California health exchange to create 500 call center jobs in Rancho Cordova

CalifCalifornia health exchange to create 500 call center jobs in Rancho Cordovaornia health exchange to create 500 call center jobs in Rancho Cordova
The Sacramento Bee by Peter Hecht –
March 23, 2013:


City and state officials confirmed Friday that Covered California, the organization instrumental to carrying out the federal health insurance overhaul in California, has signed a local lease to open a state service center on White Rock Road in Rancho Cordova.

“We welcome them,” said city economic development director Curt Haven. “They complement our other companies located in Rancho Cordova. We have a ready and willing workforce that will easily fill those jobs.”


The Covered California call center is expected to open in August. Its 500 employees, including call center agents, managers and technology specialists, will work in a city that is already home to call centers for Dignity Health, Sutter Health, Delta Dental and Vision Service Plan.


The nearly 60,000-square-foot Rancho Cordova site will be one of two statewide call centers for Covered California. A second state center is expected to be announced for another Central Valley location. And Contra Costa County will be the site of a Covered California call center in partnership with the state’s 58 counties.


“We’re just really happy that we are going to be able to move forward on this,” said Covered California spokesman Dana Howard, adding that he expects the Rancho Cordova site to be fully staffed by this fall. “This really allows Covered California to move forward with getting the millions of uninsured in California enrolled with affordable health coverage. We have a tight window to do this in. And this is just a huge milestone.”


The national Affordable Care Act, signed into law by President Barack Obama, requires state health care exchanges to be up and running by 2014.
Before Jan. 1, Covered California, which recently received a federal grant of $674 million, plans to use some of its funds to develop a website where customers can shop for insurance policies.


Covered California expects to create seven geographical exchanges reflecting different health care markets in the Sacramento region, Northern California, the San Francisco Bay Area, the San Joaquin Valley, the Central Coast, Los Angeles and the rest of Southern California.


The state health exchange will serve households earning up to four times the federal poverty level, equal to $92,200 for a family of four in 2012. State leaders also intend to expand Medi-Cal in California, relying heavily on federal dollars.


News of the new Covered California call center in Rancho Cordova comes six months after cable giant Comcast announced it was closing its California call centers – including a Natomas office that employed 300 workers.

No Pre-Existing Conditions from birth to age 19

No pre-existing condition limits from birth to age 19

Do you have a child under 19 years old? He or she can’t be denied health care coverage because of a “pre-existing condition”. A pre-existing condition is a health problem that was discovered or treated before applying for the coverage. This applies whether your child was covered under a different plan or had no coverage at all.

Here’s what’s different

In the past, health plans could limit or deny benefits or coverage for children because of a pre-existing condition.

How it impacts you

Now your health plan can’t deny your child’s coverage because of a health problem or disability that developed before you applied for coverage.

My 13-year old daughter was hospitalized with asthma recently. My health plan denied payment for the hospitalization. They said that, under our policy, my daughter’s asthma is considered a pre-existing condition. Is that right?

No. Under the new law, the health plan can’t deny payment for the hospitalization based on your daughter’s pre-existing asthma condition.

Does this law apply whether or not my child already had coverage?

Yes. Under any circumstance, your health plan can’t deny coverage for your child based on a pre-existing condition.

Does the law apply to an individual health policy I bought for my family in 2011?

Yes. However, it does not apply to grandfathered individual health policies bought before March 23, 2010.

What can I do if my plan tries to deny coverage because of a pre-existing condition?

Under the Affordable Care Act, you have the right to appeal.

I am 30 years old. Does this law apply to me?

No, not yet. But in 2014, this protection will be extended to Americans of all ages.

Health Care Reform at a Glance

Health care reform at-a-glance

Affordable Care Act (ACA) Reinsurance Fee

The Affordable Care Act (ACA or health care reform law) provides that each state create a transitional reinsurance program during the first three years (2014-2016) of the exchange’s operation. If a state does not create a reinsurance program, HHS will operate the reinsurance program in that state.

The program aims to help stabilize premiums for coverage in the individual market and lower the effects of adverse selection. This is done by giving reinsurance payments to issuers that sign up high-cost individuals in non-grandfathered individual market plans.

