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Obamacare exits, rate hikes sting self-employed, those without aid (Palm Beach Post)

Thursday, October 27, 2016


Tony Albano works as a comedy magician in South Florida, but he’s not finding much to laugh about as his Obamacare health plan pulls a disappearing act for 2017.

His current plan goes away in two months because insurer Coventry and parent Aetna Inc. are fleeing public exchanges, claiming losses are too high. That leaves him scrambling to figure out what to do next as open enrollment begins Nov. 1.

Not helping his mood: Headlines about 25 percent average premium increases nationwide and close to 20 percent for individual plans in Florida.

“In my opinion, it’s unsustainable,” said Albano, 52. “This whole situation of trying to find insurance doesn’t make you feel too easy about everything.”

The Obama adminstration says the headlines can be misleading, because consumers can still choose from multiple options in markets like South Florida and subsidies in the form of tax credits are going up, too. That’s why 80 percent of more than 1.5 million Floridians using the marketplace can still get premiums of $75 a month or less, officials say.

South Florida magician and comic Tony Albano is one of many people trying to make sense of his healthcare options in ... Read More

“Thanks to financial assistance, the large majority of current Marketplace consumers in Florida will be able to find plans with premiums between $50 and $100 per month,” said Health and Human Services Secretary Sylvia M. Burwell. “Many uninsured Floridians could also qualify for financial assistance, as could 153,000 Floridians currently paying full price for off-Marketplace coverage. I encourage anyone who might need 2017 coverage to visit HealthCare.gov and check out this year’s options for themselves.”

But Albano, who lives in Sunrise, said he makes too much money to get the kind of tax credits that push premiums under $100 a month.

“I feel like I’m paying for everybody else,” he said.

His monthly premium costs have been running close to $400, he said.

And it’s not just about the monthly premiums, he said. He has to pay out of his own pocket more than $6,000 a year — for deductibles and other costs — so his current plan makes him think twice about using even reasonably-priced preventive visits and tests. He has toweigh the possible cost to follow up if they find anything.

About 91 percent of Floridians using the marketplace are eligible for subsidies, federal officials say. Though the state’s leaders declined to expand Medicaid for lower-income residents, the share of Flordians without health insurance is down 38 percent since the Affordable Care Act took effect, standing now at about 13.3 percent, federal officials say.

Nationally, the uninsured rate is below 10 percent for the first time, they note.

The “encouragement” to get coverage isn’t entirely about talking up the virtues of staying healthy.

The penalty for not having health insurance in 2017 can be 2.5 percent of adjusted gross income or a flat fee adjusted for inflation. For the 2016 tax year, the penalty is 2.5 percent of income, or $695 per adult and $347.50 per child to a maximum of $2,085.

While some insurers are backing out of government exchanges, others say they are in for the long haul.

Blue Cross and Blue Shield of Florida, or Florida Blue, remains committed to all 67 Florida counties, senior vice president Jon Urbanek said in a webinar Wednesday: “We wanted not just to survive health care reform but to thrive.”

The 8.9 million Floridians with coverage through their employer have benefitted from historically low premium increases, federal officials say. The average family premium is $6,300 lower than it would have been if rates kept rising at a pre-Affordable Care Act pace, they say.

The median income for healthcare.gov customers in Florida is $16,000, though individuals earning up to $48,000 and families of four earning up to $97,000 may qualify for premium subsidies, according to the administration.

But many folks, such as those who serve as their own boss in a small business, say they’re getting crunched.

“The Obama Administration’s position on tax subsidies ignores the reality that many Americans, including the self-employed, aren’t eligible,” said Katie Vlietstra, vice president for government relations and public affairs of the National Association for the Self-Employed. “Therefore, at the end of the day this increase will likely result in our members and many others dropping to a less desirable plan or even doing something drastic by risking the penalty for no coverage.”

If the goal of the Affordable Care Act was to provide affordable and flexible coverage, Vliestra said, the opposite seems to be true for many entrepreneurs, micro-businesses and the self-employed — “less choice and higher prices.”

Some small businesses are finding coverage off the Obamacare exchange.

That’s the case with Synergy Development Systems Inc. of Lake Worth, which provides fundraising and donor-management software for non-profit organizations and has six employees, president Thomas Kaufman said.

Kaufman said he takes pride in being as generous as he can with employees, but premiums from UnitedHealthcare rose 15 percent last year and he’s waiting to see what happens in 2017.

“I’m absolutely worried about it,” Kaufman said. “It drives me nuts.”

Albano, who plies his comedy-magic trade on cruise ships and other venues, said he harbors suspicions about how many people are getting paid under the table and reporting low incomes to get insurance subsidies for individual plans.

For those making too much for substantial subsidies, 2017 isn’t looking like a pretty picture, he said. To be clear, he is not opposed to the idea everyone should have insurance, he said — but when some people pay a lot more than others it doesn’t feel so much like a group effort to him.

To get added to his wife’s policy in a public school system would cost about $670 a month, he figures. As open enrollment starts Tuesday, all he can do is look at whatever options remain on and off the Obamacare exchange.

“It’s just a never-ending situation,” he said.


See the article online here.

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