Missourians may have fewer health plans to choose

Missouri residents could have fewer choices for health care plans than those in many other states when enrollment opens next week for new online insurance marketplaces.

The federal Department of Health and Human Services says Missouri residents will have an average of 17 qualified health plans from which to choose in its federally run health insurance exchange. That's substantially fewer than the national average of 53 health plan options.

The federal government is running Missouri's health insurance exchange and those in 35 other states that opted not to set up their own online insurance marketplaces. The shopping sites are a key part of the 2010 Affordable Care Act signed by President Barack Obama and are intended to help people without employer-sponsored health insurance find coverage at affordable rates. The insurance exchanges also could be used by small businesses.

Missouri's projected statewide average of qualified health plans in the marketplace was half as many as in Kansas and less than a third as many as in Illinois. It's roughly equivalent to the average of 16 plan options in Wyoming, which has a substantially smaller population than Missouri.

Federal officials have not released a specific list of health insurers participating in Missouri's insurance exchange, nor detailed information about the various plans in advance of the Oct. 1 opening of enrollment. But they have provided a glimpse of the potential cost.

The Department of Health and Human Services estimates that a family of four with a $50,000 income could face average monthly premiums of $798 for a benchmark policy known as the "second-lowest-cost silver plan." But that cost could decline to $282 a month after federal subsidies.

A similar plan for a 27-year-old individual earning $25,000 could carry an average monthly premium of $220, which could be reduced to $145 with subsidies.

The actual cost to enrollees will vary depending on their personal circumstances and the insurance policies they choose.

Individuals and families could lower their monthly premium costs by choosing a "bronze" plan that has higher deductibles or copayments, or could pay more for monthly premiums by picking a "gold" or "platinum" policy that has lower out-of-pocket payments for visiting a doctor or hospital.

The subsidies, which are in the form of tax credits, vary depending on people's income, family size, age, where they live, the plans they pick and whether they use tobacco.

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