Explainer: How Tennesseans Could Pay Less For Obamacare Plans This Year | Nashville Public Radio

Explainer: How Tennesseans Could Pay Less For Obamacare Plans This Year

Nov 6, 2017

Tennesseans may end up paying less for insurance on the Affordable Care Act marketplace this year — that's as average rates went up by as much as 42 percent. Even the people who assist in signups for coverage were surprised by the final costs they're seeing.

"Actually, I was worried about the prices, but I got on the website yesterday and as long as you're getting a subsidy, it's really a very, very affordable insurance out there," says Alan Hall of Nashville, who has been a so-called navigator since the first year of Obamacare.

So how is Tennessee one of the few states where the cheapest plans are far less expensive than last year? It's complicated, but the answer also illuminates how important it is for customers to shop around and look past the much publicized rate averages.

With the ACA marketplace, nearly 90 percent of the 200,000 Tennesseans who participate don't pay the full cost of their insurance. The tax credit subsidies are what make it so much more attractive than trying to buy insurance on the individual market.

And the tax credits that offset what people pay every month are based on a single mid-level plan — the second cheapest plan in the silver tier. It just so happens that those plans went up more than most this year.

According to a policy briefing from the Kaiser Family Foundation, this was not by chance. In states like Tennessee, insurers were forced to account for the looming cut to so-called cost-sharing reduction payments (CSRs), which are only a factor in the silver tier. So they jacked up rates on the silver plans where people can qualify for the CSR money to reimburse out-of-pocket expenses like co-pays (this is separate from the tax credits).

All that to say, since monthly premium subsidies are based on a silver plan, they're going much further in 2018, especially for the bronze and gold tiers. In hundreds of counties, the cheapest gold plan costs less than the most expensive silver offering. And Tennessee is a state with one of the most dramatic drops in the least expensive plan — many times, 50 percent less, according to this map assembled by the Kaiser Family Foundation.

The deadline to enroll is December 15th. Subsidies are available even for households that make up to four times the poverty level, or nearly $100,000 for a family of four.