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Confusion about the ACA: JABA Insurance Counselors respond

A recent report on local media said that people across Central Virginia are "shocked and worried” about the rising cost of health insurance under the Affordable Care Act, as open enrollment for the coverage began on November 1. The report suggested the Affordable Care Act was no longer affordable.  

While it’s true that health insurance costs have increased significantly for some people, JABA’s certified ACA Insurance Counselor wanted to remind people that the ACA is still working fine for the people it was designed for —those with lower incomes who could not otherwise afford health insurance. 

As JABA Insurance Counselor Joe Bernheim points out, the political confusion in Washington about the future of our health insurance system — and the last minute decision not to pay for benefits that insurance companies are required by law to provide — has caused many insurance companies to pull out of the ACA marketplace, and those who have remained have had to reduce their risks by raising rates, which has hit those not income-eligible for federal subsidies the hardest.

“We have noted a large difference in insurance costs for people who do and do not qualify for subsidy support,” says Bernheim, “because the benchmark premiums have gone up. But for people with a subsidy this balances out and their net premiums haven’t changed that much. “  

“Risk for insurance companies has gone through the roof,” says one JABA ACA Counselor, “because there is currently no stability in the system.”

Indeed, one way insurance companies are trying to reduce their risk is by adjusting their rates based on state and region (and by the health networks they serve), a situation that is confusing to many people. For example, a person living in Charlottesville might have to pay more for the same plan a person living in Orange County does, and the same goes for people living in different states. 

Bottom line, though, as all our JABA Counselors emphasize —if you are income-eligible for a government subsidy, based on your individual circumstances, you can get affordable health insurance under the ACA. 

Recently, JABA counseled a 25-year old woman making $25,000 a year on shopping for health instance through the ACA. JABA was able to find her an Optima Silver Health Plan for $111.00 a month. And a family of four with an income of $55,000 was able to purchase a similar Silver plan for $224.36 a month. 

“You can have a substantial income and still get help,” says another JABA Counselor.

Indeed, individuals making $47,520 or less a year, and a family of four making $97,200 or less a year, are eligible for subsidies under the ACA. And the limits go up with household size. 

Of course, if you fall outside those subsidy limits, that’s where the trouble is, and that’s where people are getting hit the hardest. 

“Every situation is unique,” says Bernheim, “and you may be surprised by the benefits you can get. That’s why it’s important to get the facts before you decide.”

NoteJABA Counselors are available for interviews, and you are also welcome to follow them as they sign people up for the 
ACA. 

Both JABA and the Legal Aid Justice Center are offering FREE counseling appointments during the Affordable Care Act (Obamacare) Open Enrollment period, November 1 through December 15. JABA is located on Hillsdale Drive, behind Toy-R-Us on Route 29 North, and the Legal Aid Justice Center is on Preston Avenue, right near Washington Park. JABA will also have Mobile Office Units in Charlottesville and surrounding counties during the enrollment period.

Call JABA at 434-817-5248 or the Legal Aid Justice Center at 434-220-1496 and schedule your appointment.

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