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81 Percent of Tennessee Consumers Can Find Marketplace Plans for Less than $75 Per Month



81 Percent of Tennessee Consumers Can Find Marketplace Plans for Less than $75 Per Month

With Start of Window Shopping, Tennessee Consumers Can Now Check Out Options for 2017 Coverage


With the November 1 start of Open Enrollment just days away, Tennessee consumers can now visit HealthCare.gov to check out their options for 2017 coverage. A new report released today shows that 81 percent of Tennessee Marketplace consumers will be able to find a plan with a premium of less than $75 per month, and 83 percent will be able to find plans with premiums below $100. The report also shows that Tennessee consumers who come back to shop will have options, with an average of 7 plans to choose from.


“Thanks to financial assistance, the large majority of current Marketplace consumers in Tennessee will be able to find plans with premiums between $50 and $100 per month,” said HHS Secretary Sylvia M. Burwell. “Many uninsured Tennesseans could also qualify for financial assistance, as could 79,000 Tennesseans 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.”


Thanks in significant part to the Health Insurance Marketplace, the share of Americans without health insurance is at its lowest level in history, and the share of Tennesseans without health insurance stands at 10.3 percent, down 28 percent since 2010. This year’s Open Enrollment offers the chance to build on that progress and further improve access to care and financial security for Tennesseans.


Financial Assistance and Shopping Help Keep Coverage Affordable for Tennessee Consumers


85 percent of current Tennessee Marketplace consumers are eligible for tax credits that bring down the cost of coverage, and, nationwide, about 85 percent of Marketplace-eligible uninsured Americans also qualify for tax credits. In addition, an estimated79,000 Tennesseans currently paying full price for health insurance in the off-Marketplace individual market could be eligible for tax credits if they purchase 2017 coverage through the Marketplace.


Tax credits increase dollar for dollar with the cost of a consumer’s benchmark plan, and so they protect the large majority of consumers from rate increases. For example, a 27-year-old in Memphis, Tennessee with income of $25,000 paid $143 per month to purchase the benchmark (second-lowest cost silver) plan in 2016. For 2017, a 27-year-old with income of $25,000 will pay almost the exact same amount ($142 per month), because, while benchmark premiums have increased, tax credits will increase to compensate.


Shopping also helps keep coverage affordable for consumers. If every returning consumer in Tennessee selected the lowest-cost plan available within their current metal level, average premiums would decrease by $37 per month, or 28 percent, from 2016 to 2017. In fact, many consumers do not choose the lowest-cost plan available, because they are willing to pay more for a wider network or other plan features. But this calculation confirms that affordable options for 2017 coverage are available to consumers who shop around to find a better deal.


This year, Marketplace consumers in Tennessee will be able to choose from an average of 7 health insurance plans. Three issuers will be offering coverage in Tennessee, and Tennesseans will be able to choose among plans with different combinations of premiums, out-of-pocket costs, networks of hospitals and physicians, and prescription drug coverage options. For people with employer-sponsored health insurance, plan choice is typically narrower: for example, in 2015, 30 percent of people with employer coverage not only had just one issuer, but also just one plan option.


Headline Premium Increases Do Not Reflect What Tennessee Consumers Actually Pay


Through 2016, Marketplace rates remained below initial projections from the independent Congressional Budget Office, and belowthe cost of comparable coverage in the employer market. Tennessee’s 2014 Marketplace rates were the lowest of any HealthCare.gov state. Even though average Marketplace premiums are increasing more than they have the past two years, premiums in 2017 will remain roughly in line with projections issued by the Congressional Budget Office during the debate over the Affordable Care Act (ACA).


One reason for higher premium increases this year is issuers bringing their rates in line with costs now that two years of cost data are available. In addition, some of the ACA’s programs designed to support the new market in its early years are ending this year. Efforts to undermine the ACA such as Tennessee's lack of Medicaid expansion and Congressional actions to block funding for the law contribute to higher premiums. And some states have long faced unique challenges in reining in health care costs. 


