Kansas legislators have introduced a bill that will offer more affordable and flexible options to Obamacare plans, providing Kansans with more choice and improved health care coverage. This is an encouraging step in the right direction towards providing Kansans with better healthcare coverage options.
However, the Farm Bureau plan would exempt from ACA transparency requirements, making it harder for consumers to know what they’re getting for their money. That is why Kansas should pause on Farm Bureau plans and instead consider better policies like expanding Medicaid access to more low-income adults according to ACA standards.
Cost-sharing reductions
The Affordable Care Act offers two forms of financial assistance to low-income individuals and families: premium tax credits and cost sharing reductions. Premium tax credits reduce the amount you have to pay toward a health plan, while cost sharing reductions allow for less out of pocket spending when visiting the doctor or for medical expenses.
People whose income exceeds 250% of the federal poverty level (FPL) may qualify for both types of financial assistance. To do so, they must enroll in a qualifying health insurance plan offered through an online Marketplace and fulfill other necessary criteria.
When people apply for cost-sharing reductions, they’ll automatically be enrolled in silver plans with reduced deductibles, copays and out-of-pocket maximums. However, due to the differences between these plans – benefits, visit limits, provider networks and drug formularies – it’s essential to compare them with other silver options available through the Marketplace.
Premium tax credits
Health insurance can be costly, so the Affordable Care Act strives to reduce costs for consumers by offering two forms of financial assistance – premium tax credits and cost-sharing reductions.
These credits can assist with paying your monthly health insurance payments (or “premiums”) and reducing your deductible. The amount received depends on your family’s income level.
Additionally, you can use your credit to purchase a high-deductible health plan (HDHP) with an HSA (health savings account). HDHPs offer tax benefits as well as the capacity for tax-free savings on qualified medical expenses in the future.
According to new federal government data released this month, 77% of health insurance buyers in Missouri and Kansas experienced premiums of $100 or lower after applying their tax credits. Overall premiums declined 83 percent as a result of these reductions.
EPOs
Kansans who need or desire health insurance can purchase affordable ACA coverage through the federally operated marketplace. You may apply for coverage anytime during open enrollment period (November 1 – December 15), which runs from November 1 to December 15.
Your choice of plan should be determined by your needs and budget. Some Kansas residents receive coverage through their employer, while others enroll in Medicaid or Medicare programs.
In addition to ACA health plans, the state also offers EPOs (exclusive provider organizations) and short-term, limited duration insurance (STLDI).
EPOs require you to use providers within their network; going outside will result in full payment of all expenses incurred. Furthermore, EPOs don’t need a referral from your primary care doctor for specialist appointments (except for emergencies), making them ideal for those seeking affordable health care options.
Medicaid expansion
Medicaid is a joint federal-state program that assists low-income people pay for healthcare services. It currently covers poor children and some of their parents, pregnant women, seniors and people living with disabilities.
The Affordable Care Act (ACA) offers states the opportunity to expand their Medicaid programs to include childless, non-disabled adults with incomes up to 138% of the federal poverty level – about $26,347 for a family of three and $15,417 per individual. While critics have claimed this expansion would be too costly or negatively affect employment prospects, experts say it has been shown effective at increasing access to healthcare and improving outcomes for those able-bodied individuals.
However, a dozen states are refusing to accept federal funds to expand their Medicaid programs. Research demonstrates that failing to expand Medicaid causes an “insurance gap” between those earning too much to qualify for subsidized private coverage and those unable to afford it; it disproportionately affects people of color who are 60% more likely to be in this situation than whites.
