As the much-anticipated health care exchanges opened amid bitter partisan debate and technical problems, the federal government released data late Tuesday showing that about 100 insurers were participating in the federally run marketplaces, offering more than 1,700 varieties of health insurance plans.
As anticipated, the premiums vary widely from state to state and region to region, the data shows, from $100 a month for a 27-year-old in one Oklahoma county who chooses the lowest-level bronze plan to more than $1,900 for someone of the same age choosing the highest-level gold plan in a Virginia suburb of Washington.
While federal officials have released selected information about the insurance offerings available under the Affordable Care Act, Tuesday was the official unveiling of plans and their costs in the 34 states whose marketplaces are being operated largely by the federal government and available through the Web site healthcare.gov. The remaining states have developed their own marketplaces, or exchanges.
While more detailed information is expected to become available in the coming days and weeks, federal officials revealed the rates for six representative groups – a 27-year-old, a 50-year-old, a family, a single-parent family, a couple and a child — late Tuesday afternoon.
The premiums are before tax credits, or subsidies, that could significantly lower the cost of coverage in many cases. The data does not provide specific detail about the plans, such as out-of-pocket costs. In many cases, lower premiums result in higher co-payments for certain kinds of care.
A 27-year-old resident of Comanche County, Okla., for example, can purchase the cheapest health plan from Blue Cross Blue Shield of Oklahoma for a monthly premium of $100. Or that same individual could spend nearly three times as much and choose instead the most expensive plan, from the same carrier, at a monthly cost of $280.
But the range is even wider in some regions.
Within each state there are multiple plan options with a range of prices. Plans with the cheapest monthly premiums – but with the highest deductibles and cost-sharing – are labeled “bronze” and
cost an average of $242 for a 27-year-old. “Gold” plans, among the most expensive of the choices but with lower deductibles and out-of-pocket expenses, can be purchased for an average premium of $310 for
a 27-year-old. And “silver” plans split the difference, with an average premium of $262 for a 27-year-old.
In comparison, a 27-year-old resident of Prince George County, Va., will spend a minimum of
$159 each month for a “bronze” plan through Anthem Blue Cross and Blue Shield or as much as $1,923 for a “gold” plan through Optima Health.
Various types of plans are available. Only about a third are the most restrictive H.M.O.’s.
Most states have access to hundreds of each type of plan by metal tier, although smaller states tend to have fewer options. Also, states are divided into regions for the purpose of pricing, and any given region in a state may not have access to all plans.
For example, more than 6,000 plans are available in Texas, but residents of Harris County, where Houston is, has access to fewer than 40 plans, including a dozen bronze and silver plans and 14 gold.
Dozens of counties have limited choices. For example, for the information provided, about 100 counties nationwide have five or fewer options including just one or two within a metal tier options. The most extreme example is Florence, Wis., which has only two choices, from the same carrier – silver and gold plans with costs ranging from a low of about $280 for a 27-year-old for a silver plan to a high of about $1,064 for a gold family plan.