By Carla Anderson
February 10, 2014
Applications covering more than 93,000 Alabama residents were completed between Oct. 1 and Dec. 28 according to the Jan. 13 enrollment report issued by the U.S. Department of Health and Human Services (HHS). Almost 29,000 people have selected a private health plan — up from about 3,500 at the end of November. An additional 9,676 people were deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP).
Eighty-three percent of those in Alabama who selected a health plan qualified for financial assistance, which is slightly above the national rate of 79 percent. Nine percent selected a bronze plan, 70 percent selected a silver plan, 13 percent selected a gold plan, and 8 selected a platinum plan. Nationally, the breakouts were 20 percent bronze, 60 percent silver, 13 percent gold and 7 percent platinum. Both nationally and in Alabama, one percent of selected policies were catastrophic plans.
Enrollment for private insurance in 2014 continues through March 31. Policies purchased by the 15th of the month will be effective the first day of the following month. Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater. Enrollment for Medicaid or CHIP continues throughout the year.
The federal government is operating the health insurance marketplace in Alabama, based on Gov. Robert Bentley’s November 2012 decision against a state-run marketplace. Bentley cited annual operating costs of up to $50 million as his reason for opting for a federally operated exchange. Bentley also ruled out an expansion of Medicaid in the state.
The decision against a state-run exchange came somewhat as a surprise. While the Republican governor consistently opposed many provisions of the Affordable Care Act, he repeatedly expressed support for a state health insurance exchange. He supported exchanges during his campaign for governor, and as governor, he used an executive order to establish the Alabama Health Insurance Exchange Study Commission. In November 2011, that commission unanimously recommended Alabama implement a state-run exchange. However, bills to establish a state-run exchange failed to pass in both the 2011 and 2012 sessions.
Blue Cross and Blue Shield of Alabama, which dominates the health insurance market in the state, and Humana are selling individual health insurance through the federal marketplace in Alabama. Blue Cross and Blue Shield of Alabama and United Healthcare are selling small-business policies. According to HHS, Alabama consumers have the fewest choices among the 36 states with partnership or federally facilitated marketplace. State residents will have an average of seven health plans from which to choose; the national average is 53.
According to a report released by HHS, the average cost for a bronze plan —the lowest-cost option — in Alabama is $247 a month. The national average for a bronze policy is $249 a month.
More than 640,000 people in Alabama (16 percent of the population) are uninsured and eligible to use the marketplace.
State Exchange Profile: Alabama
The Henry J. Kaiser Family Foundation overview of Alabama’s progress toward creating a state health insurance exchange.
Let your Alabama governor and legislators know how you feel about the state’s proposed health insurance exchange.Alabama Governor Robert Bentley