By Elana Gordon, WHYY
Tue, Mar 18 2014
Subsidies in the health law were designed to lower insurance costs for people who make around $11,000 to $46,000 a year. But for young people earning toward the higher end of that range, it's more complicated than that. A new study shows that in major cities, some young people are falling into a gap where they make about $46,000 or under, but don't actually qualify for government help to pay their insurance premiums.
And as the Affordable Care Act barrels toward its March 31 enrollment deadline, insurers need people age 18 to 34 to sign up.
Brian Loughnane, 26, was making $36,000 when he looked for a policy on healthcare.gov in December.
“There was something that said ‘You’re eligible for a subsidy,’” but then, he says, “after I put in the rest of my information, it said it was zero dollars.”
That's because subsidies kick in only when a baseline plan exceeds a certain percentage of a person’s income. The higher one’s income the more expensive premiums must be before subsidies kick in. It didn’t, in Loughnane’s case, and that’s the young person’s subsidy gap. Kev Coleman, with the health information technology company HealthPocket, recently looked at plans for young adults in eight major cities, and all of them had these subsidy gaps.
"What we found is that on average, once you were above $31,744 dollars you probably were not going to qualify for a subsidy," says Coleman.
This may mean there are enough low-cost insurance options being offered in those cities. But not necessarily. Coleman points out that depending on their age, income and city, premiums could be as much as $250 to $350 a month, and make up 9.5 percent of their income. Will young people perceive that as affordable?
“When you combine these results with the fact that young people under the age of 35 are statistically healthier, they probably place a lower priority on the need for health insurance – this may help explain why we’re seeing an underenrollment in the younger adults, verses the targets originally set by the administration,” Coleman says.