Time Warner's Charlotte News 14 omitted critical information about health care premium prices in a report leading up to state-based insurance exchanges opening on October 1 by only reporting average premium prices while omitting the subsidized prices many North Carolina residents would receive under the Affordable Care Act.
The September 25 report relied on data from the Department of Health and Human Services (HHS) which listed average subsidized prices for North Carolina residents:
New estimates show people in North Carolina who shop for health insurance coverage on the federally run, online marketplace could pay more and have fewer choices than the national average.
The U.S. Department of Health and Human Services said premiums for a mid-range plan sold on the health exchange will be $379/month on average. The average cost for that same plan across 48 states will be $328 when the new health insurance markets start.
The figures provided by News 14 represents unsubsidized averages of all people under age 65 but does not tell the entire story for many North Carolina residents. A report by Families USA found that, if Medicaid had been expanded in North Carolina, 868,520 residents would be eligible for tax credits under the exchanges. Yet, as Kathleen Stoll, director of health policy for Families USA explained, this figure is a low estimate because the report assumed the state would expand Medicaid.
Of the more than 850,000 residents eligible for subsidized insurance, younger customers can expect to pay less and will have access to low-cost "catastrophic plans" that provides emergency coverage for people under 30.
Even without the catastrophic coverage plans, premium prices for young adults in North Carolina would be drastically lower than the average price for most individuals purchasing insurance, and they can choose from a variety of "bronze, silver, gold, and platinum plans in the Health Insurance Marketplace." According to an HHS release, a 27-year-old in the state making $25,000 a year can be covered for just $88 dollars a year after applying the tax credit. The same 27-year-old could get a "silver" plan for $145 a month.
Low-income families benefit even more from subsidies. A "bronze" level plan for a family of four making $50,000 can be purchased for $74 dollars a month after applying tax credits, with a "silver" plan costing $282 -- both well under the average price stated in the article.
Nationally, tax credits will allow 6.4 million people to purchase insurance for less than $100 each month. Including the subsidized prices for plans bought on the exchanges is critical to understanding true insurance costs because many of the new shoppers will be low-income uninsured, meaning they are most likely to be eligible for subsidies. As the Kaiser Family Foundation explained in a primer on the makeup of the uninsured:
Most people without health coverage are in working families and have low incomes. Adults make up a disproportionate share of the uninsured population because they are less likely than children to be eligible for Medicaid. While a plurality of uninsured people are White non-Hispanic, racial/ethnic minorities are at especially high risk of being uninsured.
Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. The consequences of reduced access to care over time can be serious, including preventable hospitalizations, poor overall health, disability, and premature death.
These low- to mid-income individuals and families will be able to access subsidies based on 2013 poverty guidelines, which according the Miami Herald could mean subsidies for families as high as $10,000 a year:
When the marketplace open enrollment period under the new health care law begins on Oct. 1, the tax credits will be ready and waiting for eligible citizens and legal residents who earn between 100 percent and 400 percent of the federal poverty level.
In 2013, that includes individuals earning from $11,490 to $46,000, two-person families earning between $19,530 and $78,120, and four-person families earning between $23,550 and $94,200 a year. Tax credit eligibility will be based on the 2013 federal poverty guidelines until the 2014 guidelines are determined.
The size of the tax credit for a person receiving insurance coverage under Obamacare could range from a few hundred dollars to more than $10,000, based on family size, income and the cost of coverage in an individual's area.
The amount will become known after submitting an online coverage application through the insurance marketplaces, which will be operated by either the states or the federal government. Once a person signs up for a marketplace health plan, the tax credit will be sent directly to the insurance company and applied to the plan member's monthly premiums in 2014.