By Rebecca Mayo, J.D.
The Patient Protection and Affordable Care Act (ACA) (P.L. 111-158) has expanded health coverage and the percent of population without health coverage has substantially decreased since it was enacted. However, around 10 percent of the elderly population is still uninsured. The Kaiser Family Foundation (KFF) set out to find out how many uninsured people who may be shopping on the Marketplaces may be eligible for premium subsidies large enough to cover the entire cost of a bronze plan.
Tax credits. The premium tax credits are calculated using the second-lowest cost silver plan in each rating area as a benchmark. Since the cost of these plans still ends to be relatively high, the subsidy-eligible Marketplace enrollees receive a large premium tax credit. Because of this, bronze plans are more likely to be available for $0 for many enrollees.
Findings. The KFF focused on the approximately 15.9 million uninsured people who could be shopping on the Marketplace, regardless of whether or not they were eligible for a subsidy. The analysis found that 27 percent of uninsured individuals who could shop on the Marketplace, or 4.2 million people nationwide, were eligibility to purchase a bronze plan with $0 premiums after subsidies in 2019. The availability varies state by state from less than 5 percent in some states to more than 45 percent in other states.
Plan selection. While 4.2 million uninsured people may be eligible for $0 bronze plans, it may not be the best choice for some people. The average deductible on bronze plans is $6,258, while the average deductible for silver plans ranges from $239 to $3,169. Further, single individuals with incomes below 200 percent of the poverty level can purchase silver plans for roughly $20 to $130 per month after subsidies. Thus, bronze plans may be alluring with $0 premium, but enrollees with significant health needs may still need to consider silver plans to meet their needs.
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