Making sense of health exchange

It wasn’t until May of this year that Ken Woods, president of Dublin Health and Benefit Group, learned his health insurance brokerage firm — which helps connect people to the right insurance plan — would continue to have a role in the ever-changing landscape of insurance. But who will be the ultimate winners and losers is a question that’s yet to be answered.

Anthem Blue Cross Blue Shield is the only insurance carrier in New Hampshire offering plans in the government subsidized health insurance marketplace, or health exchange as it’s also known. And Anthem is only offering these plans in a network of 16 out of 26 hospitals in the state. Monadnock Community Hospital isn’t in the network. In an interview Wednesday, Woods helped put this situation in perspective.

Anyone can buy products in the marketplace, but tax credits will only be available — at various increments — to people below 400 percent of the federal poverty level. For a single person, it’s anyone making less than $45,960 a year. The tax credits will be available immediately to the insured, offering people previously unable to afford insurance in New Hampshire unprecedented access, effective Jan. 1. Woods pointed out that eligibility for the insurance tax credit is based solely on annual income and anyone can buy in the marketplace regardless of tax credit eligibility. But this coming year, with just one carrier in the exchange, choices are limited.

Woods speculated that low population in New Hampshire is the reason there’s just Anthem to choose from in the insurance marketplace, and in such a small population there are even fewer people eligible for the federal subsidies.

Whether you believe in the Affordable Care Act as the answer to the health insurance crisis or not, with rates growing exponentially each year, Woods said something had to be done. Now a lot of uninsured folks will get access, and they won’t be shut out by high costs or previous medical conditions. But there’s still work to be done to ensure our new subsidized system remains sustainable. As Woods said, “Obamacare isn’t the solution to all of our problems.... It doesn’t control costs, it doesn’t bring everyone to the table because the penalties aren’t high enough.” In 2014, the penalty for not obtaining insurance is just $95 with that rate expected to grow in the years ahead.

In the Monadnock region, at least for the coming year, folks who want to get their insurance through the exchange will have to drive to Keene to get care from doctors in the network. That’s a minor inconvenience, Woods said, when compared with the difficulties associated with being uninsured.

We couldn’t agree more.

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