louisiana guide to health insurance

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Louisiana health insurance exchange / marketplace

148K Louisiana residents signed up for 2015 coverage

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The 2015 open enrollment period offers another opportunity for the 751,000 Louisiana residents who don’t have health insurance coverage. Louisiana’s 16.6 percent uninsured rate is higher than the national average of 13.4 percent.

One new insurer joined the marketplace in Louisiana for 2015. Despite the increase in competition, average premiums are also increasing in 2015. Subsidies will help temper the impact of those increases for many consumers who shop on the marketplace. For the 2014 coverage year, 88 percent of Louisiana residents who signed up for private health insurance received financial assistance, and their average monthly premium after subsidies was $83 according to a federal report.

2015 open enrollment

As of Jan. 30, 148,552 Louisiana residents had selected a qualified health plan (QHP) through the marketplace. More than one-third of those who signed up are from the New Orleans-Metairie area.

An HHS enrollment report shows that Louisiana’s enrollment through the two months of 2015 open enrollment was 58 percent new enrollment and 42 percent renewals. Eighty-eight percent of those selecting QHPs qualified for tax credits to help pay premium costs.

Open enrollment continues until Feb. 15, with coverage effective March 1.  After Feb. 15, only consumers who experience a qualifying event, such as getting married, will be able to sign up for insurance.

Rates and carriers for 2015

The number of insurance companies selling through the marketplace in Louisiana grew from five to six for 2015 coverage according to the U.S. Department of Health and Human Services. UnitedHealthcare, the nation’s largest health insurance company, joined the marketplace in Louisiana and about 20 other states. United took a very conservative approach in 2014, participating in just five states.

The Commonwealth Fund analyzed premiums and deductibles across all the metal tiers, differences in premiums between urban suburban and rural areas, and insurer participation in nearly all states. For Louisiana, the analysis showed premiums up 12 percent on average. In contrast, the analysis showed a 0 percent change in premiums nationally. According to another study by the Commonwealth Fund, premiums in state individual insurance markets rose an average 10 percent or more each year from 2008 to 2010.

Paying more for NOT being covered

Penalties, like premiums, are rising. If you don’t qualify for exemption and don’t get health insurance in 2015, you’ll owe a penalty when you pay your 2015 taxes. 2015 penalties are the greater of:

  • 2% of annual household income
  • $325 per adult or $162.50 per child under 18

There are caps that limit penalty amounts. See HealthCare.gov for a list of exemptions and penalty caps.

2014 enrollment recap

During 2014 open enrollment, 101,778 Louisiana residents — about one in five of those eligible — signed up for a qualified health plan (QHP) according to the Kaiser Family Foundation. In addition to those purchasing private insurance, 14,359 people qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria.

The Urban Institute estimates Louisiana’s enrollment in the marketplace to reach 305,000 in 2016.

ACA and exchange implementation in Louisiana

Louisiana is among the 26 states that left all responsibility for its health insurance marketplace to the federal government. Gov. Bobby Jindal repeatedly rejected a state-run exchange and even returned a $1 million federal planning grant.

Jindal also rejected Medicaid expansion in the state, a decision that leaves 34 percent of uninsured Louisiana adults in the coverage gap, so they can’t get help through Medicaid nor do they qualify for subsidies to purchase insurance through marketplace. According to the Kaiser Family Foundation, almost 242,000 Louisiana residents are shut out of both Medicaid and subsidies to purchase insurance through the marketplace.

The decision against Medicaid expansion affects not only uninsured individuals, but also Louisiana healthcare providers and its overall economy. The state provided $18 million in stopgap funding in late August 2014 when Baton Rouge General Mid City Hospital announced it would close its emergency room due to the expense of providing uncompensated care for the uninsured. Despite the infusion, the emergency room will close by early April 2015. An Urban Institute study says Louisiana is losing out on $15.8 billion in funding between 2013 and 2022 by not expanding Medicaid, while contributing $5.7 billion in taxes over the same period that will be used states that have expanded.

Louisiana health insurance exchange links

HealthCare.gov
800-318-2596

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

Louisiana Department of Insurance, Office of Health Insurance
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in Louisiana.
(225) 219-4770 / Toll Free: (800) 259-5301