Reinsurance contributions and payments

As stated by the Department of Health and Human Services (HHS), the reinsurance program requires health insurers and third-party administrators (TPAs) to make contributions to the reinsurance program to reinsure individual market insurers who cover people with expensive claims. The contributions are required for both fully insured and self-funded plans. The group market is required to make these contributions, but will not receive payments under the reinsurance program. Reinsurance payments are only provided to individual market insurers who insure high claimants in non-grandfathered plans. A

recent notice proposes that HHS collect all contributions under a national rate, estimated to be a fee of $5.25 per member per month in 2014.* The fee will be included in monthly billing statements for fully insured plans.

*This is an estimated amount and may be subject to change; amount may vary by state.

 

Attachment point – the annual threshold dollar amount per individual claimant of claims’ costs paid after which an issuer can take reinsurance payments ($60,000)

 

Reinsurance cap – the payment limit per individual claimant when an issuer can no longer get reinsurance payments ($250,000)

Coinsurance rate – the share of an issuer’s claims costs that are above an attachment point and below a reinsurance cap for the benefit year (80%)

Those three factors are decided by HHS or by the state with HHS approval. Any payments to issuers will depend on high claimants from their individual market enrollees.

State-operated versus HHS-operated transitional reinsurance programs

final rule published by the HHS March 23, 2012 says that states can choose to either:

Launch their own transitional reinsurance program, or

Have HHS create the program on their behalf, whether or not they set up a state-run exchange. States that decide to run their own program will be responsible for all reinsurance payment functions.

If HHS runs the transitional reinsurance program, it will also handle the reinsurance payments. A

recent HHS bulletin states that it is deciding how reinsurance payments will be identified, calculated and given to individual market issuers by HHS-operated programs.

The table below has key dates related to HHS-operated reinsurance program.

Key dates for HHS-operated reinsurance programs

Questions and answers

Q. Who determines how much the ACA Reinsurance Fee will be and how is it calculated?

A. The ACA Reinsurance Fee rates can vary by state, but should be the same for all health insurers and TPAs in that state. The fee we are currently quoting is based on preliminary information provided by HHS. The states must publish final benefit and payment parameters by March 1 of each year for the following year.

Q. Is there any way to reduce or eliminate the ACA Reinsurance Fee?

A. The ACA Reinsurance Fee is part of a temporary program which will decline for three years and then be eliminated.

Q. What is the anticipated impact of this fee?

A. There is an anticipated impact to health insurance rates in 2014.

Q. What type of rate impact is expected?

A. The most significant changes to rates due the ACA Reinsurance Fee and all other health care reform provisions in 2014 will be in markets for individuals and small employers, where the rating constraints, product constraints, new benefit mandates and new taxes will have the biggest impact. The impact will vary significantly between each individual and each small employer.

Q. What type of analysis has been done on the expected impact of all the health care reform provisions?

A. Examples of analyses that show the range of impact include the following:

A report, led by former CBO Director, Doug Holtz-Eakin of the American Action Forum, looked at the specific impacts of the ACA reforms taking place in 2014 and how premiums may be affected. The survey found:

On average, premiums for young, healthy people in the individual and small group market would jump 169 percent

Costs for older, less healthy people in the individual and small groups markets would decrease by an average of 22 percent

A study by the actuarial firm Milliman in Ohio that shows the range of changes expected for small employers will range from a decrease of 25 percent to an increase of 130 percent

In Indiana, Milliman found that the increase in premiums in the individual market beginning in 2014 could range from 75 percent to 95 percent, and rates for others would decrease

Other studies conducted by Dr. Jonathan Gruber of MIT in Maine, Wisconsin, Minnesota, and Colorado found that premium impacts in the individual market may increase as much as 85 percent and increases in the small group premiums may increase more than 20 percent

This content is provided solely for informational purposes. It is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue Shield of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

More Physician Plan to Retire

WASHINGTON — THURSDAY, March 21, 2013 (MedPage Today) — Most physicians have a pessimistic outlook on the future of medicine, citing eroding autonomy and falling income, a survey of more than 600 doctors found.

Six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years, a survey from Deloitte Center for Health Solutions found. That perception is uniform across age, gender, and specialty, it said.

Another 55 percent of surveyed doctors believe others will scale back hours because of the way medicine is changing, but the survey didn’t elaborate greatly on how it was changing. Three-quarters think the best and brightest may not consider a career in medicine, although that is an increase from the 2011 survey result of 69 percent.

