Hundreds of thousands of Hoosiers stand to gain financial help buying 2017 health coverage

WASHINGTON, D.C. - Already, about 8.8 million Americans, and 139,437 Hoosiers, who buy health insurance through HealthCare.gov, receive tax credits that help make coverage more affordable.

But about 12 million more Americans, including 327,800 Hoosiers, may also be eligible for help during this Open Enrollment, but not know it, according to the U.S. Department of Health and Human Services.

This group includes:

  • Current HealthCare.gov consumers: 4,800 Indiana consumers who didn’t get tax credits last year could be eligible for tax credits in 2017, even if their income remains the same, because financial assistance moves along with rates. That’s 14 percent of currently unsubsidized Indiana Marketplace consumers.
  • Off-Marketplace individual consumers: About 45,000 Hoosiers who currently pay full price for individual coverage off-Marketplace could be eligible for tax credits if they purchase a 2017 plan through HealthCare.gov instead.
  • The remaining uninsured: About 278,000 uninsured Hoosiers earn incomes indicating they, too, could be eligible for financial assistance. Nationwide, 84 percent of Marketplace-eligible uninsured Americans have incomes suggesting they are tax credit eligible. 

In Indiana, 33,707 people have already signed up for coverage in the first month of Open Enrollment, more than last year at this time. But many more Hoosiers might benefit from visiting HealthCare.gov before the Dec. 15 deadline for Jan. 1 coverage and checking out their options for affordable, quality health insurance.

Affordable by designThe Marketplace’s tax credits are designed to keep pace with premium increases. This means that for many consumers already receiving tax credits, the value of that financial assistance will increase this year to keep pace with the cost of coverage in their area. It also means that more individuals may qualify for tax credits as premiums rise. For people eligible for financial assistance, the ACA specifies the share of income the consumer is expected to contribute toward health coverage. The tax credits make up the difference between that amount and the actual cost of a consumer’s benchmark (second-lowest-cost silver) plan.

For example, in 2017, a 27-year old in Indiana making $25,000 per year will pay $142 per month to purchase the benchmark plan, almost exactly the same as in 2016. That’s because the 27-year old will, on average, get an $87 tax credit.

Check out your options. The Marketplace is open for business, and HHS is encouraging anyone who might need coverage next year to visit HealthCare.gov and check out their options before the December 15 deadline for coverage that starts January 1. Millions of Americans could be surprised to find out they’re eligible for financial assistance this year, even if they weren’t last year, giving them affordable, quality options to choose from. Visit HealthCare.gov to browse and shop for quality, affordable health plans. More than 48 percent of current Indiana Marketplace consumers will find plans for less than $75 per month, and the vast majority can save by coming back to actively shop instead of waiting to be re-enrolled in their current plan.

The state-by-state tables below show the number of consumers nationally who could benefit in 2017 from the financial assistance Marketplace tax credits provide. If these consumers were to take advantage of the help offered on HealthCare.gov, they could find affordable, quality options.

 

Table 1. Availability of Financial Assistance among Current Health Insurance Marketplace Consumers

 

Percent  of Consumers Receiving Tax Credits in 2016*

Percent of Consumers Potentially Eligible for Tax Credits in 2017

Number of Unsubsidized Consumers in 2016

Number of Consumers Potentially Newly Eligible for Tax Credits in 2017

Percent of Unsubsidized Consumers in 2016 Who Are Potentially Newly Eligible for Tax Credits in 2017

