Question: How will the Affordable Care Act help consumers and small businesses lower their health insurance costs?
Answer: There will be reimbursements and tax incentives to help purchase health insurance for individuals between 100 percent and 400 percent of the federal poverty level. Small businesses with less than 25 employees may qualify for tax credits for the purchase of health insurance. Younger consumers and businesses with younger employees may see reduced premium rates. In addition, there are a variety of cost-control measures in the Affordable Care Act, such as accountable care organizations and incentives, to reduce unnecessary and inefficient care in hospitals.
Q: What is the estimated average premium on the state’s health insurance exchange opening on Oct. 1?
A: Under ACA, significant changes in how insurance companies set premiums will occur in 2014. The premiums will vary by the characteristics of the persons insured, so it’s difficult to estimate the average premium.
Q: What kind of routines or programs can people and companies implement to help change their health profile?
A: Lifestyle choices are important. Losing weight and exercising can help. Eliminating behaviors such as smoking and substance abuse are good ideas. Under ACA, rates for a smoker can be up to 50 percent higher than a nonsmoker. Some companies have incentive programs that give employees benefits in exchange for meeting desired health targets and for making good lifestyle choices. The health insurers can be of assistance in setting up these kinds of programs.
Q: What are some strategies to save on out-of-pocket medical costs?
A: Under the Affordable Care Act, consumers shopping on the exchanges will be able to select a metal level (e.g. platinum, gold,
silver, bronze). This will determine the level of cost-sharing. By picking a more expensive health plan that has lower cost-sharing (deductibles and co-payments), people will see lower out-of-pocket medical costs. It may be tempting to buy a cheaper plan with higher cost-sharing, but when the time comes to pay the medical bill, this could be a source of regret for some people.
Q: Where can consumers and businesses find resources to help them lower insurance costs?
A: Starting from Oct. 1, 2014, individuals and small businesses can go to the Hawai‘i Health Connector to shop and compare plans and rates. Websites like Hawaii Health Connector (www.hawaiihealthconnector.com), Healthcare.gov, Kaiser Family Foundation and the Insurance Division websites provide good information on the ACA,
individual subsidies and small-business tax credits. You can lower insurance premium costs by taking a higher deductible or higher cost-sharing, but there is a trade-off. Assessing the trade-off involves a prediction about how likely a person is to need medical care.
