Looking at Obamacare: Subsidized healthcare deals for some, but not for everyone

Source: The Montana Standard, ButteAug.迷你倉新蒲崗 25--HELENA -- If you're single, earn about $15,000 a year and have no health insurance, subsidized policies under Obamacare will be available this fall for as little as $23 a month -- and with good benefits.But if you're single, make $40,000 a year and have no health insurance, you may not get a subsidy -- and the policy you can buy under Obamacare would cost about $240 a month, with lesser benefits.This same pattern holds true for most uninsured Montanans who will choose to shop for health insurance on the new Internet "marketplace," a linchpin of Obamacare, the federal health-care law known formally as the Affordable Care Act (ACA).Those with lower incomes will find some very affordable health coverage for purchase, thanks to the generous federal subsidies offered under the ACA.Those with higher incomes, however, will have to pay a higher share of their income toward buying coverage, even with subsidies.The ACA, of course, requires all Americans to have health insurance by 2014 or pay a tax penalty.The Internet marketplace -- one in each state -- is Obamacare's main tool for making affordable, private health insurance available to a big chunk of the nation's 50 million uninsured. Shopping on the marketplace begins Oct. 1.In an attempt to make these policies affordable, the federal government is providing subsidies (officially, "tax credits") for those who buy insurance on the marketplace. The subsidies are available only to those whose income ranges from 100 percent to 400 percent of the federal poverty level.It's estimated that 150,000 to 200,000 Montanans may be eligible for subsidies, as they shop for insurance on the marketplace.The amount of that subsidy and how much it offsets the cost of insurance will differ greatly depending on your age, income and type of coverage you choose.To get an idea of what those subsidies might be, the Lee Newspapers State Bureau calculated the insurance cost and subsidies for nine hypothetical Montana households. Here's what we found:For those in lower income brackets, most policies are an excellent deal, as the subsidies offset a larger share of the cost for low-income earners. Those earning below 250 percent of the federal poverty level also get more generous policies for a lower cost.Higher-income households are expected to pay a higher share of their income for their policies, and may get minimal subsidies or no subsidy at all.Families with children are probably more likely to get a higher subsidy, because the poverty level threshold for their households is higher.Older households can expect to pay higher premiums -- but if you're older and have very low income, a lot of that premium will be offset by the subsidy.However, one income group is left out in the cold: Those earning less than 100 percent of the federal poverty level, or $11,490 for a single person and $23,550 for a family of four.People in this group are not eligible for any subsidies. They're technically required to have health coverage in 2014, but may be able to get an exemption.Under the ACA as passed by Congress, this group was to be covered by an expanded Medicaid program. But the U.S. Supreme Court in 2012 said the Medicaid expansion is optional for states -- and the 2013 Montana Legislature vot迷你倉出租d against expanding Medicaid in Montana.Three companies are selling policies on the Montana marketplace, starting Oct. 1: The Montana Health Co-op, Blue Cross and Blue Shield of Montana, and PacificSource.The Lee Newspapers State Bureau analysis assigned specific policies from each company to various hypothetical families, to determine what those families would pay, with the subsidies, for their coverage.For example, a married couple at age 55 earning $50,000, with no kids, would pay an average of $1,157 a month for a Blue Cross policy that has a $2,000 deductible and 20 percent coinsurance after the deductible is met. (Premium amounts will vary according to where you live in the state; some regions are higher or lower than others.)Yet after a subsidy is applied, the couple would pay $627 a month for the policy. The subsidy would be paid directly to Blue Cross, or whichever insurer the couple chooses on the marketplace.The "deductible" is what you pay out from your own pocket for medical services before insurance coverage kicks in. Anything above that amount, the "coinsurance" is the percentage of costs that you payUnder these policies, however, some preventive-health benefits are covered entirely, without a deductible.The ACA also dictates that those earning less than 250 percent of the federal poverty level get better benefits than someone earning more money and paying the same price for a policy.For example, a 35-year-old single parent with two kids, earning $30,000, can get a policy from the Montana Health Co-op for just $100 a month -- and the deductible is only $500, with 20 percent coinsurance.The same-sized family who earns above 250 percent of federal poverty -- $48,375 for a family of three -- would pay more to get a policy with a $1,750 deductible and 40 percent coinsurance.Another group with special benefits under the ACA is Native Americans whose household income ranges from 100 percent to 300 percent of the poverty level. They can buy just about any plan on the exchange, with a subsidy, and have no deductible, no coinsurance and no copays -- essentially 100 percent coverage.Some households, however, won't get any subsidy, even though they earn less than 400 percent of the poverty level.A 40-year-old single person buying a PacificSource policy that has a $3,000 deductible and 50 percent coinsurance would pay an average of $236 a month. But they would get no subsidy, because the premium is below the maximum percentage of their income they're expected to pay for insurance.Those shopping for health insurance on the marketplace won't know their actual premium or subsidy until marketplace opens for business Oct. 1.There's also no shortage of assistance for consumers shopping on the marketplace. Insurance agents, trained "navigators," state and federal government websites and health clinics around the state are just some of the resources."Insurance and Obamacare are pretty complicated," says state Insurance Commissioner Monica Lindeen. "I encourage folks to get their questions answered. ... I would hate to see Montanans miss out because Obamacare seems too complicated."Copyright: ___ (c)2013 The Montana Standard (Butte, Mont.) Visit The Montana Standard (Butte, Mont.) at .mtstandard.com Distributed by MCT Information Services迷你倉