With Portions of Obamacare Set to Begin, Questions Remain

by Mark Friedman  on Monday, Sep. 2, 2013 12:00 am  

“People think the premiums are going to be way high and unaffordable,” she said. “I don’t think that’s going to be the case.”

She said if premiums are higher, it will be primarily because the plans offered through the Health Insurance Marketplace have more benefits than some individual plans that have previously been sold in the state. Stock, at QualChoice, said the health care reform law required a number of changes that could increase the price for some buyers. For example, Obamacare makes it illegal to charge different premiums for men and women, which is currently common in the individual insurance market.

For many, maybe most, Arkansans who buy insurance through the new marketplace, the price will be offset to some degree by federal tax credits. Tax credits will be available for households with incomes that fall between 100 and 400 percent of the federal poverty level. For 2013, those income brackets are about $11,000 to $45,000 for an individual and up to $94,000 for a family of four.

“We’re in a state where 78 percent of the people are under 400 percent of the poverty level,” Crone said.

Those whose household income falls below 100 percent of the federal poverty level will be able to obtain private insurance from one of the four Health Insurance Marketplace companies and have their premium paid and all out-of-pocket expenses paid. Those Arkansans who fall between 100 and 138 of the federal poverty level would have their premium paid, but would have to cover some of their out-of-pocket expenses, such as copay, she said. And those whose income is more than 138 percent of the federal poverty level will have to pay for some expenses.

This is the “private option” that Arkansas lawmakers adopted in lieu of expanding the existing Medicaid program, and those private policies will be paid for with the federal funds that would have otherwise gone to expanding Medicaid.

There are believed to be 200,000 to 250,000 Arkansans who will qualify under that scenario.

 

 

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