Many ObamaCare plan choices, affordable options, available in Wisconsin
Open enrollment and re-enrollment period starts November 1
Many worry about the premium price increases they hear about in the news. Nationally, premium increases on the Affordable Care Act (“Obamacare”) Marketplace, HealthCare.gov, are reported to average 25%. Wisconsin’s Marketplace plans show an average premium increase of about 16%.
Consumers who qualify for a federal subsidy won’t have to pay premium increases that are being reported in the news. The increase in federal financial assistance will offset the increased premium prices. The average net premium (after federal subsidy) in 2017 for Wisconsin consumers selecting the lowest cost plan within their metal tier will be an estimated $138 per month.
Federal premium subsidies through the Marketplace will continue to keep premiums affordable for most Marketplace consumers. About 85% of those purchasing Marketplace insurance coverage in 2016 qualified for federal subsidies, known as advance premium tax credits (APTCs), resulting in an average 73% reduction in the price of the premiums. The 224,208 Wisconsin residents who purchased Obamacare policies chose policies that required their paying an average monthly premium of $125. About 70% of these consumers had a Marketplace coverage plan choice available to them for less than $100 per month, and about 60% could have obtained coverage for less than $50 per month.
As well, many consumers in Wisconsin have been purchasing policies “off-exchange” and not through the Obamacare Marketplace, paying much higher prices than they should: estimates suggest that 51,000 of these Wisconsin residents who purchase “off-exchange” coverage would be eligible for federal premium subsidies if they purchase their coverage through the ACA Marketplace instead. It is also important to also note that an estimated 124,000 currently uninsured residents are eligible for Medicaid or BadgerCare and can apply today for such coverage. This coverage has no premium and very little cost-sharing.
The departure from or change of service area of some health insurers in the Affordable Care Act (“ObamaCare”) Marketplace will bring an estimated 37,160 residents to shop for a new health plan. They, and the 224,208 Wisconsin residents who bought Marketplace health insurance policies last year, will have a many health plan choices available to them through the Marketplace, with open enrollment set to begin on November 1. Consumers should select a plan by December 15 for coverage to begin January 1, 2017.
Shopping for health plans during open enrollment is common for consumers, who use the opportunity to find better prices, different sets of benefit, or different provider groups. When 150,000 Wisconsin residents reenrolled from 2015-16, 39% of those previously covered switched to a different Marketplace health insurance plan. The overall high rate of re-enrollment (81%) demonstrated the need and ongoing demand by these consumers for Marketplace coverage.
Most counties in Wisconsin will have at least three insurance carriers offering multiple plans through the Marketplace. While some insurers have left, three new carriers – Children’s Community Health Plan, Aspirus Arise, and Health Partners – have entered the Marketplace. This map shows information on which plans are available and in which counties. The continuing strong participation by Wisconsin insurance carriers in the Marketplace promotes competition and allows consumers to switch plans based on price and other considerations.
The potential enrollment in Marketplace plans remains substantial. In addition to those who will be re-enrolling in coverage, about a quarter (84,000) of the estimated 353,000 Wisconsin residents who remain uninsured, are currently eligible for federal subsidies to purchase health insurance through the Affordable Care Act (“Obamacare”) Marketplace.
Consumers are encouraged to seek help to enroll or re-enroll in health insurance coverage. They can call 2-1-1 to find local help, go online to HealthCare.gov, or contact Covering Wisconsin, the state’s largest federally-certified and state-licensed Navigator entity, at 608.261.1455.
