Roughly 4.2 million people who don’t have health insurance could get coverage for free ― if they act fast.
No, that’s not the tagline from a late-night television ad. It’s the real-life finding of a new report from the Henry J. Kaiser Family Foundation.
The finding, like those schlocky TV spots, comes a big catch. The coverage itself would be threadbare. Most of those consumers would probably be better off paying the modest monthly premiums it would take to get insurance that’s a lot more generous.
Regardless, the statistic is a reminder that millions of people without any health insurance can still get covered for not a lot of money ― but only if they sign up before the end of open enrollment, which in most parts of the country is Dec. 15.
The Kaiser report focuses on the availability and prices of “bronze” plans, which are the least generous of four types of health insurance that the Affordable Care Act has made available to people buying coverage on their own, rather than through an employer.
These are the plans sold through HealthCare.gov or one of the state-run marketplaces, like Covered California or Maryland Health Connection. (A full list of state-run exchanges is here.) People who buy those plans may qualify for tax credits that discount premiums, sometimes substantially ― by hundreds or even thousands of dollars a year.
The sizes of the tax credits vary with income so people who need more help can get it. But the sizes of the tax credits also vary from market to market to adjust for local insurance prices.
In some places, and for some people, the tax credits are so big that they cover the entire cost of a bronze plan. In those instances, people can get bronze coverage for 2019 and spend literally nothing on premiums.
Kaiser researchers ran the numbers and figured out that, among people who are eligible to buy coverage through one of the marketplaces, about one-quarter of those who still don’t have insurance could get free bronze plans. That works out to about 4.2 million people.
Of course, bronze plans are cheap for a reason.
They cover preventive care for free, as all plans that comply with the Affordable Care Act must. But they don’t pay for much else until bills hit a deductible ― which, this year, averages $6,258 for an individual policy.
That is why policy experts, enrollment counselors and consumer advocates typically urge would-be buyers to check out “silver” plans, which are more generous.
Silver plans aren’t generally going to be free, even with large tax credits. The premiums are too high for that. But people with relatively low incomes ― in other words, the ones who would get the big tax credits ― still won’t have to pay much. And they will be eligible for a special version of the silver plans that have lower out-of-pocket costs.
For people with incomes no higher than two times the poverty line, which is about $24,000 for an individual, average premiums for the typical silver plans are $20 to $130 a month, according to Kaiser, with annual deductibles between $239 to $3,169.
That’s probably a better deal than bronze for most people ― even the consumers who could get bronze at no cost.
“If you have significant medical needs, paying a bit more each month for a silver plan can actually cut your potential health spending in half,” Cynthia Cox, co-author of the report, told HuffPost.
She said that a low-income person who ends up in the hospital could end up with $7,000 in bills with a bronze plan, but less than $3,000 with a silver plan, even including the premiums, depending on the circumstances.
One reason for big discounts, ironically, is President Donald Trump’s efforts to sabotage the Affordable Care Act.
In late 2017, he decided to cut off one set of federal payments to insurers. Insurers had to raise premiums in response.
But in most states, they deliberately raised premiums on only a small subset of plans in a way they knew would trigger bigger subsidies from the government.
The result for the federal government was higher federal spending. The result for consumers was more financial assistance ― and some pretty good deals.