 2014, the law requires most people who are currently uninsured to purchase health insurance.

"If you have insurance coverage through your employer, nothing will change. If you are on Medicare, and you are elderly, nothing will change. And if you're on Medicaid, the state program for lower income people, nothing will change. It's just the people who don't have coverage now," says James Knickman from the New York State Health Foundation.

Those who don't have coverage now are likely wondering how much this is going to cost them.

The answer depends on a number of factors, such as where you live, how much you make, and how much insurance you want to have.

"As with all other purchases, there's a trade off. Most of us do not buy Mercedes-Benz, even though they're the best ones. We can't afford that, and I think there's the same issue here," Knickman says.

Insurance will be purchased through state sponsored exchanges, and consumers will get to choose from different levels, including bronze, silver, gold and platinum.

The less consumers pay for the premium, the more they'll pay for services.

Bronze coverage, for instance, will have the lowest premium, but on average will only cover 60% of medical costs - a good idea for those who don't go to the doctor much.

"So, anytime you go to the doctor, you might end up paying a co-payment, you might pay a lot of money up to a deductible. It means that you are probably going to save money if you are healthy. If you're unhealthy, you are probably going to end up paying a lot of money every time you go to the doctor," says Tal Gross from the Mailman School of Public Health.

On the other end of the spectrum, the premiums for a platinum plan will be substantially higher, but the consumer's share of the doctor bills will be a lot lower, since these plans will cover an average of 90% of healthcare costs.

Again prices will vary from state to state, but the Congressional Budget Office estimates that in 2016 the annual premium for a single person buying a bronze plan will likely be between $4,500 and $5,000.

For a family, that number will be around $12,000.

However, they also expect that more than half of those purchasing through the exchange will qualify for a federal subsidy. ClientIP:, UserAgent: CCBot/2.0 ( Profile: TWCSAMLSP