Three independent estimates by Wall Street analysts and a consulting firm told The New York Times up to 7 million people, under provisions of the Affordable Care Act, could qualify for the no-premium plans, the majority in the bronze category, the least expensive available. Bronze policies require people to pay the most in out-of-pocket costs, for doctor visits and benefits such as hospital stays, the Times reported Sunday.
ACA supporters say the availability of free-premium plans and inexpensive policies that cover more indicate the law is achieving its goal of making health insurance more widely available. A number of those who qualify have incomes just above the threshold for Medicaid, an analysis by the consulting firm McKinsey and Co. indicated.
"The whole point of the law was not only to cover the uninsured, but so people didn't have to make choices between food or drugs, or going to the doctor or dentist," said Karen Davis, a health policy expert at the Johns Hopkins Bloomberg School of Public Health. "It's what it is designed to do."
Many insurers tried pricing their least expensive plans so they would be free or nearly free with the addition of subsidies based on a person's income and the cost of a mid-level, or silver, plan, the Times said.
Independence Blue Cross in Philadelphia has four plans that are free to some customers, but the company, as well as other insurers, has been careful not to publicize its free coverage out of fear of alienating customers who will need to pay more for coverage more appropriate for their needs, the Times said.
"We're not advertising zero dollars," said Brian Lobley, a senior vice president at Independence Blue Cross, while noting monthly premiums in the $20 to $30 range.
While varying in design, bronze plans generally cover about 60 percent of a person's medical costs in addition to standard benefits such as prescription drugs, maternity care and mental health treatment. All plans limit annual out-of-pocket costs to $6,350 for individuals and $12,700 for families. But insurers and advocates said out-of-pocket costs can be discouraging to people with low incomes.
Experts said paying slightly more for a silver plan may be a much better option because they make about 250 percent of the federal poverty level -- $28,725 for an individual and $58,875 for a family of four -- and are eligible for the most generous assistance, but only if they choose a silver-level plan.
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