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California health plan raises questions of cost, affordability

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Published: June 13, 2013 at 4:13 PM

SACRAMENTO, June 13 (UPI) -- Health coverage could come with $2,000 deductibles and $45 doctor co-pays, raising questions about the affordability of state-based exchanges, analysts say.

A plan developed in California reveals how much clients of the state exchanges could actually pay under the federal health law nicknamed Obamacare, CNNMoney reported Thursday.

A "silver-level" plan, one of four possible plans with the second-cheapest premiums, would cost an average of $321 a month. Customers who choose that plan would have a $2,000 deductible, $45 co-pays for primary care visits and a $250 charge for emergency room visits.

The elite gold or platinum plans have no deductibles and cheaper co-pays. But they have higher monthly premiums.

Obamacare caps out of pocket expenses. In the platinum plan, a patient would spend no more than $4,000 a year in the platinum plan; no more than $6,400 in the less expensive plans.

Marian Mulkey, director of the health reform initiative at the California Healthcare Foundation, said, the hardest question "is will it be a good deal and will consumers be able to afford it."

The answer depends on how healthy enrollees are and whether they are currently insured.

Gary Claxton, director of the healthcare marketplace project at the Kaiser Family Foundation, says, it's "hard for anyone who isn't well off to afford it."

However, "in many cases, depending on the plan, the coverage will be more comprehensive than what the enrollee currently has," said Anne Gonzalez, a spokeswoman for Covered California that is running the state's exchange.

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