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SALT LAKE CITY — A big chunk of the Affordable Care Act takes effect next month and Utahns are getting a first look at the premiums.
Utah has had its own health exchange since 2009, which offers plans to small businesses. Now the feds are stepping in with health plans for individual Utahns.
Utahns will have 99 plans to choose from when the state's insurance marketplace goes online next month.
Jason Stevenson is a health care advocate for the Utah Health Policy Project. He compares the choices to the cereal aisle in a grocery store.
"When you walk in there, you sort of know a little more about what you want," he explained. "You're looking for a brand, for a flake, looking for Cheerios. You kind of have an idea already. With the plans being offered, you're also going to know (if you are) looking for a plan that's going to have low premiums and have higher deductibles."
Unlike cereal, the 99 plans will be lumped into three categories - Bronze, Silver and Gold. Bronze has the cheapest plans with the least coverage. The Gold tier holds the most expensive plans with the most coverage.
"It's the same private insurance they have right now, but they'll have the option of getting the tax credits and they'll have the option of being able to shop in a much more competitive environment," Stevenson said.
In the marketplace, all those insurance companies are ... looking over their shoulder to see what rates the other guy is offering you.
–Jason Stevenson
Just how competitive? That state insurance department has only released the numbers of the Silver tiered plans.
They show a 27-year-old in Salt Lake County can expect to pay between $162 to $255 on their monthly premium.
For a 40 year-old, that range rises to between $173 and $271. A Silver tiered plan will cover 70 percent of a buyer's medical expenses.
"The price of that insurance will be based on three factors: how old you are, whether or not you use tobacco, and what geographic area you live in," Stevenson said.
Geography does matter. People in Utah County might have to pay $50 more a month in premiums than residents of Salt Lake County. It can go up to $60 more for Washington County residents.
Under Obamacare, you cannot be denied coverage because of your health history.
"A person's pre-existing health condition has no reflection on the premiums they pay for health insurance," Stevenson said.
Federal health officials say more than 90 percent of Utahns eligible to buy insurance on the exchange will also get a tax subsidy. How much you'll get depends on how much you make.
- Start shopping Oct. 1, 2013
- Coverage begins Jan. 1, 2014
- www.healthcare.gov
"So each month you write a check for your portion of the premium. And the federal government will write a check for its premium. Those two checks will meet at your insurance company and make up the full premium," Stevenson said.
Opponents say those federal subsidies for the health exchanges will only cause insurance premiums to soar. But Stevenson says the new system will drive down prices because insurers will have to do much more than simply quote a price.
"In the marketplace, all those insurance companies are in a big corral. They're all competing for your business. They're looking over their shoulder to see what rates the other guy is offering you," Stevenson said.
What's next?
So what happens on Oct. 1 when the marketplace opens? How do you figure out what is right for you? You can shop on your own through healthcare.gov.
Or, you can go to one of 11 federally funded community health clinics in the state (get a list at www.auch.org/about-health-centers) and see a navigator. The Utah Health Policy is training those navigators and several other groups to assist the public.
"They're going to sit next to them, one-on-one, go through the application process, figure out what is the best choice for them, ask questions about how they use insurance, what their family members need to make the best choice there," Stevenson said.
Under the Affordable Care Act, nearly every American must have health insurance by next year or pay a $95 tax penalty for the year. That's a lot cheaper than paying monthly premiums, but even if you've paid the penalty, you're still uninsured. If you get in an accident, you're still responsible for the medical bills.
