New data shows that a large share of Oregonians using HealthCare.gov qualify for the subsidies that help pay for coverage. In 2018, the number is 115,889 people, or more than 74 percent of HealthCare.gov enrollees from our state. A total of 156,105 Oregonians have plans through HealthCare.gov. Union County ranked as the county with the largest percentage, 91%, of enrollees qualifying for a subsidy.
“These numbers underscore just how important it is to check if you are eligible for financial assistance when you shop for coverage at HealthCare.gov. The savings can be significant,” said Chiqui Flowers, administrator of the Oregon Health Insurance Marketplace.
Oregonians who enrolled in 2018 insurance at HealthCare.gov and qualified for subsidies have an average net premium of $138 per month. That average is down from last year, when it was $147, and shows significant savings compared to the average full-price premium of more than $500 per month.
People can get 2018 health plans through HealthCare.gov now only if they lose other coverage or experience a major life change, such as getting married. Open enrollment for 2019 coverage, when almost anyone can enroll, will be Nov. 1 to Dec. 15, 2018.
Qualifying for help paying for coverage and how much you can receive depends mostly on your household income and the full-price premium for a midrange plan in your area, for your age. Average full-price premium, average subsidy, and number of people enrolled vary across the state.
For example, the 2018 Oregon data show:
- Morrow County has the smallest number of people enrolled with a subsidy: 196
- Lake County has the smallest average premium after subsidy, among those who qualify: $101
- Columbia County has the largest average premium after subsidy, among those who qualify: $174
- Multnomah County has the largest number of people enrolled with a subsidy: 26,247
- Hood River County has the smallest percentage of people enrolled qualifying for a subsidy: 66%
Cameron Smith, director of the Department of Consumer and Business Services, notes a major split in coverage affordability, beyond the geographic variation.
“There’s a real tale of two categories here. People without financial assistance face rising premiums, and those who qualify for help are largely insulated from the hikes, or even enjoying a price drop,” Smith said. “The HealthCare.gov subsidies make a difference if you can get them. At the same time, we are working to stabilize premiums for everyone. One approach, a reinsurance program that helps moderate the increases that high claims can trigger, is already under way.”
The HealthCare.gov enrollment data were released this week by the federal Centers for Medicare and Medicaid Services. The numbers cover 2018 health plans selected by people using HealthCare.gov during open enrollment – Nov. 1 to Dec. 15, 2017 – whether or not the consumer has paid the first month’s premium for the coverage chosen.