After more than three years of preparation and debate, the health insurance marketplace created by the Affordable Care Act is open for enrollment in coverage
starting as early as Jan. 1. The Kansas marketplace is run by the federal government, as are those in 25 other states. In the remaining states, 17 are managing their own marketplaces and seven are partnering with the federal government.
The first day has seen technical challenges and limited online functionality, the plans available and the prices for coverage in the marketplace are shown here.
The Kansas marketplace includes 72 plans sold by four companies: Blue Cross Blue Shield of Kansas, Blue Cross Blue Shield of Kansas City, Coventry Health Care of Kansas and Coventry Health and Life Insurance.
Plans sold on the marketplace are arranged in four coverage tiers — bronze, silver, gold and platinum — plus “catastrophic” plans that are available only to people who are under age 30 or meet specific criteria. All plans cover roughly the same services, but the tiers differ based on cost-sharing features. Consumers who purchase a bronze tier plan will pay, on average, lower premiums for the insurance but a higher share of the deductibles, co-pays and co-insurance for health care. Consumers who purchase a platinum tier plan will pay more in premiums but a lower share of the cost of health care they receive.
Gold and silver plans have monthly premiums and cost-sharing requirements that fall between those for bronze and platinum plans. Catastrophic plans are low-cost, high-deductible plans that require the enrollee to meet a substantial deductible before providing benefits, with the exception of providing many free preventive care services required by the ACA.
Of the 72 plans, 65 are offered to individuals and families and seven are offered to small businesses. Each insurer offers a variety of plans to individuals and families, spread across the coverage tiers. For individuals, two plans are platinum tier, 15 are gold, 24 are silver, 16 are bronze and eight are catastrophic coverage plans. For small businesses, two plans are gold tier, three are silver and two are bronze, as shown in Figure 1.
The plans and their cost vary across the state by so-called “rating areas” based on factors including previous health care spending and the cost of doing business in each area. While not all insurers offer the same plans across Kansas, every county has at least two companies selling insurance through the marketplace.
The average number of plans offered to families and individuals in each county is 37, below the national average of 53 plans, according to recent data from the U.S. Department of Health and Human Services (HHS). This has caused some to question whether the choice of plans will be sufficient to attract consumers to the marketplace in Kansas.
-info from the Kansas Health Institute