ObamaCare: Texas Citizens, Businesses gear up for Healthcare Marketplace

When the Health Insurance Marketplace opened Oct. 1 as a result of passage of the national health care law, the Affordable Care Act, small businesses in Texas and across the country will have a variety of choices to make to participate in the Small Business Health Option Program (SHOP). Similarly, individual consumers in Texas should find more affordable health care because of the competition the new program is expected to cause in the Marketplace.

SHOP, designed for small employers with 50 or fewer full-time employees, offers quality brand name health insurance plans and lets small employers make side-by-side comparisons that will help them pick the best health care option for their needs. And, individual citizens and families in Texas will have more than 50 health plans from which to choose for their health care needs.

The SHOP program and the federal health care overhaul and how it will affect Texans were topics of discussion for U.S. Health and Human Services Secretary Kathleen Sebelius when she visited Dallas this week to discuss how best to inform communities and businesses about the new health care program.

With less than a week to go before the new health insurance Marketplace opens and Texans and others across the country will be able to shop for the plan that best fits their needs and their financial situation, Sebelius said that the increased competition among providers in Texas is driving down costs.

“We are excited to see that rates in the Texas Marketplace are even lower than originally projected,” said Sebelius. “In the past, consumers were too often denied or priced out of quality health insurance options, but thanks to the Affordable Care Act, consumers will be able to choose from a number of new coverage options at a price that is affordable.”

A six-month open enrollment period will start Oct. 1 and run through March of next year for individuals. Coverage begins as early as Jan. 1, 2014. Texans will be able to pick from three different plans – gold, silver or bronze – and young adults will also have the option of purchasing a “catastrophic” plan, increasing their number of choices. In Texas, the average premium for the lowest-cost silver plan will be $287 and for the lowest cost bronze plan it will be $211. The U.S. Department of Health and Human Services notes that the majority – about six out of 10 – of the individuals who are uninsured today will be able to find coverage for $100 or less per month in the Marketplace, taking into account premium tax credits and Medicaid coverage.

Texas businesses will get some help from a consortium of federal agencies and private-sector organizations as those businesses search for a suitable health insurance plan. HHS will be working with the U.S. Small Business Administration, the Small Business Majority, Main Street Alliance, Business Forward and the U.S. Hispanic Chamber of Commerce on an education and outreach campaign to help small employers.

Sebelius said one of the main concerns of small businesses historically has been the high cost of providing health insurance options for employees. “Many who would like to offer insurance to their employees have faced few choices, high administrative costs and skyrocketing premiums when an employee gets sick,” she said.

SHOP offers small employers quality brand name health insurance plans and lets them make side-by-side comparisons when choosing a coverage option that is right for their business. Those employers may also qualify for Small Business Health Care Tax Credit to help defray the cost of their premiums. Beginning in 2014, that tax credit could be as much as 50 percent of an employer’s premium contributions.

Small employers will be able to enroll in insurance plans through SHOP on a monthly basis throughout the year. The SHOP Marketplace for federally facilitated Marketplace states like Texas opens Oct. 1, when small employers can start the application process and get an overview of available plans and premiums in their area. Detailed information on the SHOP application and enrollment process are available at HealthCare.gov. SHOP will also have a call center operational on Oct. 1 at 1-800-706-7893. The Small Business Administration and HHS will offer webinars about what SHOP offers and how it works. Additional resources will be available at Business.usa.gov.healthcare

15-41