arizona guide to health insurance

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Arizona health insurance exchange / marketplace

AZ marketplace enrollment tops 204K

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More than 204,000 Arizona residents enrolled in private health insurance through HealthCare.gov during 2015 open enrollment. About 628,000 Arizonans were eligible to enroll through the marketplace, according to the Kaiser Family Foundation.

Still not insured?

The 2015 open enrollment period, when anyone could sign up for insurance, ended Feb. 15. However, you can still enroll under some circumstances.

  • If you weren’t aware of the tax penalty for not having health insurance, can enroll between March 1 and April 30. You’ll still need to pay any penalty you were assessed for 2014, but you can minimize the 2015 penalty by getting covered by April 30.
  • If you have a qualifying life event, you get a 60-day special enrollment period to select a health plan.
  • If you qualify for Medicaid, you can sign up at any time.

2015 plans and premiums

Three more insurers are participating in the Arizona marketplace for 2015: UnitedHealthcare, Assurant Health, and Phoenix Health Plans. In total, 13 insurers are participating in the second open enrollment period, up from 10 last year. Nationally, the number of participating insurers is up about 25 percent.

A Kaiser Family Foundation analysis shows premiums down 10 percent in the Phoenix area, but flat or up in many other parts of the state. Visit HealthCare.gov and enter your ZIP code to see the specific insurers, plans and premiums available where you live.

While rates are increasing for some Arizona residents, the baseline is better than in many other areas. In 2014, Arizona’s premiums were among the lowest of states using the federal exchange in 2014.

What happened during 2014 open enrollment?

Arizona saw positive effects during the first year with the Obamacare marketplace in operation. The state’s uninsured rate dropped by 2.9 percentage points, state hospitals have seen uncompensated care costs drop by nearly one-third, and the state added health care-related jobs.

Just more than 120,000 Arizona residents signed up for qualified health plans (QHPs) during open enrollment for 2014. An additional 101,282 people qualified for Medicaid or the Children’s Health Insurance Program (CHIP).

Among Arizona residents selecting a QHP, 77 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Arizona consumers was $113. Among states using the federal marketplace, the average was $82. Twenty-six percent of Arizona enrollees pay $50 or less per month after subsidies.

Twelve percent of Arizona residents selected a bronze plan (20 percent nationally), 60 percent selected a silver plan (65 percent nationally), 14 percent selected a gold plan (9 percent nationally), 13 percent selected a platinum plan (5 percent nationally) and 1 percent selected a catastrophic plan (2 percent nationally). Twenty-one percent of Arizona enrollees were between the ages of 18 and 34.

Arizona and Medicaid expansion

Medicaid expansion was passed by the Arizona Legislature with some Republican support and was approved by Brewer. The Medicaid decision allowed people earning less than 138 percent of the federal poverty level — about $15,000 for an individual — to gain health coverage. About 300,000 are eligible under the expanded criteria.

Some Republican legislators and conservatives challenged Medicaid expansion. They first launched a petition to put Medicaid expansion on the November 2014 ballot. The referendum push failed, prompting a legal challenge. The suit claimed that because the tax plan to fund the state’s portion of expansion costs was passed with less than a two-thirds majority, it was unconstitutional. Oral arguments were made in mid-December 2013, and a judge dismissed the case in early February 2014.

A group of conservative Republican representatives appealed the decision, and the Arizona Court of Appeals ruled that the case could proceed. The Arizona Supreme Court heard the case in November 2014 and later ruled that the case could proceed. Gov. Doug Ducey is said to be reviewing the decision and consulting with legal experts on how to proceed.

In February 2015, the Arizona legislature passed a bill limiting Medicaid eligibility to five years for those who are able to work. The bill excludes pregnant women, those caring for young children, and people with disabilities. Gov. Ducey has not indicated if he plans to sign the bill. The five-year restriction would require a federal waiver, which is not likely to be granted.

Arizona health insurance exchange links

HealthCare.gov
800-318-2596

Cover Arizona

Arizona Department of Insurance: Health Insurance Exchange

Office of Health Insurance Exchange