“Physicians recognize ‘the new normal’ will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care,” the survey’s findings stated.

About two-thirds of the survey responders said they believe physicians and hospitals will become more integrated in coming years. In the last 2 years, 31 percent moved into a larger practice, results found. Nearly eight in 10 believe midlevel providers will play a larger role in directing primary care.

Four in 10 doctors reported their take-home pay decreased from 2011 to 2012, and more than half said the pay cut was 10 percent or less, according to Deloitte. Among physicians reporting a pay cut, four in 10 blame the Affordable Care Act (ACA), and 48 percent of all doctors believed their income would drop again in 2012 as a result of the health reform law.

Other findings:

  • 26 percent believe Medicare’s sustainable growth rate formula will be    repealed in the next 1 to 3 years
  • One in 10 believe medical liability reform will pass Congress in the    next 1 to 3 years
  • A quarter of physicians would place new or additional limits on    accepting Medicare patients if there were payment changes
  • 55 percent of physicians believe the hospital-doctor relationship will    suffer as admitting privileges are put at risk to comply with hospital    standards of meaningful use
  • 31 percent gave the U.S. healthcare system a favorable grade of    “A or B” compared with 35 percent in 2011

Despite those pessimistic views, seven of 10 said they were satisfied about practicing medicine, although that number was lower for primary care providers and higher for younger age groups, the survey found. Dissatisfaction was attributed toward less time with patients, long hours, and dealing with Medicare, Medicaid, and government regulations.

Speaking of the ACA, fewer physicians (38 percent in 2012) believe the ACA is a step in the wrong direction compared with 44 percent in 2011. The number who think the law is a good place to start remained the same.

Two-thirds of physicians in the Deloitte survey say they use an electronic health record (EHR) that meets meaningful use stage 1 requirements, but that number has been lower in other surveys. Three in 5 respondents were satisfied with their EHR.

Deloitte mailed the survey to more than 20,000 physicians selected from the American Medical Association’s master file. Just 613 returned completed surveys, giving a margin of error of 3.9 percent at the 0.95 confidence level.

Source: Survey: More Docs Plan to Retire Early

Premium Tax Credits for Low-Income

Premium Tax Credits for Lower-Income Individuals
In 2014, a “premium tax credit” will be available to help pay for coverage purchased through the Exchange for individuals and families:
  1. Who do not qualify for Medicare or Medicaid and
  2. Are not offered affordable, minimum value health insurance through an employer,
  3. Taxpayers, with income between 100% and 400% of the federal poverty line (FPL)
  4. Purchasing insurance through an Exchange.
SAMPLE TAX CREDIT FOR PURCHASE IN COVERED CALIFORNIA
% of FPL
Annual Income (family of 4)
Unsubsidized Annual Premium
Tax Credit
Annual Premium After Credit
Monthly Premium After Credit
150%
$35,137
$14,245
$12,840
$1,405
$117
200%
$46,850
$14,245
$11,294
$2,951
$246
300%
$70,275
$14,245
$7,569
$6,676
$556
400%
$93,700
$14,245
$5,344
$8,901
$742
Adjusted 2013 Federal Poverty Guidelines