Fortunately, financial assistance and the ability to shop around for coverage will buffer most consumers from the effects of this transition year. Last year per month, average premiums for the 85 percent of Tennessee consumers with tax credits went up by only $2, or 2 percent, even though benchmark rates increased 23 percent.


“Before the ACA, up to 2.8 million Tennesseans with pre-existing conditions were at risk of having no coverage options at all, and the individual market offered no easy way to shop and compare plans,” said Kevin Counihan, CEO of the Health Insurance Marketplace. “Now, consumers can shop around to find coverage that fits their needs and get tax credits to help pay for it. Thanks to shopping and financial assistance, consumers will continue to have robust options for quality, affordable coverage.”


HealthCare.gov Tools Will Help Consumers Find Plans That Work for Them


In addition to helping consumer save money, shopping also lets them find plans with the features that matter most to them and their families. HealthCare.gov offers a number of tools to help:


·         Out-of-pocket costs calculator. Out-of-pocket costs are important to consider in choosing a health plan, but headline deductiblesoverstate out-of-pocket costs for most consumers. Nationally, most Marketplace consumers qualify for financial assistance that lowers their deductibles; financial assistance helped reduce the median Marketplace deductible to $850 for 2016. In addition, Marketplace plans cover preventative services and an average of seven additional services with little or no cost sharing before consumers meet their deductibles, often including primary care visits, prescription drugs, and even specialist visits.


HealthCare.gov’s out-of-pocket calculator helps consumers put together the full picture of their health care costs, including premiums, deductibles, copays, and coinsurance, taking into account plan features, financial assistance, and individual health care needs.


·         Physician and drug search tools. Nearly four-fifths of Marketplace consumers report that they are satisfied with the choice of physicians and hospitals in their network. To help consumers continue to find plans that cover the providers important to them, HealthCare.gov includes a physician look-up tool letting consumers search for a preferred provider or facility. Consumers can also search for whether a plan covers particular prescription drugs.


This year, HealthCare.gov will be piloting and then phasing in further improvements to make the shopping experience more intuitive and streamlined. The new Plan Compare 2.0 will offer a simpler, step-by-step sign-up process that integrates improved physician and drug look-up tools directly into the shopping experience and simplifies and improves shopping for consumers using mobile devices.


In 2016, the large majority of current Marketplace consumers were pleased with their coverage, reporting similar levels of satisfaction as people with employer plans. Improved search tools will help Marketplace consumers continue to find plans that meet their and their families’ needs.


The Affordable Care Act Is Strengthening Coverage for Tennesseans


The Marketplace is one of many ways in which the ACA continues to improve health care affordability, access, and quality for people in Tennessee.


·         Affordability. The latest available data show premiums for the more than 150 million Americans with employer coverage continuing to rise at the low rates observed since the ACA was enacted.  In 2015, the average family premium for the 3,369,000 Tennesseans with employer coverage was $2,100 lower than it would have been if pre-ACA premium growth had continued.


·         Access. Only 10.3 percent of people in Tennessee went uninsured in 2015, down from 14.4 percent in 2010. That dramatic drop means 266,000 more Tennesseans had coverage.


·         Quality. For those who already had coverage, the ACA provided new protections, including guaranteed limits on out-of-pocket costs, no limits on annual or lifetime coverage, and preventive services without cost sharing. The ACA is also strengthening health care quality, with large drops in patient harms. For example hospital readmission rates for Tennessee Medicare beneficiaries havedropped by 9 percent.


“Tennessee has made historic progress under the ACA, and now we want to build on that progress to further improve affordability, access, and quality,” said Secretary Burwell. The President has taken a number of steps to improve the ACA, and thinks we can do even more – such as expanding Medicaid in states that have declined to do so, providing more tax credits for middle-income families and young adults to further improve affordability, adding a public plan fallback to give people more options in places where there still are just not enough insurers to compete, and supporting innovation by states to achieve the same goals of the ACABut this Open Enrollment, we are focused on getting as many uninsured people covered as we can. 


Open Enrollment, which starts November 1 and ends on January 31, provides another opportunity for Tennesseans to find affordable coverage for them and their families. Learn more on HealthCare.gov.


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