Thursday, July 8, 2010

Premium Assistance for Coverage in Exchanges

Kaiser Family Foundation
Health Reform Subsidy Calculator
Premium Assistance for Coverage in Exchanges

An example for a 50 year old with a family of four, with income at 401% of federal poverty level:

$93,934 - Projected income in 2014

$16,858 - Unsubsidized health insurance premium in 2014

N/A - Maximum % of income the family has to pay for the premium

$16,858 - Actual family required premium payment

$0 - Government tax credit

$12,500 - The maximum out-of-pocket costs the person/family will be responsible for in 2014 (not including the premium)

$29,358 - Premium plus out-of-pocket costs

31% - Percent of income for premium plus out-of-pocket costs

Comment: This calculator is useful for determining anticipated individual and family costs for insurance premiums plus out-of-pocket expenses for plans obtained through the insurance exchanges, if execution of the program is optimal.

Uncertainties arise since
1) premiums are not guaranteed and could be much higher if private insurers fail to restrain cost increases, and
2) out-of-pocket costs could be much higher based on plan design, limitations of provider networks, and expenses for disallowed services and products. Furthermore, most individuals and families will not even be allowed to purchase plans through the exchanges.

What kind of reform is this? We could have covered everyone without the need to create personal financial
hardship had we adopted a single payer national health program. In fact, we can still do that.

You can read/subscribe to messages like this at

No comments:

Post a Comment

The TrueMajority OREO video... featuring an animated Ben Cohen.