Few buying on health marketplace will pay full rate

As more information emerges about rates for health insurance to be bought on Maine’s new marketplace/exchange, it’s critical to keep in mind that relatively few will pay the full rate.

Most people will get discounts through a subsidy. The amount varies by family income.

Covering more people will reduce cost-shifting, which has increased costs for people who already have insurance.

You can get an idea of how much the premium and subsidy will be by using a calculator created by the Henry J. Kaiser Foundation.

I tried it for a family of four with the median household income in Maine, $47,898. This family has two adults and two children and no one smokes.

If this family buys the Silver plan, they would pay $3,074 a year. The Bronze plan would cost $1,385 but there could be more out-of-pocket expenses.

Another family, a single non-smoking mother or father with one child and a $25,000 annual income, could pay $1,729 annually for health insurance at the Silver level. The Bronze plan would cost this family just $284 a year.

Try it at this link.

Three more things to keep in mind:

1. Smokers pay more than nonsmokers. That is a federal requirement. The Kaiser calculator includes smoking and nonsmoker rates and subsidies.

2. Premiums are higher in rural areas of Maine. That is due to a state law that was signed into law by Gov. LePage and passed when Republicans controlled the state legislature. The Kaiser calculator does not show different costs by region in Maine.

3. Thousands of very low income Mainers won’t get subsidies because the law was devised to have them receive coverage through Medicaid. Since Gov. LePage vetoed Medicaid expansion and the Maine Legislature came close but didn’t overturn the veto, this is not an option for them.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives.