alabama guide to health insurance

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Alabama health insurance exchange / marketplace

Alabama exchange enrollment tops 168K

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More than 168,800 Alabamians signed up for qualified health plans (QHPs) through HealthCare.gov during 2015 open enrollment according to the U.S. Department of Health and Human Services (HHS). During the 2014 open enrollment period, the total number of health plan signups in Alabama was 97,870.

Eighty-nine percent of Alabama residents who purchased QHPs through Jan. 30 qualified for premium subsidies. Those subsidies reduced the average monthly premium from $360 to $92.

Still some chances to enroll

The 2015 open enrollment period ended Feb. 15. However, you may still be eligible to enroll.

  • Did you recently file your 2014 taxes and discover you had to pay a penalty for not having health insurance? If so, you have until April 30 to sign up for 2015 coverage. While you will still have to pay the 2014 penalty, you’ll protect yourself from an even bigger 2015 penalty.
  • Did you experience a qualifying life event? If so, you are entitled to a special enrollment period to select a health plan.
  • Are you a Native American? If so, you can sign up for a QHP at any time.
  • Do you qualify for Medicaid? Enrollment is accepted year-round.

Penalties rise for 2015

The individual mandate, which says you must have health insurance or pay a penalty, is one of the least popular features of Obamacare. However, just 1.4 percent of people will pay a penalty, according to the Congressional Budget Office.

For those who do have to pay, penalties increase for 2015. Those who don’t qualify for an exemption will have to pay the greater of:

  • 2% of annual household income. The maximum penalty under this calculation method is the national average premium for a bronze plan, which is just over $3,000 according to Exhibit 1 in this Commonwealth Fund analysis.
  • $325 per adult or $162.50 per child under 18. The maximum penalty per family using this method is $975.

Use the healthinsurance.org penalty calculator to see how much you may owe.

Coverage for small businesses

Through the federal Small Business Health Options Program (SHOP) exchange, small businesses with 50 or fewer employers can now shop online for health insurance coverage. Small employers and non-profit organizations can shop on their own or work through a broker or agent. After the employer defines the plan to offer, employees enroll online through the SHOP.

There is no defined open enrollment period for the SHOP marketplace. Small employers can set up a plan anytime of the year.

Nearly 125,000 found coverage in 2014

Nearly 98,000 Alabama residents signed up for qualified health plans (QHPs) during 2014 open enrollment. That was about 21 percent of estimated 464,000 people eligible to use the marketplace, according to the Kaiser Family Foundation. Nationally, about 28 percent of eligible people enrolled in a health plan through the ACA marketplaces. In addition, Kaiser also reported 22,564 Alabamans qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria.

Alabama’s uninsured rate dropped 3.2 percentage points from 2013 to 2014, falling to 14.5 percent according to the Gallup-Healthways Well-Being Index.

How Alabama is handling health care reform

The federal government operates 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.

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.

Alabama residents had more choices and slightly higher prices during the 2015 open enrollment period. Historically, Alabama’s health insurance market has been considered one of the least competitive in the nation.

Humana and Blue Cross and Blue Shield of Alabama, which dominates the health insurance market in the state, sold individual health insurance through the federal marketplace in Alabama for 2014. UnitedHealthcare joined the exchange for 2015, and its plans are now available through the marketplace in all 67 Alabama counties. Previously, United policies were available only outside the marketplace.

A study by the Commonwealth Fund shows Alabama premiums increased just 3 percent from 2014 to 2015, which is much less than the increases seen in the years leading up to the passage of the Affordable Care Act. Rates for individual health insurance increased about 10 percent each year between 2008 and 2010.

Alabama has not expanded Medicaid. Gov. Bentley opposed Medicaid expansion, and his position became the subject of campaign ads, editorials, billboards, and websites during 2014. Late in 2014, Bentley reintroduced a discussion on Medicaid expansion. Bentley said his administration will explore options to obtain federal Medicaid funding for a state-designed solution with a work requirement for recipients. Conservative groups promptly accused Bentley of flip-flopping.

An August 2014 study published by the Urban Institute shows the impacts of not expanding Medicaid. In Alabama, about 254,000 people will not qualify for Medicaid coverage through 2016. In terms of financial impact, the authors calculated that while Alabama would spend $1.08 billion to expand Medicaid over a ten-year period, the state is losing out on $14.4 billion in federal spending and state hospitals are losing $7.0 billion in reimbursement over the same period.

Alabama health insurance exchange links

HealthCare.gov
800-318-2596

Alabama Department of Insurance – Health Insurance Reform Information Center

State Exchange Profile: Alabama
The Henry J. Kaiser Family Foundation overview of Alabama’s progress toward creating a state health insurance exchange.