Alabama

Alabama health insurance marketplace: history and
news of the state’s exchange

BCBS of Alabama and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

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Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Alabama exchange overview

Alabama uses the federally-facilitated marketplace, which means residents enroll in exchange plans through Healthcare.gov.
Blue Cross Blue Shield of Alabama was the only health insurance carrier offering plans in the Alabama exchange in 2017, and they already insured the majority of the state’s exchange enrollees prior to 2017, when there were multiple insurers offering coverage. But for 2018, residents in the Birmingham area can choose from two different insurers in the exchange, as Bright Health is now offering a total of six exchange plans in that area, plus two off-exchange-only plans.
No subsidy? Can’t afford Obamacare? Get up to 360 days of short term coverage for as little as $50 a month.
2016 was the first year that Alabama participated in the rate review process for ACA-compliant plans (for 2017 coverage). Prior to that Alabama did not have an effective rate review process, so the federal government handled rate review for Alabama. The federal government still conducts rate review for Oklahoma, Texas, and Wyoming, but Alabama has joined the majority of the states that have an effective rate review process.

2018 enrollment

170,211 people enrolled in private individual market plans through the Alabama exchange during open enrollment for 2018 coverage. This was a 4.6 percent decrease from 2017, when 178,414 people bought coverage. ,As was the case in the majority of the states that use HealthCare.gov, peak enrollment cam in 2016, when 195,055 Alabama residents bought plans in the exchange. Enrollment in most states that use HealthCare.gov declined in 2017, and then declined again in 2018.
The declines are due to a variety of factors, including the Trump Administration’s decision to sharply reduce funding for exchange marketing and enrollment assistance, and the shorten the open enrollment period for 2018 from three months down to just over six weeks (this shorter enrollment window was already scheduled for the fall of 2018, but the Trump Administration moved it up a year, and simultaneously reduced funding for the exchanges). In addition, confusion about the status of the ACA, particularly the individual mandate, played a role in the declining enrollment, as did much higher premiums for people who don’t get premium subsidies (people who do get premium subsidies are mostly protected from the impact of rate increases).
Open enrollment for 2018 coverage ended December 15, 2017. But residents in several states, including Alabama, had a special enrollment period due to the impact of Hurricane Irma. The special enrollment period was initially scheduled to run through December 31, 2017, but was later extended through March 31, 2018. The designated area included the whole state, so all Alabama residents had until March 31, 2018 to enroll in coverage through the exchange.

