HHS Lauds Savings Opportunities Available to American Consumers with ACA November 1, 2015 Open Enrollment

The United States Department of Health & Human Resources (HHS) is promoting what it styles as “affordability and choice” in the Health Insurance Marketplace used by US consumers to buy health insurance mandated by the Affordable Care Act (ACA). Tomorrow, the Open Enrollment Period for shopping health insurance coverage within the Health Insurance Marketplace begins. In a 33-page report, entitled “2016 Marketplace Premium Landscape Issue Brief 10-30-15 Final,” issued yesterday, HHS indicates that the ACA is “continuing to promote competition, choice and affordability in the Marketplace for plan year 2016.”

Atlanta/Augusta Georgia Business and Healthcare Law Firm

As new and prior enrollees weigh options available in the Health Insurance Marketplace to determine what insurance plans may best suit their needs and resources, they should consider the “premiums, deductibles, out-of-pocket costs, provider network, formulary, and customer service” particulars of the various plan options, according to the report. The HHS report outlines “Key Findings,” which include those summarized as follows:

  • The ACA promotes access to affordable health insurance plans
  • Shopping saves money: about 86 percent of enrollees “can find a lower premium plan in the same metal level before tax credits by returning the Marketplace to shop for coverage.
  • About 72 percent of current enrollees can find a plan for $75/month, or less, after factoring tax credits.
  • About 57 percent of current enrollees can find a plan for $75/month or less within their metal level.
  • Next year, a 27-year-old with $25,000/year income will on average receive an annual tax credit of $1,164, compared to $972 this year. A family of four with an income of $60,000 will on average receive an annual tax credit of $5,568, compared to $4,848 this year.
  • The average consumer has 10 insurance issuers in his/her state. On average, enrollees can pick from 5 issuers for coverage next year.

The report emphasizes that the Marketplace allows consumers “to comparison shop.” Not surprisingly, the report concludes that “[s]urvey evidence suggests that the premium [amount] is the most important factor in consumers’ decision-making when shopping for insurance.” The report explains that “Marketplace consumers are highly sensitive to net premium price (i.e., premium after advance premium tax credit) and nearly one-third of consumers who reenrolled in a Marketplace plan in 2015 switched to a new plan.” Most enrollees (86%), if willing to shop, will be able to “find a lower premium plan in the same metal level by returning to the Market place to shop for 2016 coverage.” Tables contained in the report provide more detailed information and data. Among other information, the report’s tables include helpful state-by-state data and analysis of premium changes between 2015 and 2016. One of the more significant facts asserted in the report is that “[i]f all consumers switched from their current plan to the lowest-cost premium plan in the same metal level, the total savings would be $4.5 billion.” Overall, the report appears intended to encourage consumers to shop for the best insurance plan for them.

If you have questions about this post, contact our Georgia business and healthcare law firm at (404) 685-1662 (Atlanta), (706) 722-7886 (Augusta) or info@hamillittle.com.

Disclaimer: Thoughts shared here do not constitute legal advice. Please consult with an attorney to discuss your legal issue.

Source: HHS

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