Midstate residents struggle with health insurance costs
Vicky Taylor, Public Opinion | 11.02.16
Photo by Submitted
Keystone Health insurance navigators Daisy Heredia, left, and Yazmin Ojeda go through paperwork for a client looking for health insurance on the federal Affordable Health Care marketplace.
(Chambersburg) -- More of Franklin County's working and middle-income residents are struggling with rising health insurance premiums this fall, and some are deciding to pay the federal tax penalty rather than buy insurance.
Joanne Cochran, Keystone Health's president and CEO, blames the increasing cost of premiums, coupled with high deductibles and even higher out-of-pocket costs once those annual deductibles are met.
"When the Affordable Care Act was first passed, the lure to get uninsured Americans to sign up for health insurance was the promise of generous premium subsidies," Cochran said.
But that promise came with a catch for people earning between three and four times the federal poverty rate.
Those individuals and families may have to pay up to 9.5 percent of their income toward the premium next year before the subsidy kicks in, while prices on the federal marketplace, where the uninsured find policies that qualify under the act, are soaring in 2017.
Open enrollment for marketplace health insurance began Nov. 1.
The worst hit will be those making between $58,590 and $78,120 annually, Cochran said.
"As a result, some middle-class families are deciding health insurance is beyond their reach," she said.
She believes this could spell political trouble for the law that has become known as Obamacare, and insurers could also see problems if premium costs deter the signup of the healthy enrollees they need to offset the costs of covering the sick.
Cochran believes the real question will be whether insurance premiums will even be affordable for most middle class Americans.
"Half of American families spent 3.1 percent or less of their income on health care before Obamacare took effect," she said.
Those who had job-based coverage generally spent less than those who bought their own insurance, since employers generally paid a large percentage of health insurance for their employees.
By 2015, 25 percent of all households spent 8.2 percent or more on health care, including insurance premiums and out-of-pocket costs. That figure will go up in 2017, creating situations where some people will have to choose between buying health insurance or buying groceries.
"These are the ones most likely struggling to pay bills, and who risk falling into medical debt," Cochran said. "I am often told that 'I cannot afford to feed my family and buy health insurance, so I feed my family.'"
Keystone has 11 insurance navigators who help anyone in the community find health insurance on the marketplace, a service it offers for free to the community. Offices are located at 51 S. Main St., 455 Lincoln Way East, 820 Fifth Ave. and 830 Fifth Ave.
Pam Laye, supervisor of outreach and enrollment, said the average person in Franklin County will pay $422.52 monthly in 2017 for a high-deductible health insurance policy on the marketplace up to a maximum of over $600 a month for a lower-deductible policy with lower out-of-pocket maximums.
Both individuals and families in this area will have only two insurance companies to choose from: Highmark and Capital Blue Cross.
The area's poor and low-income residents will have better choices, especially since Gov. Tom Wolf expanded Medicaid when he took office in January.
Cochran said about 13,000 county residents became eligible for Medicaid then.
The working poor receive bigger subsidies from the federal government to pay their health insurance premiums also.
Still, there are those big deductibles and high out-of-pocket expenses that scare many, even those who can get most of their premium paid with government tax credits.
"If you are in the marketplace, you are struggling," Cochran said.
This article is part of a content-sharing partnership between WITF and Public Opinion Online.
Published in Affordable Care Act
Tagged under Affordable Care Act