Health Care In The States

Finding Health Insurance For 71 Cents Per Month

By Jeffrey Hess, Mississippi Public Broadcasting

January 2nd, 2014, 5:38 AM

If you’re looking for evidence that healthcare.gov, the federal health insurance marketplace, is working much better these days, you might want to ask Arlene Wilson.

Insurance navigator Gloria Shields, left, helps Arlene Wilson shop for health insurance on the exchange (Photo by Jeffrey Hess/Mississippi Public Broadcasting).

The 56-year-old is a chef with a popular pizza shop in Jackson, Mississippi.

Wilson says that “most jobs don’t offer” health insurance. Because “most of us live paycheck to paycheck,” she says she’s been unable to afford insurance for the past eight years.

But the health law was designed to help people like Wilson and her co-workers.

Aided by insurance navigator Gloria Shields, Wilson ventured through the online enrollment process.  It took two hours, but: “I got the premium plan. Which pays up to 90 percent [of medical costs].”

Just as important, she received a subsidy – a tax credit of $711 per month. “So the only thing I have to pay a month is 71 cents. Less than a dollar,” she says.

Wilson’s plan is so inexpensive because she makes less than 17-thousand dollars a year and the premiums are reduced by federal subsidies tied to her income.

About 275-thousand uninsured Mississippians are eligible for the health insurance exchange and, like Wilson, they are slowly signing up for new plans.

But only two insurance companies are offering plans in the state and they only overlap in four of the state’s 82 counties. About 20 percent of Mississippians only have the choice of one company’s plans.

One of the companies, Humana, launched a late-December ad campaign to drive more people to the site according to spokesman Mitch Lubitz.

“There has been a ramp up as the healthcare.gov has gotten easier to use and there have been other options for people to go on and get information and enroll.” Lubitz says.

Mississippi’s Insurance commissioner Mike Chaney acknowledges the improvements in the enrollment process but is still skeptical that enough people will sign up for rates to be stable.

“From a zero to ten I would give it a confidence level of about a three. That is still not very good, but it is better than the one I was at the week before last,” he says.

Chaney says the unofficial count is around two-thousand people enrolled as of the middle of December but he says if trends continue to improve his confidence will rise to a five.

This story is part of a collaboration that includes Mississippi Public Broadcasting, NPR and KHN.

9 Responses to “Finding Health Insurance For 71 Cents Per Month”

  1. Ray says:

    Article is full of lies and facetious numbers (and incorrect facts, and general garbage).

    1) There is no “premium plan”. I presume they mean “platinum” (Platinum has a 90% AV, referred to in article).

    2) AV is an actuarial value. It does not mean it will “pay 90% of expenses” as the article states, this is a HUGE difference. It may pay 0%. It may pay 100%. The average across everyone on that plan will be around 90%. There is a big confusion about this, AV is not Coinsurance.

    3) SUBSIDIES ARE NOT AVAILABLE ON PLATINUM PLANS AT ALL!!!!!!!! This is a law! There is NO WAY she is getting that a subsidy for that plan.

    4) Also, it’s IMPOSSIBLE to get a tax credit that high in Mississipi, the maximum for someone making $17,000 in Jackson is $276.93

    5) Unless she is on a bronze plan, there is no way to pay under $50.

    Please correct or remove this article, there are already millions of confused Americans, we don’t need Kaiser Health spreading bad info as well. The navigators already have that under control.

  2. SteveH says:

    Ray, the “premium plan” is in a quote, it’s what the person the article is about said.
    The premium subsidy can be used for any plan, bronze, silver, gold or platinum. You may be thinking of the Cost sharing subsidy which is only available for people on the Silver plans.

  3. Spencer says:

    What Steveh says is correct, you can get subsidies on bronze, silver, gold, or platinum plans. Ray may be thinking of the catastrophic plans, which cannot typically have subsidies applied against the premiums.

    Also, Ray, if you go through the healthcare.gov estimator tool (https://www.healthcare.gov/find-premium-estimates/) and input the information that you suggested, you will see that there are silver, gold, and even platinum plans that can be purchased for under $50 per month. Going through the healthcare.gov estimator, assuming a hypothetical 35-year-old who makes $17,000/year is applying from Hinds County, that person gets a subsidy of $335 per month, and pays a platinum plan premium of under $5 (yes, five) dollars per month.

  4. Ray says:

    I stand corrected. Jackson isn’t in Jackson county, it’s in Hinds.

