Some 33,000 Oklahomans may be missing out on Obamacare tax credits

Oct. 05--Some 33,000 Oklahomans who buy individual health insurance are missing out on tax credits they would get if they bought their policies on healthcare.gov, according to new analysis released Tuesday by the federal government.

Among American consumers who bought individual policies on health care.gov, as well as offline, more than 70 percent would qualify for tax credits, said Sylvia M. Burwell, secretary of the U.S. Department of Health and Human Services. Moreover, qualifiers usually can buy policies with monthly premiums of less than $75, Burwell said.

Independent agents in the state agreed that some are missing out on lower costs by not taking advantage of the tax savings. Meanwhile, at least one Oklahoma consumer calls the Affordable Care Act, which is also known as Obamacare, "unaffordable health care" for his family.

In advance of the Nov. 1 through Jan. 31 open enrollment period for health insurance coverage next year, the Department of Health and Human Services is making sure consumers know their options, Burwell said in Tuesday's news release. The agency, she said, is targeting those who would qualify for the credits through regional TV, radio and digital marketing, and giving insurance agents tools to register consumers faster.

Consumers may be eligible for tax credits if their incomes are between 100 and 400 percent of the federal poverty level, which would extend to about $100,000 for a family of four.

Nationally, the new analysis shows 1.9 million Americans of the 6.9 million who buy health insurance policies offline may qualify for tax credits that some 9 million Americans already receive.

Eighty-four percent of roughly 135,000 Oklahomans with healthcare.gov plans currently qualify for subsidies. Among those, the average monthly premium fell from $89 in 2015 to $80 this year, largely due to consumers changing plans, according to HHS.

Many don't apply

"I'm not sure of the number 33,000, but I would agree with the premise that many people would qualify but don't even apply," said Randy Schreier, an independent agent with Oklahoma Employee Benefits & Insurance LLC. "It may be due to lack of knowledge about their options, lack of time when trying to do this on your own, or fear of giving your personal information to the government."

Connie Morgan, president of Sue Wilson Brokerage Inc., agrees.

"It's true that some folks don't know premium tax credits and cost sharing are available. Some do know and don't want to have anything to do with accepting help from the government," she said.

Online estimator

Nicole Amend, spokeswoman for Blue Cross and Blue Shield of Oklahoma, urges consumers to visit the insurer's English and Spanish subsidy estimator -- at www.bcbsok.com/insurance-basics/understand ing-health-insurance/premium-tax-credit- estimator -- to see if they qualify for credits.

"As we head into open enrollment, we want to remind consumers currently receiving financial assistance to update their financial and family information with the government by Dec. 15 to ensure they receive the proper amount of assistance," Amend said.

Schreier refers customers to the nonprofit Kaiser Family Foundation calculator at kff.org/wp- content/themes/vip/kff/static/subsidy-calcu lator-widget.html.

"This quick calculator asks six questions and will let you know if you are in the ballpark for a subsidy," he said.

Blue Cross will be the only state participant on healthcare.gov next year.

Meanwhile, premiums will likely increase by an average of 76 percent for Oklahomans who buy individual coverage through the Affordable Care Act's marketplace, the state Insurance Department said Tuesday. The increases for individual market plans range from 58 to 96 percent.

As to the increases, Amend said rates are based on anticipated medical care and pharmaceutical costs, and that BCBSOK since 2014 has had combined losses of more than $300 million. "While other companies have exited the health insurance marketplace in Oklahoma, we continue to offer coverage in all 77 counties -- this shows our commitment to the health and wellness of all Oklahomans," she said.

Analysis from the federal government in late August found that, even if premiums rise 50 percent next year on Oklahoma's individual policies for health insurance, 84 percent of Oklahomans who buy policies on the healthcare.gov marketplace will be able to buy coverage for $100 or less per month. Federal spokespeople said that's due to two factors: tax credits increase along with premiums and consumers can shop around to find the best plan.

But Oklahoman Chris Fleuridas, 66, is insured through Medicare and calls the ACA "unaffordable."

For a Blue Cross gold policy with a $500 deductible he bought on healthcare.gov for his wife, 63, they pay $773.89 a month with a subsidy of $279. The total premium is $1,052.89 a month, up from $793.72 in 2015, with higher deductibles and less coverage, Fleuridas said.

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