Marketplace renewal messages for consumers should be considered in the context of a more extensive set of changes and trends in the health insurance landscape. These include a change in eligibility, plan selection, and increased benchmark silver plan premiums.
Increase in benchmark silver plan premiums
The benchmark Silver plan is an insurance product that’s aimed at consumers who earn up to 150% of the federal poverty level. Its main benefit is that it allows for premium tax credits that can offset the cost of a plan. If you’re interested in getting the most out of your premium tax credit, it’s a good idea to shop around and find the best plan for your needs.
The Inflation Reduction Act of 2010 extends eligibility for premium tax credits to consumers with an income at or above 400 percent of the federal poverty level. Moreover, the Inflation Reduction Act reduces the cost-sharing ratio to near zero. This is especially important for low-income enrollees with relatively low deductibles.
In addition, the Inflation Reduction Act is a good sign for older marketplace consumers with age-adjusted premiums. This means that you’ll pay a smaller tip on average than you would if you had the same income at an earlier time. The Inflation Reduction Act has also led insurers to respond to concerns about the ACA by offering more competitive pricing and making changes to the benchmark Silver plan.
The premium tax credit is based on the cost of the benchmark Silver plan, which is equal to the sum of all the plan’s different components. In addition to the benchmark Silver plan, a benchmark Bronze plan, a benchmark Platinum plan, and a benchmark Silver plan is available. It’s also possible to get the benchmark Bronze plan at the same time as the benchmark Platinum plan, as long as both methods are in the same family.
Although the benchmark Silver plan was the only insurance product that received a bump in premiums, you’ll likely receive a similar spot in the cost of your following insurance policy. Many other options are available, such as HealthCare.gov, private insurers, and employer-sponsored health insurance.
Change in eligibility and plan selection
A growing proportion of consumers in the ACA Marketplace are in the 55-64 age range. This is a result of the expansion of premium subsidies under the American Rescue Plan Act and the Inflation Reduction Act.
The total number of Marketplace consumers depends on a county’s total population. In Wisconsin, 212,209 consumers selected Marketplace plans for the plan year 2022.
The ACA Marketplace enrollment has climbed to a record high of 13.8 million people. This has been attributed to the extended enrollment period and the increased affordability of premiums. In 2022, the maximum allowable out-of-pocket limit will increase from $8,700 to $9,100.
The Inflation Reduction Act of 2022 extends the availability of enhanced Marketplace subsidies for three years through 2025. This extension will benefit consumers with incomes over 400% of the federal poverty level. Those in the lowest income range may also qualify for cost-sharing reductions.
Changes in the federal policy and the underlying premiums amplify the need for active re-enrollment and consumer outreach. However, these efforts must address consumers’ knowledge of cost-sharing exposure, healthcare options, and the resources available to help them enroll.
A growing portion of consumers with incomes above 300% of the federal poverty level are selecting plans from the ACA Marketplace. This is a result of the Inflation Reduction Act, which extends the availability of premium tax credits to consumers with incomes above 400% of the federal poverty level.
In addition to the age and income demographics, other factors impact enrollment. These include economic and employment circumstances.
For instance, younger adults tend to remain uninsured. They are more likely to be located in rural areas with low-speed internet access. They may need to be more knowledgeable about the deductibles and other plan design features.
Increase in the tax credit amount
The American Recovery and Reinvestment Act (ARRA) and the Affordable Care Act (ACA) have brought many changes to the healthcare landscape. For example, the enhanced subsidies that went live on April 1, 2021, have significantly reduced the cost of Marketplace coverage for a growing number of consumers. Similarly, the ACA has lowered the nation’s uninsured rate from roughly 9% in 2015 to a more manageable 4% today. The best part is that nearly everyone with income below 150% of the federal poverty level has access to two silver plan options with no or near-no premiums.
For instance, the CMS’s new federal marketplace has more than 3 million Marketplace enrollees compared to just under one million last year. However, this does not include state-based Marketplaces. This influx of newly insured has led to a few bumps in the road. It is no surprise, then, that premiums for many enrolled will skyrocket once the government’s subsidy program ends. The ACA has also introduced metal tier requirements for low-cost plans.
The ACA also introduced the concept of the benchmark plan or, as it is better known, the benchmark or benchmarking plan. These plans serve as a guide for consumers as they compare and contrast various health insurance options. This model has proven to be a game changer for the nation’s healthcare system. Ultimately, this may have been the most significant factor in the improved quality of care provided to the broader populace.
This particular benchmark plan is an excellent albeit modest example of the more mundane changes that are bound to be felt by future Marketplace enrollees. Despite the many positives, there is no denying that the healthcare market is still a work in progress.
In the context of the consumer experience, the double reed gaff is an unpalatable cha-cha and is best averted. Fortunately, a few insurers have seen fit to modernize the equine by the ethers, and a few more have stomped the throes. A little legwork can go a long way, especially in a crisis. Hopefully, it will only take a few well-researched, well-planned, and -funded revisions to make the apologies above a thing of the past. After all, you’ve got to get your clients where they are in the first place, eh? Besides, the more informed can get the kudos they deserve, and a happy client is always a good thing.
The Affordable Care Act (ACA) marketplaces allow consumers to choose a health plan and receive subsidies. These subsidies can help low-income individuals afford coverage.
The marketplaces are committed to improving equity and educating consumers on their coverage options. To ensure that the marketplaces communicate the right messages, state-based marketplaces are developing new outreach strategies.
The ACA’s “no wrong door” policy allows consumers to complete a single application for health plans. In addition, the online marketplace is designed to serve consumers from all walks of life.
Various factors can prevent consumers from shopping for coverage on the marketplaces. One of these is the presence of a dominant insurer. This insurance company can drive potential enrollees to its platform for enrollment and renewals. This means that they may need help to see other QHP options. In turn, this can result in higher premiums for the sicker population in the market.
The ACA marketplaces use lessons learned from last year’s open enrollment period to help ensure that incoming consumers can choose a plan that meets their needs. They also use messaging to inform consumers about the availability of lower-cost programs.
Although the marketplaces are trying to educate consumers, some still need to be sure they understand the marketplace’s approach. Many people are using websites that offer coverage outside of the market. However, these websites often don’t compare with the tools available in the marketplace.
In the meantime, some consumers need to be more informed about enrolling. In addition, the Trump Administration has cut funding for navigators and outreach efforts by more than 80 percent.
These changes make it even more critical for marketplaces to develop effective messaging and outreach strategies. It’s also crucial to ensure that these initiatives reach consumers who need them most.