Open enrollment for health plans from the Affordable Care Act starts Saturday, and Ohioans will have more options this year. The number of companies offering insurance on Ohio’s exchange has jumped from 12 to 16, assuaging concerns that competition would decrease, rather than increase under the new law. The new entries include Dayton-based Premier Health, a health network that is branching out into the insurance market for the first time, and a CO-OP called InHealth Mutual.
CO-OP stands for consumer operated and oriented, an alternative model of health insurance that was set up by the original Affordable Care Act law.
“I’ve often thought about us as co-ops being very much like the credit union of health insurance,” says InHealth CEO Jesse Thomas. “We are really owned by policy holders, we are governed by policy holders, and we don’t look to make a profit like the for-profit companies that are publicly traded.”
The Affordable Care Act, passed in 2010, created a loan program to fund these customer-owned health plans, but many have been slow to get off the ground and most states still don’t have them. The CO-OP concept grew out of demand for a public option, a policy idea that was overwhelmed by the push to keep health insurance provision in the United States entirely in the private market.
Thomas says InHealth will offer services in all 88 counties of Ohio, and by the end of 2015 more than half of its board will have to be people who hold policies with the company. He says the goal throughout has been to be consumer-driven, and to specifically address the needs of Ohio’s uninsured and underinsured residents. If the company finds itself with a surplus, that will go towards reducing premiums or improving care.
Average premium rates for plans available on the Ohio marketplace have gone up slightly since last year, although some plans have actually gotten cheaper. People can go to healthcare.gov to look at prices starting now; a “window-shopping” option allows you to preview the premium price, although it won’t calculate your subsidy. This year’s open enrollment period runs just three months, from Nov. 15, 2014 to Feb. 15, 2015, and deadline extensions are significantly less likely now that the website has been up and running for more than a year.
Those don’t get health coverage in 2015 will face even steeper tax penalties than the first year. Ohio residents under 65 are eligible for marketplace subsidies from the federal government if they make between 138 and 400 percent of the federal poverty level. Those who make above that can shop on the marketplace but won't get subsidies; those who make below that are likely eligible for Medicaid.
Lewis Wallace is WYSO's managing editor, substitute host and economics reporter. Follow him @lewispants.