NC health plans fewer, costs higher than US norm

Published 12:00 am Wednesday, September 25, 2013

RALEIGH (AP) — North Carolina residents will pay more than the national average and have fewer choices on the state’s federally run online marketplace for health insurance, figures released by federal health officials showed Wednesday.
Average premiums in North Carolina for a mid-range health insurance plan under the Affordable Care Act will be $369 a month before tax breaks are applied, according to federal figures released Wednesday ahead of the launch of new health insurance markets on Tuesday. The average monthly cost for mid-range coverage across 48 states will be $328, the U.S. Department of Health and Human Services said.
Costs will vary widely across the state, depending on age, income, county of residence, deductibles and how many doctors consumers want included in their network.
Prices also will drop once tax breaks are applied for those eligible. Some North Carolinians with low incomes will pay no monthly insurance premiums after the federally subsidies are applied.
States with lower premiums tend to have more competition, the federal report found. The average is eight insurers offering coverage for the 36 states studied where the federal government will operate the online marketplace. North Carolina is among the states were officials opted to leave operating the plan to Washington.
Only Blue Cross and Blue Shield of North Carolina will offer insurance plans available statewide on the exchange. The only other company selling coverage on North Carolina’s exchange is Coventry Health Care of the Carolinas. It plans to offer plans on the exchange in 39 counties, including rural ones and those that include Raleigh, Charlotte, Greensboro, Asheville and Fayetteville. Aetna acquired Coventry in May.
North Carolina shoppers also will have fewer than half the policies to choose from than the average of 53 plans across the 36 states.
Federal officials gave cost estimates for a 27-year-old and a family of four earning $50,000 a year, and in each case described average prices with and without tax credits.
The statewide average cost for a mid-range health insurance plan for a 27-year-old would be at least $237 monthly, falling to $145 if he or she earned just $25,000.
A 27-year-old living in Charlotte would spend at least $247 a month for the lowest-cost mid-range plan. After a tax break, the mid-range plan with the second-lowest cost would be $145. In the metro area that includes Greensboro, High Point and Winston-Salem, the lowest-cost mid-range plan would be $224 a month without a subsidy.
Young adults also could choose to pay lower premiums with a plan that covers prevention, some primary care, and high costs in cases of major accident or illness. The lowest cost catastrophic plan would cost $123 a month on average in North Carolina, the federal agency said.
A family of four with an income of $50,000 a year would pay $880 in premiums for the mid-range health insurance plan before their tax credit, dropping to $282 after the break.
Individuals making less than about $46,000 a year and families of four earning less than $94,000 a year would qualify for subsidies. Anyone making below the poverty line of $11,490 for an individual and $23,550 for a family of four won’t be eligible for subsidies through the online marketplace. They are among 500,000 people who were supposed to be covered by an expanded Medicaid program, which North Carolina lawmakers rejected.
The liberal advocacy group Families USA estimates 869,000 North Carolina residents will be eligible for federal subsidies to help purchase insurance under the state exchange. But the amount will vary widely depending on income, location, the plan, family size, age, and even tobacco use.