2018 insurers and rates:
Cost of CSR added to silver on-exchange plans

Blue Cross Blue Shield of Alabama confirmed in June 2017 that they would continue to offer coverage in all counties in the state in 2018. Their rates increased by an average of 36 percent in 2017, although subsidies increased enough to offset that for the vast majority of Alabama’s exchange enrollees. And for 2018, they implemented a rate increase less than half that size, despite the assumption (which proved correct) that cost-sharing reductions (CSR) would not be funded by the federal government, as well as an assumption that the individual mandate wouldn’t be well enforced (the mandate is still being enforced in 2018, but the penalty will be eliminated after the end of 2018). So although rate hikes were steep for 2017, the rate increase for 2018 would have been in the low single-digits if it weren’t for the uncertainty caused by the Trump Administration.
For 2018, Bright Health has joined the Alabama exchange, but only in the Birmingham metropolitan area. Bright Health first entered the Colorado market for 2017, and their plans are available in both Colorado and Alabama for 2018. There had been reports that Bright Health would offer Medicare Advantage plans in Alabama for 2018, but the Alabama Department of Insurance confirmed in mid-August that Bright Health would also offer individual market qualified health plans in the exchange in the Birmingham area.
The following average rate increases were implemented for 2018 in the Alabama exchange:
Blue Cross Blue Shield of Alabama (statewide): 15.6 percent average rate increase, although the bulk of the rate increase applies to silver plans. The approved rate increases were based on the assumption that cost-sharing reductions (CSR) would not be funded in 2018, and that the individual mandate would not be well enforced.
Bright Health (Birmingham metropolitan area): New to Alabama, so there is no applicable rate increase. But a revised rate filing submitted in August noted that the cost of CSR has been added to silver on-exchange plans for 2018 (but not to off-exchange silver plans)
The rate increases are largest for silver plans because those are the plans to which cost-sharing reductions (CSR) apply. BCBSAL’s rate filing noted that “the proposed rate increases for the QHP silver plans are much higher than the proposed rate increases for the remainder of the plans.” The filing indicates that the rate increases range from 2 percent for Blue Cross Select Gold to 21.2 percent for Blue Value Silver. The rate filing also notes that two BCBSAL plans —Blue Secure Silver and Blue HSA Gold — are sold only off-exchange. So the Blue Secure Silver plan does not have the cost of CSR added to the premiums, since nobody on that plan will have CSR benefits, as they’re only available on-exchange (Blue HSA Gold also does not have the cost of CSR added to premiums, as it’s a gold plan and also off-exchange).
The Trump Administration announced in October that CSR funding would end immediately, but BCBSAL and Bright Health had already made that assumption in their premiums for 2018. Since the government isn’t funding CSR for 2018, the insurers have to collect higher premiums for those plans to offset the cost. But the vast majority of enrollees (including virtually everyone who receives CSR plans) are receiving premium subsidies, which grew in 2018 to offset the higher premiums.
The CSR approach that Alabama’s insurers took — adding the cost of CSR to on-exchange silver plans, while also making off-exchange silver plans available without the cost of CSR added to their premiums — is the approach that protects virtually all enrollees. People who qualify for premium subsidies are protected from the rate hike, because the cost of CSR is added to silver plans, and premium subsidies are based on silver plan rates (specifically, the second-lowest-cost silver plan in each area). So the subsidies keep silver plan rates fairly consistent from one year to the next, and the larger-than-normal premium subsidies can also be used to cover even more of the cost of plans at other metal levels.
People who aren’t eligible for premium subsidies can purchase plans at other metal levels that don’t have the cost of CSR added to the premiums. If they want a silver plan, they can purchase one that’s only marketed off-exchange (no premium subsidies are available off-exchange, so again, this is only a logical choice for applicants who are 100 percent certain that they won’t qualify for premium subsidies in 2018)
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Premium subsidies are available in Alabama to applicants who earn between 100 percent and 400 percent of the federal poverty level; for an individual, that’s between $12,060 and $48,240. For a family of four, it’s between $24,600 and $98,400.
Premium subsidies can be used to offset the cost of any metal-level plan (ie, anything but a catastrophic plan). So the larger subsidies will be enough to keep the cost of the second-lowest-cost silver plan affordable, but they’ll go even further (relative to 2017) when applied to bronze or gold plans, since the pre-subsidy rates on those plans aren’t increasing by as much as the silver plans (as noted above, this is because the cost of CSR has been added to silver plan premiums, but not to premiums at other metal levels).
As an example, consider a family of four in Birmingham: 45-year-old parents, and two kids, ages 16 and 14 (we’ll keep them the same age in both 2017 and 2018, to make it easier to compare the rates). If this family earns $60,000/year, the lowest-cost plan available to them in the exchange was $93/month in 2017. But for 2018, they can get a plan for $1.19/month in premiums.
And if their income is $55,000 instead, there are four plans available to them for 2018 with no premiums at all. Two are from Bright and two are from BCBSAL, since the Birmingham area has plans available from both carriers in 2018. But all four plans have $0 premiums for this family at an income of $55,000 in 2018.
Note that at an income of $55,000, they would be eligible for CSR benefits if they pick a silver plan instead of one of the $0 premium bronze plans, and some advocates prefer that anyone eligible for CSR benefits be steered towards silver plans rather than high out-of-pocket bronze plans. But for our hypothetical family earning $55,000 in 2018, the cheapest silver plan would be $319/month in premiums, and with that income, a family of four qualifies for only the weakest level of CSR benefits. So the out-of-pocket costs for a silver plan, while not as high as they are on a bronze plan, are still fairly high.
There’s no right or wrong answer when it comes to picking a plan, as each person and family will have different needs, budgets, and risk tolerance. But the fact that the cost of CSR has been added to Alabama’s silver plan premiums for 2018 means that non-silver plans offer particularly good value for those who receive premium subsidies and prefer non-silver plans.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.