Wed September 18, 2013
NC Health Insurance Marketplace: Here's What's In Store
We'll have a new way to sign up for health insurance in about two weeks. A key part of the Affordable Care Act called the marketplace, or exchange, opens for enrollment on October 1.
North Carolina's leaders chose not to set up their own marketplace, so the federal government will run the one here. It's supposed to be a one-stop website that makes it easy for consumers to do apples-to-apples comparisons of different insurance companies and their plans.
But in North Carolina, Blue Cross Blue Shield will dominate the marketplace. Its plans range from $145 a month to about $950 a month. And it may be the only company offering plans in many counties.
One of the people in charge of making sure the marketplaces work in the Southeast is Renard Murray, a regional administrator for the Centers for Medicare and Medicaid Services. In an interview with WFAE, he said even if there is little competition, North Carolinians will benefit from the marketplace because the plans have to cover essential health benefits and then some will offer services beyond those.
"We're also providing what we call advanced premium tax credits, where individuals in the marketplace who have incomes below 400 percent of (the federal poverty line) – that's about $92,000 for a family of four – they will qualify for a tax credit that will help them to defray the costs of the premiums," Murray said. "Individuals who may have incomes below 250 percent of the federal poverty level would also qualify for what we call cost sharing. That's not something that's available in the private market but is definitely available in the marketplace."
The penalty for not getting health insurance starting next year is $95 or 1 percent of your annual income, whichever is higher. (You have to apply for coverage by the end of March.) And that penalty increases each year.
Murray said he can't assess how a consumer would feel about taking the penalty instead of getting insurance, but he says one illness could cause financial devastation for people who are uninsured.
To hear more of what Murray had to say about the penalty, the marketplace and how people will access it, listen to the interview at the top of this story.