Waiting till the last minute to buy an Obamacare health plan? Here’s what you need to know

Dec. 07--Our health care system is so out of whack that it has made silver more expensive than gold.

If you have no idea what I'm talking about, you'll find out if you're shopping for health insurance on the Obamacare marketplace before the Dec. 15 deadline to obtain a plan for next year.

Those plans are categorized by levels -- platinum, gold, silver and bronze. Kind of like the Olympics.

In past years, people shopping on the healthcare.gov website knew they could get the best coverage in platinum and gold plans. Premiums were higher but co-pays and deductibles were lower, meaning less out-of-pocket costs when you needed care.

That made sense -- you pay more, you get more. You could get a little less coverage and pay less with silver plans, and so on with bronze.

But that pecking order was scrambled this year.

Now, gold plans may be more affordable than silver for some people. And bronze plans may be worth more than you think, too.

If the government really wants to fix our health care system, this would be a good start. You can't expect people to make wise decisions when you confuse them. Put it back in logical order next year.

Things got goofy because the federal government stopped subsidizing insurance companies with what were known as "cost-sharing reduction" payments. Those payments offset insurers' expenses for keeping out-of-pocket costs low on silver plans offered to lower-income families.

Binghui Huang, Tim Darragh and Anthony Salamone

President

Donald Trump's decision Thursday to end subsidies to insurance companies that provide coverage to lower-income individuals should not affect most Lehigh Valley policyholders immediately, but the disruption and uncertainty the move brings threaten higher costs in the future, insurance...

President Donald Trump's decision Thursday to end subsidies to insurance companies that provide coverage to lower-income individuals should not affect most Lehigh Valley policyholders immediately, but the disruption and uncertainty the move brings threaten higher costs in the future, insurance...

(Binghui Huang, Tim Darragh and Anthony Salamone)

The Trump administration stopped making those payments for next year as it tried to unravel Obamacare. Whether the payments, made since 2014, were even legal was debatable because Congress never authorized them.

Without those subsidies, insurers increased the cost of next year's silver plans on healthcare.gov. That made gold plans more affordable, for reasons that may confuse people even more.

While the payments to insurers are gone, the government still gives tax credits to qualifying individuals and families to offset their insurance costs. The credits are based on a formula that considers a buyer's income versus the cost of silver plans.

As the cost of those plans has increased, the government has had to provide higher tax credits. That gives individuals and families more buying power and also means the government isn't saving money by not paying insurers. The Congressional Budget Office projects the change will cost taxpayers $6 billion in 2018.

While the credits are based on the cost of a silver plan, they don't have to be spent on a silver plan. People can use them on a gold plan, too . That means many folks will be able to buy a plan that provides better coverage for less money than "cheaper" plans. When was the last time you got that kind of offer?

An Allentown family of four that qualified for a tax credit of $916 may find a silver plan with a monthly premium of $427, or a similar gold plan for $346, according to the Pennsylvania Insurance Department. And the gold plan's annual deductible would be $3,300 less than the silver plan.

A 30-year-old single person in Allentown with tax credits could get a gold plan for $36 a month less than a silver plan, with a deductible that's $1,650 lower, the department said.

State officials have been promoting the need for people to think out of order as they shop for coverage.

"Premiums for gold and bronze level plans are generally going up much less than for silver plans, meaning consumers can use their higher subsidies to purchase gold or bronze plans, which may be a better deal because of this," acting state Insurance Commissioner Jessica Altman said a few weeks ago at an enrollment event in Bethlehem.

"While gold level plans can have the highest monthly premiums, they also have the lowest out-of-pocket costs, such as deductibles and co-pays," she said. "Because of the increased subsidies, someone who has ongoing medical costs may actually find more reasonable premiums and a better option in a gold-level plan."

Bronze is worth a look, the department said, because after tax credits some could be had for no monthly premiums. Deductibles would be high, though, so that's something to consider.

There still is about a week to buy insurance. If you waited until the last minute, it may make sense to go for the gold because it may be more affordable than you think.

Binghui Huang

The Senate's proposal to eliminate the requirement to purchase health insurance in 2019 would upend the

Affordable Care Act marketplace and likely increase premiums in Pennsylvania and elsewhere, health officials say.

Without a penalty for the uninsured, young and healthy people likely would drop...

The Senate's proposal to eliminate the requirement to purchase health insurance in 2019 would upend the Affordable Care Act marketplace and likely increase premiums in Pennsylvania and elsewhere, health officials say.

Without a penalty for the uninsured, young and healthy people likely would drop...

(Binghui Huang)

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