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Health & Fitness

Tampa area will pay at low end of health care marketplace

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Published:   |   Updated: September 26, 2013 at 10:33 AM

Tampa area residents who need health insurance can expect to find some of the state's lowest rates when the federal online marketplace opens next week.

Across Florida, individuals will see rates for mid-level health coverage averaging between $257 and $328, a price comparable to a new car payment, according to new information from the U.S. Department of Health and Human Services.

But the report shows that the initial premiums insurance companies charge on the Health Insurance Marketplace will fluctuate a lot, depending on where people live.

For example, a Tampa family of four with an income of $50,000 a year would pay $721 in monthly premiums for the mid-range health insurance plan, before any subsidies are applied to reduce costs. The same family in Orlando would see an $816 price tag.

Likewise, a 27-year-old living in Tampa and making $25,000 a year would pay a $199 monthly premium for the mid-range “silver” plan. A similar Orlando resident would pay $225.

But tax credits based on annual income will help equalize the premiums among Florida's metro areas. Once tax credits are included, the Tampa and Orlando families would both have a monthly premium of $282. The young adults would both pay $145 a month.

Health and Human Services Secretary Kathleen Sebelius said urban areas are likely to have access to more plans offered statewide. In rural counties, consumers may have only one option.

“For millions of Americans, these new options will finally make health insurance work within their budgets,” she said in a call with reporters about premiums and plan choices in 36 states where the federal government will open the marketplace on Tuesday.

The Affordable Care Act created the online service to help meet a Jan. 1 mandate that most Americans have health insurance. The exchange is for consumers who can't afford insurance or don't have access to workplace insurance — about 20 percent of Florida's population. The liberal advocacy group Families USA estimates that 1.7 million of the 3.5 million uninsured Floridians will be eligible for federal subsidies that will help them buy insurance.

The level of medical coverage and costs will be based on four metal tiers: bronze, silver, gold and platinum. Individuals making roughly $46,000 a year and families of four with an income less than $94,000 will be able to get subsidies on monthly premiums on the marketplace.

The premiums concern licensed health care advisor Eric Brown of Tampa. Some comparable individual policies he found on the traditional commercial market have lower monthly premiums than those on the exchange, he said Wednesday.

Individuals can continue to buy health insurance from agents like Brown. Subsidies, however, are only available on the federally-run exchange.

Simulations Brown ran for a single, non-smoking man in Tampa were more than $50 to $100 lower for monthly premiums.

The federal exchange premiums may create sticker shock, especially for those whose income doesn't merit a subsidy.

“If you have to go and just pay the premium, you will be disappointed,” Brown said.

Also, people who previously paid low premiums and had minimal benefits may balk at the rates, he said. The health law requires all new individual plans to offer 10 essential benefits, adding to the services available but also to the cost for some who used to buy so-called catastrophic policies.

Starting Jan. 1, only adults younger than 30 and some with limited income can choose a catastrophic policy. But they won't be able to earn tax credits, according to Healthcare.gov, the marketplace website.

Come Tuesday, individuals shopping on the exchange need to look beyond the monthly premiums, Brown said. The cost of deductibles and co-pays, as well as the doctors you want to see are significant factors to consider.

“One good thing about the Affordable Care Act is that it's simplifying the health insurance buying process,” Brown said. “But it's also the first time a lot of (unisured) people have ever looked.”

The premiums also don't address a lingering political issue in Florida. State Republicans are vehemently declining to consider expanding government-backed Medicaid for the state's poorest uninsured adults. As a result, federal health officials anticipate roughly 1 million Floridians will fall into a gap where they won't qualify for subsidies through the online marketplace.

The Florida Department of Health also recently ordered county health departments to ban “navigators” from conducting outreach on their property. And Gov. Rick Scott, a vocal opponent of so-called “Obamacare,” questioned the security of the marketplace application process.

Information from The Associated Press was used in this story.

mshedden@tampatrib.com

(813) 259-7365

Twitter: @MaryShedden

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