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2/7/2013 1:06:00 PM Email this articlePrint this article 
Obamacare: Premiums or penalties?

Vince Lovato
Staff Writer

While politicians and insurance industry officials hash out the complicated details of impending health care reform, rank-and-file citizens just want to know what to do, when to do it, and how much it's going to cost.

"I believe there are many, many people who want the information and want to understand options, timelines, etc.," said Broker Martha Rochester-Gant, past president of the Entiat Valley Chamber of Commerce. "They have heard all the mixed messages for the past couple of years. It's time to shed light on the truth as we know it today."

Chelan County insurance agents are trying to get the details, but what they do know is that we all have to be patient.

Agents' concerns

Washington's state Health Benefit Exchange starts Jan. 1, 2014, and most people will have to buy insurance through the exchange by then, leaving some brokers wondering where they fit in.

"I believe many local agents have not gotten their arms around the issue either," Rochester-Gant said. "Their fear is the commissions they used to get have gone down to less than 50 percent of what it was two years ago. They are all getting out of the business of individual health sales based on fear of the unknown."

Rochester-Gant said she would make $12 per month commission for a policy for a typical 40-year-old.

Timelines

The insurance commission will make decisions by Feb. 21 that should lift the veil of confusion but everyone must enroll by Oct. 1, with policies in effect by Jan. 1, 2014.

The system is a sliding scale based mostly on income and dependents. The Kaiser Family Foundation estimated some hypothetical costs.

In one scenario, a family of four with an annual income of $60,000 will pay an annual premium in the amount of about $12,000, or $1,000 per month. That would be offset by a tax credit of $7,000. But it is unclear whether the credit will be taken monthly or after the family paid the monthly premiums. Still, the monthly cost would be more than $400.

The same family making $35,000 would pay about $115 per month after its tax credit, though the overall cost of premiums would be the same $12,000.

Those hardest hit will be young, single wealthy people who might not get any assistance at all but are still required to enroll and purchase coverage through the exchange.

Penalties

Those without insurance will face penalties. Starting in 2014, each uninsured adult will pay a $95 monthly fine. For each child, the parents will be fined $47.50 topped at $285 per family per month, according to the Kaiser Family Foundation. (See a chart on page 3 of this week's edition.)

Those fines skyrocket in 2015 to $325 for adults and $162.50 per child.

In 2016, those fines go to $695 and $347.50.

The exchange

According to the state insurance commissioner, the exchange will be an online marketplace where individuals, families and small businesses can:

• Shop for and compare private health plans with the same benefits;

• Get answers to questions about their health coverage options;

• Find out if they're eligible for health programs or tax credits to help make coverage more affordable; and

• Enroll in a health plan.



Reader Comments


Posted: Friday, February 8, 2013
Article comment by: Mike B.

Articles states "Those hardest hit will be young, single wealthy people who might not get any assistance at all but are still required to enroll and purchase coverage through the exchange."

The subsidies for individuals cap out at 400% of the federal poverty level, which is just about $45,000. So those single people will receive no subsidy above that income level.

I don't think it's fair to categorize a young single person, making $46,000 per year, as "rich" as the article indicates. The truth is the Obamacare subsidies will benefit the low-to-lower-middle classes, not the middle class.


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