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Editorial: Health plan exchange enters second year, with more options

Wed., Nov. 12, 2014

In a surprise move, the U.S. Supreme Court has said it will resolve another legal challenge to the Affordable Care Act. The crux of the dispute is whether taxpayer-funded subsidies are available only through state-based insurance exchanges, or through all of them.

Thirteen states run exchanges. The rest are run by the federal government.

The court isn’t expected to issue a ruling until late June. Washington and Idaho have state-based exchanges, so insurance shoppers should turn their attention to the upcoming enrollment period, which begins Saturday.

Washington Healthplanfinder is offering in-person assistance on the opening weekend at several malls across the state. In Spokane, help is available at the River Park Square food court on Saturday from 11 a.m. to 3 p.m. and Sunday from noon to 4 p.m. Enrollment in Apple Health (Medicaid) occurs year-round. Other enrollment events can be found at wahealthplanfinder.org. The website also has information on how to contact local brokers, whose services are free.

First-time buyers can learn more about the basics of health insurance at www.knowyourplan.org. To ensure coverage on Jan. 1, you must sign up and pay for a qualified plan by Dec. 23. Enrollment and payment can occur as late as Feb. 15, but coverage wouldn’t begin until March.

As the second year of the exchanges gets underway, here are some things to consider:

You can keep your current plan if it’s still available. If you have received a letter about renewal, you’re set. However, if your income changed, the amount of your subsidy may change, too. About 1 million Washingtonians have signed up since the exchange opened last year, and about 85 percent of them qualified for a subsidy or Medicaid. In general, families of four with incomes up to about $94,000 qualify for a subsidy, as do singles earning up to $46,000. The lower the income, the bigger the subsidy.

You might want to shop even if you are happy with your current plan because the exchange is offering about twice as many options this year. A total of 10 insurance companies are offering about 90 health care plans, though not all are available statewide.

Those who fail to buy coverage are subject to a penalty of $325 (up from $95) or 2 percent of income, whichever is greater.

The exchange now offers insurance for small businesses (up to 50 employees). Some may qualify for subsidies.

Last year, Idaho piggybacked on the federal sign-up system, but now it has its own technology platform, found at yourhealthidaho.org. More than 76,000 Idahoans signed up last year, giving the state one of the best enrollment rates in the country.

Nine insurance carriers will be offering 192 health and dental plans, or about 50 more than last year. Small business plans are also available. Sign-up events and help finding personal brokers can be found at the website.

The Affordable Care Act remains controversial, and supporters will be holding their breath for that Supreme Court ruling. But for now, it’s the law of the land. So it’s wise to sign up.