Premiums explanation

Despite threats by the incoming Trump administration to dismantle the Affordable Care Act soon after taking office, healthcare providers are urging consumers to stay the course.

The deadline to purchase an ACA plan through the marketplace is Thursday. The primary insurance carrier in Arizona – Blue Cross Blue Shield – urges consumers to enroll to avoid a lapse in coverage that will begin Jan. 1.

“The cost of medical care is very expensive. People don’t realize that one hospital stay can cost between $5,000 and $10,000,” said Jeff Stelnik, senior vice president of strategy, sales and marketing at BCBSAZ. “We encourage individuals, including those in very good health to look to purchase an individual plan to protect themselves and their finances.”

To help offset the costs of health insurance from the marketplace, Stelnik added, there are federal subsidies.

“For 2017, there will be significant amount of federal premium assistance,” Stelnik said. “People who may not have had the opportunity to purchase a plan last year may actually qualify for subsidies this year.”

Nationwide, there are 12.7 million people enrolled in the marketplace with more than 200,000 Arizonans enrolled in ACA plans as of February 2016.

In general, to qualify for subsidies a family of four living under 400 percent of the poverty level – or making approximately $90,000 – would qualify for some level of subsidy, Stelnik said.

“We estimate about 13,000 to 14,000 residents in Mohave County are eligible, and in La Paz it’s more than 1,000,” Stelnik added. “We believe there are a significant number who qualify for subsidies who aren’t aware they could get them. Based on last year, only about half of the people who qualified for subsidies enrolled in the marketplace.”

The Department of Health and Human Services recently reported more than 100,000 people selected plans on the day after the presidential election, and there were 53,000 more enrollees during the first 12 days of open enrollment this year than last.

Although people are turning to the marketplace for their health insurance needs, many believe the ACA has its warts.

“The ACA has challenges and there are absolutely changes that are needed,” Stelnik said. “As we move forward we expect to see changes and our focus has always been on the affordability and we are looking to work with policymakers on the local and national level to help with the affordability that consumers need. Blue Cross, despite losing $185 million in the first two years of the Affordable Care Act, we remain committed, particularly to the rural communities who don’t have any alternatives.”


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