The Affordable Care Act will establish health insurance exchanges in each state- providing folks (and small business employees) an additional opportunity to get health insurance coverage starting 1/1/14. The future exchanges will provide marketplaces for folks to directly compare and buy private health insurance based on price, quality, and other things. All the plans will need to cover all of the state-specific essential health benefits.
Various tiers of health insurance coverage will be available in the exchanges. The baseline “tier” will be a minimum amount of coverage that people need to have to satisfy the federal mandate to have health insurance (or face a tax penalty). Insurers will be required to offer plans that fit within four levels (tiers) of coverage: bronze, silver, gold, and platinum. I posted a little more about these tiers last week.
You all probably know that there’s a mandate that requires everyone to have health insurance or pay a tax penalty. Some people will be enrolled in Medicaid and some will have their own insurance or insurance through work— and others will get it through the health plans on the exchange. Folks with incomes above 100% but less than 400% of the federal poverty level will receive a premium subsidy when they get insurance via the exchange. Folks earning less than 150% of the poverty level will be subsidized via tax breaks so their premium is only 2% of their income ($50 per month for a family of four). This report provides a graph that includes the details of the sliding scale for premium subsidies.