Is the Healthcare.gov Marketplace Finally “Affordable”?

FORT MYERS

Since March, millions of people have flocked to Healthcare.gov’s exchange to take advantage of expanded government subsidies during a special enrollment period opened for help during the pandemic. When the American Rescue Plan (ARPA) was passed, it not only offered stimulus checks, but also expanded the affordability of health insurance plans purchased through the Affordable Care Act marketplace.

In the past, anyone earning more than $51,000 was not eligible for subsidies. For a couple, that limit was $68,000, rising slightly with each family member covered by a plan.

“It was a cliff,” said Margot Kast, an independent insurance agent in Naples.

ARPA allows subsidies for people with incomes above 400% of the poverty line and increases the level of assistance for lower-income Americans who were already eligible for such assistance.

Kast said it’s more of a plateau now, and she’s been able to find savings for households making up to $200,000 and even $300,000 a year.

She showed an example of a 60- and 62-year-old couple who make $70,000 a year and are eligible for multiple plans with no monthly bonuses. Last year, the same couple would have paid $2,000 a month for the same plan. It’s important to note that many plans still have very high deductibles: This means the insurance company won’t pay anything until a person has already paid a certain dollar amount out of pocket.

“It actually creates an incentive to keep making money,” Kast said. “Before, there was almost no incentive to make money.”

According to the Kaiser Family Foundation, the number of people eligible for a grant to purchase Marketplace coverage increased by 20%.

“After doing the research, you feel like it’s too good to be true because we’ve never qualified for subsidies in the past,” said Molly Capiga, a North Fort Myers homemaker, whose husband earned a medium salary.

The Capigas purchased a plan during the special registration period that costs only $98 per month. They previously paid $645 per month for a plan with a $12,000 deductible. Your new plan has a similar deductible.

Capiga’s husband isn’t offered insurance through his job = so they’ve had private insurance for the past five years. She said each year her monthly expenses would increase, while her deductibles would also increase.

“It’s been really hard to budget for, and then when things go up [$200]-$300 a month, it’s absolutely verging on being prohibitive,” Capiga said.

But all expanded subsidies come with a huge price tag for every American taxpayer. The Congressional Budget Office estimates that it will increase the federal deficit by $34 billion over the next 10 years.

“I’m leaving it up to the President and the White House to work out how they’re going to work on budget issues,” said Dr. Rachel Levine, Assistant Secretary of the US Department of Health and Human Services. “But I think there is an absolute need for quality, affordable healthcare for everyone in the United States, and that has become more evident during COVID-19.”

At the time of publication, a White House spokesman was unable to provide further insight into these budget issues.

dr Levine cited the program’s success as proof it was money well spent. She said that as of mid-May there were about 1 million new signups for Marketplace plans, in addition to the additional 2 million people who had existing plans.

Anyone with an existing plan can renew their plan with additional qualifying grants.

“It’s big business. This could be as big as it was when the Affordable Care Act started,” said Kast, who estimates she’s helped hundreds of people save money with new marketplace plans since March.

If you or your spouse are offered insurance through an employer, you probably aren’t eligible for a plan on Healthcare.gov, but Kast said it’s worth checking to see if your coverage has changed in any way over the past year.

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