Most enrollees in the state insurance marketplaces that the healthcare reform law establishes in 2014 will likely have to pay “substantial” upfront costs for their coverage, according to estimates by three actuarial and benefits consultancies released Thursday.
'Substantial' costs expected with exchanges
Although many of the details of the marketplaces—envisioned as similar to existing online travel comparison sites and called exchanges—remain unsettled, the Kaiser Family Foundation commissioned three consultancies to estimate costs that beneficiaries will likely face, based on the law's mandates and prices in the current insurance market.
The three firms—Actuarial Research Corp., Aon Hewitt and Towers Watson—expected varying levels of costs for the 16 million beneficiaries projected to participate in the exchanges but they also agreed that those plans will “require that patients meet a substantial upfront deductible,” according to the Kaiser analysis of the firms' estimates.
For example, in the so-called bronze plan, or the cheapest and likely most-popular level of insurance planned for the exchanges, beneficiaries' upfront deductibles will range from $2,750 for single coverage, plus 30% coinsurance once the deductible is met, to $6,350 with no coinsurance. Family deductibles will range from $5,500 to $12,700.
“These deductibles are considerably higher than the minimum for a high-deductible plan that qualifies for a health savings account,” wrote the authors about existing low benefit plans that the 2010 law partially targeted.
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