DOVER, Delaware — In the first year of implementing the national health care law in Delaware, state officials focused on offering encouragement and incentives for people to sign up for insurance coverage.
With open enrollment for 2015 beginning Saturday, this year's message about the Affordable Care Act is more direct: sign up or pay a penalty.
"We think last year we had the highly motivated people that were interested in getting insurance," said Delaware Health and Social Service Secretary Rita Landgraf. "The public needs to be aware that this is a law, that there is a mandate, and that there will be penalties moving forward."
The penalty for not having insurance started this year at $95 per person, or 1 percent of household income, whichever is greater. It will increase to $325 per adult, or 2 percent of household income, for 2015, and will climb even higher in 2016.
People thinking about paying the penalty and opting out of insurance coverage need to know that as of Feb. 1, those either eligible for Medicaid or required to purchase coverage under the act will no longer be eligible for charity care under the state's Community Healthcare Access Program. That means they could be faced with paying medical bills, as well as the penalty.
State officials had hoped to enroll 35,000 of the estimated 90,000 uninsured residents in private insurance plans in the first year of Delaware's new health care exchange. The final enrollment totaled about 14,400, less than half of the state's goal but well above a federal target of 8,000.
State officials have declined to set an enrollment goal for 2015, and it remains unclear whether the act is meeting its goal of reducing the number of uninsured people because enrollees have not been asked whether they were previously uninsured.
What is certain is that most people enrolled in Delaware's exchange will be paying higher premiums next year. State officials approved an across-the-board, 3.99 percent average premium increase for individual policies offered by Highmark Blue Cross Blue Shield, which insures the vast majority of people in Delaware's exchange.
And people who temporarily extended plans not compliant with the federal law can expect severe sticker shock when choosing compliant plans. Nick Moriello, president of Health Insurance Associates, Delaware's largest independent health insurance agency, said some individuals and business owners could see premiums double.
"They're facing their first experience with the Affordable Care Act right now. ... These are unhappy folks," he said.
Individuals can choose from 23 exchange plans for 2015, up from 19.
The state's Small Business Health Options Program has 16 plans available, up from 11 this year. The average premium rate increase for such plans is 3.6 percent.
Businesses with fewer than 100 full-time employees are not required to provide coverage next year. Businesses that have 25 or fewer employees with average salaries of less than $50,000 are eligible for 50 percent tax credits on premiums if they do offer coverage.
Officials are urging people already enrolled in the exchange not to automatically renew their plans without looking at their choices because they might find a better deal.
According to figures released by federal officials earlier this year, the 81 percent of subsidized enrollees in Delaware's exchange were paying the third-highest average monthly premium in the country after accounting for tax credits.
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