    The one county in the state with a platinum plan that I see. It also appears to be the only county in the nation where a Platinum plan costs less than a Silver plan, and silver plans are over $600/month.

    I guess it is possible, it’s just an exception to the rule.

    But, Steveh, there is no “premium plan Which pays up to 90 percent [of medical costs].” It’s not the name of a plan, “premium” is never used in a marketing name because of the confusion it generates. The only plan available there is called “Humana Local Preferred Platinum 1000/1500 Plan”

    For reference, she also would have qualified to go on a Silver CSR option from the same carrier with the same network. Compared to the “platinum” plan she chose, there would be:
    -No Premium at all
    -Half the deductible
    -Half the Max Out of Pocket
    -Half the drug deductible
    -Same coinsurance

    A cheap platinum may make a good headline, but this is an exception to the rule, and she still would have been better off going with a silver CSR plan. Good thing she went with a navigator, a broker would get his pants sued off…

  5. Spencer says:

    Ray,

    There are four counties in the state that have a platinum plan offered, DeSoto, Hinds, Rankin, and Madison. These are four of the five counties in which two companies offer plans (in all but one other county, there is only one company offering plans).
    As you saw, you can have the platinum plan from one insurer cost less than the silver plan from another, just because of the guesses that the actuaries from the different companies had when they were coming up with their plan costs. I’m sure you’d see situations like this in other states where there are not very many companies offering coverage, and where there happens to be a significant difference in cost.

    I think all Steveh was saying about the “premium” plan is that the writer of this article simply quoted the consumer and did not “correct” her words. The consumer may have been slightly confused, or may have just misspoken.

    Finally, there are still some pros and cons to be weighed in the platinum vs. CSR Silver plan discussion. Depending on an individual’s needs, they may find the platinum plan to be better. Of note are the differences in prescription drug coverage after the deductible is reached. One plan is not “strictly better” than the other.

  6. Judy says:

    The main point is that this lady, Arlene, , now has health insurance…! :-)

  7. Richard says:

    The bad news, the Affordable Care Act is not perfect, and unless it is, Republicans will constantly try to repeal it and try to return to allowing the insurance companies decide who gets covered and who doesn’t. The good news, with over two million already enrolled on the health exchanges and with almost four million new enrollees in Medicaid, we aren’t going backwards. If anything, we are one step closer to a single-payer healthcare system.

  8. Sarah says:

    I am battling cancer. My greatest fear isn’t the cancer. My greatest fear has been not having health insurance. When I was diagnosed, my insurance company canceled my policy immediately. I could not find any insurance company to issue me a policy because of my diagnosis. With the Affordable Care Act (ACA), the fear is gone. I enrolled on the health exchange and they never asked me about my health history. For the first time in many years, I now have affordable health insurance that can’t be canceled as long as I pay my premium. Millions of Americans like me now have peace of mind knowing that they can get the treatments they need. Republicans want to take that away. Republicans want to see my policy canceled. Republicans have no compassion. I hope we never see the ACA repealed. Before the ACA, my life was hopeless. With the ACA, I now have hope! Thank you President Obama!

  9. K says:

    Sarah: I’m happy for you that you were able to get affordable health insurance and that your fears are being alleviated. That’s a very good outcome of this healthcare reform :) . But it has affected a lot of people in a lot of different ways, and I would caution you not to make blanket statements about “all republicans”. I’m a registered republican, and in October I waited to see what would happen before deciding that Obamacare was either a “good” or “bad” thing. I’m still undecided, and I’ll tell you why:
    When I hear stories like yours, of course I believe that we are moving in the right direction. However, I am 24 years old, recently graduated from college, newly married, and a new homeowner. In November, as a result of the ACA, my husband and I were both notified that our insurance plans were being canceled, and they’ve since been replaced with plans with much higher premiums. We were getting by with our mortgage, our car payments, my school loans, and all life’s other expenses, but now this sort of comes as a terrible blow, and we’re really having trouble making ends meet. For people like me, the ACA is not good news: it’s created a lot of stress and worry for my family. I think everyone should have access to affordable healthcare, but I’m disappointed that the conditions of the act have elminiated so many prior health plans that had been affordable for working people like myself. I don’t qualify for a subsidy, by the tiniest margin. I’m frustrated. So no, I don’t want to see your policy canceled. But I didn’t want to see mine canceled either.

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