Health plan affordability will vary by situation

jnsbranti@modbee.comApril 9, 2013 

Here's the good news: Everyone in America should have health insurance starting in January.

The bad news: It's not going to be cheap.

Only large employers will be forced to offer health benefits to employees. Small companies won't have to, though many of them will continue to do so.

What's new is an option for individuals to purchase their health insurance -- often at government-subsidized rates -- from a health care exchange called Covered California.

How much the insurance will cost will depend on which health care plan is selected and how much people earn.

Subsidies will be offered to families with incomes up to 400 percent of the poverty level. This year, four times the poverty level is about $62,000 for a two-person family. For a family of four, it's $94,200.

An enrollment period is expected to begin Oct. 1.

Covered California recently posted an online calculator that allows people to figure out about how much they will have to pay, based on their age and income.

That calculator is at www.coveredca.com/calculating_the_cost.

Here are some examples of how costs vary, according to that calculator:

• Mother with three kids: A 40-year-old mom with three children who earns $35,000 per year would have to pay $1,356 per year to insure her family. That's because the government would pay $12,420 of the actual $13,776 insurance cost. So she would be expected to spend just 3.9 percent of her income on insurance.

• Low-income widow: A 64-year-old earning $16,000 per year would pay only $492 annually for insurance. The government would cover $7,128 of her actual $7,620 expense. Insurance would require 6.5 percent of her income.

• Average family: A 30-year-old couple with two kids earning $53,000 (about average for Stanislaus County) would pay $3,804 per year. The government would chip in $6,540 of the $10,332 cost. Their insurance would require 7.2 percent of their income.

• Single guy: A 40-year-old man without dependents who earns $46,000 a year would have to pay $5,088 per year to buy coverage for himself. The government would not subsidize him. Health insurance would consume 11.1 percent of his income.

• Middle-aged couple: A 50-year-old couple earning $63,000 per year would have to pay $17,232 per year. They won't get government help. That insurance will devour 27.4 percent of their income.

• People in poverty: Those with extremely low income would not be required to buy their own health insurance. Instead, they would get health coverage through the government-funded Medi-Cal program.

For more information about Affordable Care Act requirements, go to the California government website, www.coveredca.com.

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