Will millions get health coverage for $100 or less?

By BenefitsPro


By Dan Cook

Health coverage for less than $100 a month? For millions of Americans? Is it just Obama administration propaganda? Or could it be true?

The U.S. Department of Health and Human Services says it may be true. But a report it issued Tuesday asserting as much is based on some less-than-certain assumptions, as well as some out-of-date figures.

In the report, HHS said if you add up everyone who is eligible for subsidized state exchange coverage and for the new Medicaid benefits, then “23.2 million, or 56 percent, of the 41.3 million eligible uninsured may qualify for Medicaid, CHIP (the children’s Medicaid program), or tax credits to purchase coverage for $100 or less per person per month.”

HHS obtained its 41.3 million uninsured Americans figure from a 2011 American Community Survey, which is produced by the Census Bureau. Oddly enough, a more recent survey by the ACS – which coincidentally also was released Tuesday – estimates the number of uninsured Americans at 48 million.

So this additional 7 million uninsured is going to throw all the math off.

Regardless, HHS says 6.4 million of the uninsured “may be able to pay $100 or less per person per month for the second lowest-cost silver plan in the marketplace in their state in 2014, after taking into account their available premium tax credits.”

HHS also estimates that an additional 4.3 million (of the 22 million) who buy the lowest-cost bronze plan may be able to pay $100 or less per person per month.

The agency bases its figures on income and family sizes, which it acknowledged were simplified and could lead to “small” effects on the data.

What many surveys have shown is that HHS also might have wanted to take into consideration the difficulty many people are likely to have navigating the system to determine the tax credits they qualify for.

Another problem? By its own admission, the agency’s estimates of what marketplace plans will cost could also be off, which, it said, "means our estimate may overstate the number of individuals who will be able to purchase a bronze plan for $100 or less.”

Meanwhile, according to the agency’s math, there’s another 12.4 million Americans who “will be eligible for Medicaid or CHIP in states that have chosen to expand their Medicaid programs to date." This group will pay either no premium or only a nominal premium in 2014, it predicted.

Here, HHS makes a rather large assumption. In a report footnote, it says: “The estimates assume that the following 25 states will expand their Medicaid programs:” and then it lists all the states that have at least indicated they might expand their Medicaid programs under the new rules. Of course, no one knows if this will happen until it happens.

The grand total of all of these populations is 23.2 million — which, of course, is not 56 percent of the 48 million uninsured ACS reported last year, but more like 48 percent of the updated Census figures.

HHS admits that its study has at least one other big limitation:

It left out “the eligible uninsured living in non-Medicaid expansion states with family incomes of below 100 percent of the federal poverty level.”

Still, whatever the real number turns out to be, the folks who may get health coverage for less than $100 a month ought to be pretty happy about it.

Originally published on BenefitsPro.com