After that, you won’t be able to get health insurance unless you have a qualifying life event such as having a baby, getting divorced or moving to a new state.
National and local groups are working hard to spread that message.
“There are new options available this year, the process is simple and financial assistance helps make plans affordable,” Antoinette Kraus, director of Pennsylvania Health Access Network, said in a news release Wednesday.
Kevin Counihan, CEO of the healthcare.govAffordable Care Act marketplace, urged people planning to buy health insurance not to delay.
“Last year, for example, a huge amount of enrollees came in the last 11 days,” Counihan said. The system is stable and prepared for the rush, he said, but call waiting times will likely increase as the deadline approaches.
There are also financial considerations.
First, there are federal subsidies for most people who buy plans through healthcare.gov. According to Enroll America, 81 percent of Pennsylvanians who purchased 2015 coverage through healthcare.gov so far qualified for subsidies.
Averages for 2015 haven’t been released yet, but for 2014 the U.S. Department of Health and Human Services said Pa. subsidies averaged $246 a month and brought average monthly premium payments down from $330 to $84.
Second, people who aren’t covered and don’t qualify for an exemption are now charged a penalty through what is known as the ACA individual mandate. For 2014, it was 1 percent of yearly household income above the tax filing threshold, or $95 per adult, whichever is greater. For 2015, it will bump up to 2 percent or $325; for 2016, it will be 2.5 percent or $695.
New numbers
Both HHS and Pittsburgh-based insurer Highmark Inc. released ACA enrollment numbers Wednesday. They show that as of Jan. 30, the number of Pennsylvanians who selected new plans on healthcare.gov or were automatically re-enrolled in 2014 plans stands at 429,996 — and that 171,235 of those plans were from Highmark.
No other locally active insurers have reported their healthcare.gov numbers to date.
Last year’s open enrollment period ran from October through March, with some applicants granted a special extension beyond that. It netted 318,077 Pa. enrollments, 131,264 of them in Highmark plans.
Highmark, Capital BlueCross and Aetna hold about 90 percent of the private health insurance market in Lancaster County, according to the American Medical Association. Capital BlueCross and Aetna have not issued enrollment reports recently.
Kelly Lieblein, regional vice president of Highmark Blue Shield, said Wednesday that despite all the changes in the industry, the insurer is holding steady.
“We hear questions sometimes about ‘What are you seeing regarding groups moving to the marketplace?’” she said. “We’re reallly not seeing as much of that as some industries thought.”
According to Highmark, its retention rate among group purchasers in Central Pennsylvania is 90 percent.
Date: February 4, 2015