BOISE -- On Monday afternoon, the Idaho Health Insurance Exchange Board met, and one of the members tells KTVB the federal government and White House "assured us that financing for the exchange will go forward regardless of what action Congress does or doesn't take in the next few days."
Some finding their current individual plan, premium is no more
Just after 10:00 p.m. Idaho time (midnight eastern), the feds were scheduled to began rolling out the exchange software package on the east coast, and by the time Idahoans wake up Tuesday, the should be able to shop Idaho's online marketplace. As that time nears, some are still confused about coverage or being surprised to find they'll have to get an Affordable Care Act plan.
In the last couple of weeks, some people who currently have an individual insurance plan, like a viewer named Danny who lives in Idaho and works in Oregon, have been getting letters that their current policy is no longer available. According to a letter he got and showed KTVB, he will now have to get an Affordable Care Act qualifying plan.
The plan his insurance provider said was developed to "replace our current plans" showed a premium at least $150 higher, with higher deductibles and co-pays.
Danny's wife has a different plan, and he says she will get to keep her current plan, though at a higher rate.
Is your plan grandfathered?
Danny is likely one of thousands of Idahoans who won't be grandfathered to keep their current individual plan. An insurance official explained that may be someone whose insurance company didn't choose to offer that option, someone who bought the policy after March 23, 2010 or someone who's changed their policy in that time.
Blue Cross of Idaho, which does NOT insure Danny, explains the concept:
"So for instance, if you increased your deductible a significant amount, you would take yourself out of grandfather status. So of the 45,000 or so people that Blue Cross of Idaho has in its individual coverage, about one-third of them only are grandfathered, two-thirds of them are non-grandfathered. Those people are going to have to choose a different plan when they renew," said Karen Early, Director of Corporate Communications at Blue Cross of Idaho.
Early says more than 100,000 people who purchase individual coverage now may be impacted and have to choose an ACA qualifying plan.
"They'll have to choose a different plan. By law, none of the insurers can offer the non-grandfathered policies after January 1st. So after January 1st, if you have coverage that renews in say April, you'll have to choose a new plan if you're in a non-grandfathered plan. You can find out if you're non-grandfathered by calling your health insurance company," Early said.
Exchange Board: Everyone should check the exchange for individual coverage
Idaho Health Insurance Exchange Board Member Margaret Henbest says anyone is encouraged to sign on to the exchange and look at the plans, though some, like Danny, shouldn't be surprised to see higher rates. She says the value could be considered better, based on benefits like adding mental health or preventative care.
"Since all the plans on the exchange have to be a qualified health plan, they have to cover certain benefit packages, they may not have access to that complete benefit package in their current plan, and that benefit package may look appealing to them," said Margaret Henbest, Idaho Health Insurance Exchange Board Member.
Danny's wife, for example, may find she can get better services in the exchange for a rate similar to her current provider's increased rate. Blue Cross explained while plans may be grandfathered in some cases, rates and premium costs are not.
Based on what he's seen in his provider's plan meant to "replace" his current, he is not impressed, finding in his case it looks like just higher costs, with added benefits he doesn't find useful for his individual health needs.
Exchange opens Tuesday morning for Idahoans to start comparing
Exchange officials urge people to check new plans because some people, though not all, will be eligible for help paying premiums, so the rates may look higher than the amount out-of-pocket.
"Anybody really that has questions about insurance now or in the future should go onto the exchange to see if they're eligible for any kind of tax credits or subsidies, whether you're an individual or a small business," Henbest said.
Early encourages people to be prepared for a process in filling out questions online to get rates. She says you will need a lot of information and patience will be required.
"More like doing your taxes than buying an airline ticket," she said.
Exchange officials expect a rush on the website in the first days of operations and also ask for patience from consumers as the work with the open enrollment process.