If you're white, single with no kids and live in the South, chances are good you'll quality for a cost-sharing reduction to help cover the out-of-pocket costs your marketplace health plan.
That's what a study conducted by the Urban Institute and funded by the Robert Wood Johnson Foundation concluded. The foundation looked at who would tend to qualify for these health insurance assistance subsidies, which are to kick in in 2016. The researchers report that, overall, 13.8 million American adults will qualify based on their income, and that nearly half of the residents in southern states and are single individuals without children. Six in 10 in the group are white/non-Hispanic.
Known as CSRs, these subsidies will pay at least part of deductibles, co-pays and co-insurance for those who qualify based on income. Those earning as much as 250 percent of the federal poverty level will quality. Specific income triggers are $29,425 for an individual and $60,625 for a family of four. Eligibility for the premium tax credits goes up to 400 percent of the federal poverty level.
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The savings wouldn't be huge—about $479 a year on co-pays, deductibles and co-insurance.
"There is plenty of concern about the impact of high-deductible plans on peoples' ability to pay for care," said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. "It's important to remember that more than half of those eligible for marketplace plans with tax credits are also eligible for cost-sharing reductions, which make a huge difference in the burden of out-of-pocket costs on those with modest incomes."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