48 Contiguous States and DC
Note: The 100% column shows the federal poverty level for each family size, and the percentage columns that follow represent income levels that are commonly used as guidelines for health programs.
Household Size
100%
133%
150%
200%
300%
400%
1
$11,490
$15,282
$17,235
$22,980
$34,470
$45,960
2
15,510
20,628
23,265
31,020
46,530
62,040
3
19,530
25,975
29,295
39,060
58,590
78,120
4
23,550
31,322
35,325
47,100
70,650
94,200
5
27,570
36,668
41,355
55,140
82,710
110,280
6
31,590
42,015
47,385
63,180
94,770
126,360
7
35,610
47,361
53,415
71,220
106,830
142,440
8
39,630
52,708
59,445
79,260
118,890
158,520
For each additional person, add
$4,020
$5,347
$6,030
$8,040
$12,060
$16,080
Source: Calculations by Families USA based on data from the U.S. Department of Health and Human Services
Determining eligibility for the premium tax credit
Modified” gross income is calculated which includes Social Security benefits that are not included in gross income for the taxable year.  In addition, some individuals and families will qualify for a cost-sharing reduction subsidy to help with deductibles and co-payments.
How will services be paid?
When an individual receives covered essential health benefits, the provider will collect only the amount of cost-sharing specified in the silver plan variation in which the individual is enrolled. The federal government will pay the insurer in advance the amounts estimated to cover the cost-sharing reductions associated with the specific silver plan variation. HHS intends to propose that this advance cost-sharing reduction payment to the insurer would occur monthly, and that, after the end of the calendar year, the federal government would reconcile the advance payments to actual cost-sharing reduction amounts.
The Exchange Determines Eligibility for Premium Tax Credit and Cost-Sharing Reductions.
Exchanges must have a coordinated system of eligibility so that an individual can simultaneously apply for enrollment, apply for premium tax credits and apply for cost-sharing reductions. Proposed IRS regulations would permit the disclosure of income and other specified information about an individual taxpayer to HHS for purposes of making eligibility determinations for advance payments of the premium tax credit or the cost-sharing reductions.
Ineligibility for the tax credit (groups with over 50 Full Time Equivalent Employees)
As a general rule, if an Applicable Large Employer’s plan constitutes “minimum essential coverage” in that it is both affordable and provides minimum value, merely being eligible for the plan will make an employee ineligible for the tax credit. The final regulations clarify that an eligible employee who declines enrollment in such a plan remains ineligible for the tax credit for each month in the coverage period related to the enrollment period (e.g., for the full plan year in the case of an annual enrollment period).
This information is subject to future guidance and regulations

CVS asking Workers To Reveal Weight, Health Info

SAN FRANCISCO  — Pharmacy giant CVS has asked workers in the Bay Area and around the nation to reveal their weight and other health information, or pay extra for health coverage.

The company announced Wednesday what it called “A Plan for Health,” that features a mix of rewards and penalties for employees.

Among the measures, employees must report their weight, body fat, cholesterol, blood pressure and blood sugar levels. Workers must also be tobacco free or enroll in an addiction program by next year.

Employees who refuse will have to pay $50 more for health coverage each month, totaling $600 a year.

“These changes aren’t just about cost, they’re about us, each of us taking personal accountability for our own health,” said Lisa Bissacia, Senior Vice President and Chief Human Resources Officer.

“(CVS Executives) better get some pretty good legal counsel and decide whether your policy is really legal, because the policy as announced is not legal,” said Richard Schramm, a Bay Area employment lawyer.

Schramm told local news organization the company is trying to tell employees what they can and can’t do on their off time.

“If we granted that right to employers, employers could tell employees who to date, who to see, what kinds of foods to eat, what to drink, all kinds of behavior off site could be controlled. And that’s absolutely not the law in California,” he said.

KPIX 5 tried talking to employees at a CVS location, but they refused to comment on the plan.

Company officials said personal information is given to WebMD, and that CVS will not have access to employee’s personal health information.

Health Care Reform Update

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country

 

Week of March 18, 2013

When last year’s U.S. Supreme Court decision upholding the bulk of the Affordable Care Act (ACA) failed to quash efforts to derail the law, experts predicted the presidential election would do so. Either a Republican president would sign its repeal or President Obama’s re-election would make continuing repeal efforts entirely futile. Repeal efforts, however, appear to be alive and well. Just last week House Republicans unveiled a budget plan that promises to cut the deficit in 10 years while repealing the ACA. In the states, the House of Representatives in Oklahoma last week approved a bill that declares the ACA “null and void” and would prohibit efforts to enforce the law. The bill would place the state at odds with federal law and is consequently ineffectual. But these actions point to continuing political battles over the ACA, guaranteeing that legislative time will continue to be spent in pursuit of repeal.

