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Feds: Most consumers can buy health plans for $900

Karen Bouffard
The Detroit News

Most consumers will be able to buy health insurance for $900 or less annually at HealthCare.gov starting Nov. 1 even if marketplace rates increase by double digits, according to an analysis released Wednesday by the U.S. Department of Health and Human Services.

If rates rose 25 percent for every plan offered on Michigan’s health insurance exchange for the 2017 fiscal year, about 70 percent of Michiganians would remain eligible to $75 per month or less, federal officials said.

Officials made the comments in an attempt to cushion concerns that Michigan plans would increase an average of 17.2 percent under proposals submitted to the state Department of Financial and Insurance Services. The department likely will announce finalized rates in mid-October, department spokeswoman Andrea Miller said Wednesday.

The state last year didn’t alter proposed rates.

Consumers eligible for federal subsidies under the Affordable Care Act will pay less than the full increase because their subsidies also will increase, said Katie Martin, acting assistant secretary for planning and evaluation at the U.S. Department of Health and Human Service.

“The structure of the tax credits will help keep rates affordable,” Martin said, adding that 82 percent of consumers qualify for subsidized rates.

But consumers still pay other costs than the premiums, such as out-of-pocket expenses.

The maximum out-of-pocket limit for any 2016 marketplace plan is $6,850 for individuals and $13,700 for families, according to HealthCare.gov. After a consumer spends this amount of money on deductibles, co-payments and co-insurance, the health plan by law is responsible for paying all of the costs of covered benefits.

The out-of-pocket limit doesn’t include monthly premiums or services the plan doesn't cover.

The analysis included consumers who don’t qualify for subsidies, as well as 150 million Americans with employer-sponsored plans. Federal officials said all consumers will benefit from the lowest rate of increase in health care costs in 50 years.

Among other findings:

■Last year’s average premium increase was $4 per month for people who qualified for tax credits at HealthCare.gov.

■More than 36 percent of Michiganians who returned to purchase health insurance last year at HealthCare.gov switched plans, saving an average of $45 per month.

■The average premium for employer-sponsored family coverage rose about 4 percent in 2015.

kbouffard@detroitnews.com