Act now on ACA to save later

The recently published article “CT exchange chief: Obamacare focus will turn to price, value,” highlighted Kevin Counihan – CEO of Connecticut’s state-run marketplace Access Health CT – and his prediction that consumer focus will soon shift to price as those who purchase their own health insurance start to examine their options ahead of 2014 and the health insurance mandate.

According to a survey released by Access Health CT, by and large, the citizens of Connecticut have indicated positive experiences with their state enrollment; complaints now revolve around the increased prices of some health plans. More than 7,615 people enrolled for coverage in the new Connecticut exchange between October 1st and November 1st.  Significantly, this number includes only 2.3 percent of Connecticut’s 344,000 uninsured. 

As with most products and services, consumers across the country keep their eyes on the issue of price.  Some -– including people in Connecticut -– are finding that their low-cost, high-deductible health coverage will no longer be offered because they do not meet ACA – (or “Obamacare” ) – requirements.  People prioritize cost and coverage in different ways; however, a recent survey says that a majority of employees weigh comprehensive coverage more heavily, and may be willing to pay more for it. They may be asking themselves if “better,” more comprehensive coverage and lower out-of-pockets are worth potentially higher cost.  

This prioritization also plays out in the workplace. The Transamerica Center for Health Studies (TCHS) conducted an extensive survey that found that health care benefits play an important role in job satisfaction, yet employers and workers face directly conflicting interests regarding health insurance coverage. Employers prioritize lower costs over higher quality, while workers prioritize higher quality over lower cost.

The launch of Access Health CT may allow Connecticut to be seen as a bellwether for other Americans who may still be focused on the failure of the federal exchange launch, but will eventually need to shift their focus to the price and benefits offered for these health plans and consumers can still shop for health care coverage in the traditional insurance market. In the time it takes to work out the glitches plaguing the federal exchange website, other Americans could learn from Connecticut’s experience and start to focus on cost, price and how the choice they make will affect their pocketbooks and their future health. 

Residents of Connecticut who enroll through the health exchange are able to choose from three basic levels of coverage: Gold, Silver or Bronze. As the metal category increases in value, so does the percentage of medical expenses a plan covers. This matters greatly, since you could still choose a plan that leaves you exposed financially if your health takes a turn for the worse.

Aspects of the ACA -– such as prohibitions against insurers’ denying coverage because of pre-existing health conditions, and the requirement that insurers remove dollar limits on coverage of required essential health benefits -– will help minimize the risk you face of high health care costs adversely affecting your financial stability. Unless you choose wisely — specific to the needs of your family and situation -– you and your family will still be at risk.  

Individuals at greatest risk of health-related financial exposure will be those who opt out of health insurance, which is allowed under the ACA and carries a $95 income tax penalty or 1 percent of income, whichever is higher, set to increase in future years. Not being informed enough about your coverage options, or not taking the time to weigh one option against another, will also increase your exposure.

While there is no lack of information about ACA and the exchanges, our survey shows many Americans still don’t feel they have the information they need to make informed decisions. Employers and community leaders can help by holding workplace information sessions, and consumers and workers can increase their knowledge through neutral information sources like TransamericaCenterforHealthStudies.org, KaiserFamilyFoundation.org and Access Health CT.

A bit of time spent now, fully evaluating the health care needs of yourself and your family and weighing options to arrive at the best one will empower you to make decisions that improve your and your family’s wellbeing and your future financial stability for years to come.

 

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