Total

85%

89%

1,297,900

286,100

22%

AK

86%

90%

2,800

600

21%

AL

89%

93%

16,700

5,300

32%

AR

87%

90%

8,500

1,900

22%

AZ

74%

83%

45,700

13,200

29%

DE

82%

86%

4,700

1,200

25%

FL

91%

94%

138,700

34,800

25%

GA

86%

92%

59,700

14,300

24%

HI

81%

86%

2,600

600

24%

IA

85%

89%

7,300

2,000

27%

IL

75%

81%

89,300

22,000

25%

IN

81%

84%

33,800

4,800

14%

KS

82%

86%

16,800

4,200

25%

LA

89%

93%

19,300

4,400

23%

ME

87%

90%

9,700

2,400

24%

MI

83%

87%

50,800

10,000

20%

MO

87%

90%

31,100

7,100

23%

MS

90%

94%

8,500

3,000

35%

MT

83%

87%

8,900

2,300

25%

NC

89%

93%

52,700

13,100

25%

ND

85%

91%

2,400

600

26%

NE

88%

92%

8,500

2,200

26%

NH

66%

70%

17,000

1,600

10%

NJ

80%

84%

54,300

8,700

16%

NM

68%

76%

16,500

3,700

22%

NV

87%

90%

10,300

2,000

20%

OH

80%

85%

41,600

7,600

18%

OK

84%

88%

21,200

5,600

27%

OR

71%

78%

39,500

8,200

21%

PA

76%

82%

94,700

20,800

22%

SC

89%

92%

22,200

4,800

22%

SD

88%

93%

2,500

800

33%

TN

85%

89%

35,000

8,900

25%

TX

84%

88%

193,300

38,600

20%

UT

86%

90%

23,000

6,000

26%

VA

82%

86%

65,700

11,400

17%

WI

84%

87%

34,800

6,000

17%

WV

85%

89%

4,900

1,200

24%

WY

90%

92%

2,100

300

16%

* U.S. Department of Health and Human Services, “Addendum to the Health Insurance Marketplaces 2016 Open Enrollment Period: Final Enrollment Report,” ASPE Issue Brief, ASPE, March 11, 2016, available at: https://aspe.hhs.gov/sites/default/files/pdf/188026/MarketPlaceAddendumFinal2016.pdf.

Note: Plan information is from the plan landscape files and active plan selections in the CMS Multidimensional Insurance Data Analytics System (MIDAS) for 38 states using the HealthCare.gov platform in 2016 and 2017. Kentucky is new to the HealthCare.gov platform in 2017 and is not included in this analysis. This analysis holds all enrollee characteristics unchanged and calculates 2017 premiums and tax credits based on the same age, family composition, and household income as in 2016. This analysis includes only enrollees who could be linked to complete plan and premium data for both 2016 and 2017, and excludes tobacco users. Consumers enrolled in catastrophic plans, which are not available to all consumers, were not considered in these calculations. For additional details, see “Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace” (available at:https://aspe.hhs.gov/pdf-report/health-plan-choice-and-premiums-2017-health-insurance-marketplace).

 

 

Table 2. Consumers Without Health Insurance Marketplace Coverage Who May Be Eligible for Tax Credits

 

Off-Marketplace Consumers Potentially Eligible for Tax Credits*

Uninsured Consumers Potentially Eligible for Tax Credits

Total

2,488,000

8,988,000

AK

5,000

27,000

AL

33,000

136,000

AR

29,000

100,000

AZ

33,000

162,000

CA

313,000

740,000

CO

52,000

98,000

CT

15,000

44,000

DC

2,000

3,000

DE

5,000

20,000

FL

153,000

879,000

GA

95,000

361,000

HI

7,000

5,000

IA

41,000

66,000

ID

15,000

79,000

IL

130,000

211,000

IN

45,000

278,000

KS

28,000

84,000

KY

17,000

82,000

LA

34,000

110,000

MA

22,000

51,000

MD

31,000

102,000

ME

10,000

44,000

MI

62,000

206,000

MN

43,000

61,000

MO

83,000

259,000

MS

22,000

79,000

MT

14,000

26,000

NC

138,000

449,000

ND

4,000

16,000

NE

14,000

85,000

NH

3,000

23,000

NJ

44,000

171,000

NM

8,000

34,000

NV

27,000

63,000

NY

68,000

142,000

OH

64,000

272,000

OK

33,000

188,000

OR

26,000

81,000

PA

111,000

304,000

RI

4,000

14,000

SC

21,000

232,000

SD

17,000

28,000

TN

79,000

235,000

TX

252,000

1,629,000

UT

56,000

102,000

VA

56,000

264,000

VT

1,000

4,000

WA

53,000

185,000

WI

51,000

87,000

WV

15,000

36,000

WY

5,000

34,000

 

* Office of the Assistant Secretary for Planning and Evaluation, “About 2.5 Million People Who Currently Buy Coverage Off-Marketplace May Be Eligible for ACA Subsidies,” ASPE Data Point, October 4, 2016, available at: https://aspe.hhs.gov/pdf-report/people-who-currently-buy-individual-market-coverage-could-be-eligible-aca-subsidies.

 

Note: Estimates of the “Potentially Eligible for Tax Credit” exclude: adults with incomes at or below 200% FPL in Minnesota and New York, who are eligible for Basic Health Plan coverage; adults with incomes at or below 215% in the District of Columbia, who are potentially eligible for Medicaid; adults with incomes at or below 138% of the Federal Poverty Level (FPL) in all other Medicaid expansion states; adults with incomes below 100% FPL in states that have not expanded Medicaid (the “Medicaid gap”); children with incomes at or below 250% FPL in all states, who may be eligible for Medicaid or CHIP; individuals estimated to be immigrants not lawfully present; and individuals with incomes above 400% FPL. Numbers shown in table may not sum due to rounding.

 

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- U.S. Department of Health & Human Services news release