The open enrollment period for the Affordable Care Act online marketplace has begun, and depending who you are, you might be spending less on a plan this year – or significantly more.
Quyen Ma is an Austin-based architect and graphic designer. She's self-employed, and she's one of many Texans who don't get health insurance through their employer or through programs like Medicaid. She says she's looking for a plan with the right network and with low out-of-pocket costs for her family.
And, so far, Ma says, the options are pretty good
Mostly though, Ma says she’s relieved the program is still around and – like a lot of people this year – she’s getting more help from the federal government this year.
“Our income falls within the certain bracket that our tax credit was increased this year,” she says. “So, we are given more tax credit for our premiums monthly.”
Ma is among a large number of Texans who receive what are called advance premium tax credits – the subsidies people get in the marketplace. It’s one of the biggest reasons people who have low to moderate incomes can afford health insurance.
That aspect of the health care law is particularly helpful this year, says Stacey Pogue with the Center for Public Policy Priorities, because premiums are going up across the board.
“There is such a weird mixed message this year because it’s true that premiums are going up a lot this year because of market instability,” Pogue says. “But at the same exact time, the way the formula for subsidies work is that subsidies are going up a lot. In fact, even more than the premiums increase.”
Pogue says a lot of those people with lower to moderate incomes are going to be able to get health insurance and pay even less than they did last year.
According to federal health officials, the average tax credit is going up about 45 percent.
“The tax credit is huge,” Ma says. “That makes it completely affordable for our family based on our income. And without the tax credit, our costs out-of-pocket would be astronomical.”
However, not everyone is going to be shielded from this year’s premium hikes.
Pogue says higher-income recipients – those who are four times above the federal poverty level – will feel the force of rate increases. So, individuals earning roughly $48,000 a year, or a family of four that brings in more than $98,000 a year, are going to see rate increases.
“They will have to pay the full cost and won’t have subsidies that offset the rate increases,” she says.
Pogue says it’s important for folks to shop around, no matter how much they make.
The enrollment period for the marketplace ends Dec. 15, and you can sign up for a plan at healthcare.gov.