Federal

The House Budget Committee voted last week to adopt the budget resolution drafted by Budget Committee Chairman Paul Ryan (R-WI).  This measure was approved on a straight party line vote, with support from Republicans and opposition from Democrats.  The full House will consider the Ryan budget this week.  The Ryan budget calls for $4.633 trillion in deficit reduction over the next 10 years.  Spending reductions would include $1.783 trillion from repeal of the ACA, $129 billion from changes to Medicare, and $810 billion from changes to Medicaid and other health care programs.  This budget includes Medicare proposals calling for a premium support system beginning in 2024, and Medicaid proposals calling for a block grant system that would provide enhanced flexibility to the states

The Senate Budget Committee approved, also along party lines, a budget drafted by Chairman Patty Murray (D-WA).  The Murray budget calls for $975 billion in new revenue and $975 billion in spending cuts over 10 years. The Senate budget also includes $100 billion in new spending in the short term on job creation and infrastructure initiatives. In a markup session held late last week, considerable discussion arose between Senate Republicans and Democrats over the budget’s deficit reduction projections – pegged at $1.85 trillion over 10 years. Ranking Republican Member Jeff Sessions (R-AL) suggested that the budget would achieve only $700 billion in deficit reduction over 10 years. The spending cuts in the Murray budget include $275 billion in health care savings “by further realigning incentives throughout the system, cutting waste and fraud, and seeking greater engagement across the health care system.”  The budget will be considered on the Senate floor this week.

 

CALIFORNIA: Legislation stemming from the special session on ACA implementation would provide coverage for an estimated 670,000 individuals who continually move in and out of Medicaid because of fluctuating income levels that affect their eligibility. The bill would allow California to request HHS approval to offer a “narrow bridge” plan on the exchange, providing affordable coverage through Medicaid managed care plans for individuals who recently lost their Medicaid coverage. Last week, lawmakers also amended the market reform bills to retain the 19 geographic rating regions established by California law in 2012. The original bill would have shrunk the state’s current 19 rating regions to six regions in 2014 and 13 regions in subsequent years.

 

 

Sticker Shock coming for Health Insurance Premiums

The Sacramento Bee –

March 13, 2013:

Some Americans could see their insurance bills double next year as the health care overhaul law expands coverage to millions of people.

The nation’s big health insurers say they expect premiums – or the cost for insurance coverage – to rise from 20 to 100 percent for millions of people due to changes that will occur when key provisions of the Affordable Care Act roll out in January 2014.

Mark Bertolini, CEO of Aetna Inc., one of the nation’s largest insurers, calls the price hikes “premium rate shock.”

“We’ve done all the math, we’ve shared it with all the regulators, we’ve shared it with all the people in Washington that need to see it, and I think it’s a big concern,” Bertolini said during the company’s annual meeting with investors in December.

To be sure, there will be no across-the-board rate hikes for everyone, and there’s no reliable national data on how many people could see increases. But the biggest price hikes are expected to hit a group that represents a relatively small slice of the insured population. That includes some of the roughly 14 million people who buy their own insurance as opposed to being covered under employer-sponsored plans, and to a lesser extent, some employees of smaller companies.

The price increases are a downside of President Barack Obama’s health care law, which is expected to expand coverage to nearly 30 million uninsured people. The massive law calls for a number of changes that could cause premiums for people who don’t have coverage through a big employer to rise next year
– at a time when health care costs already are expected to grow by 5 percent or more:

– Changes to how insurers set premiums according to age and gender could cause some premiums to rise as much as 50 percent, according to America’s Health Insurance Plans, or AHIP, an industry trade group that’s funded by insurers.

– A new tax on premiums could raise prices as much as 2.3 percent in 2014 and more in subsequent years, according to a study commissioned by AHIP. Policyholders with plans that end in 2014 probably have already seen an impact from this.

– Requirements that insurance plans in many cases cover more health care or pay a greater share of a patient’s bill than they do now also could add to premiums, depending on the extent of a person’s current coverage, according AHIP.

The Obama administration says the law balances added costs in several ways, including tax credits that will bring down what many consumers will pay for insurance.

“The health care law will bring down costs and save money for young people and families,” said Erin Shields Britt, a spokeswoman for the Department of Health and Human Services. “It’s misleading to look at one provision of the law alone. Taken together, the law will reduce costs.”

WHERE ‘RATE SHOCK’ MAY STRIKE

The impact of some cost hikes will be wide ranging. The new premium tax, for instance, will affect individual insurance, some employer-sponsored coverage and Medicare Advantage policies, which are privately-run versions of the government’s Medicare program for the elderly and disabled.

Other price hikes will vary due to factors like a person’s current coverage and age. Young people who currently have low-cost coverage may see some of the biggest hikes.

In many states, insurers charge a 60-year-old customer $5 in premiums for every $1 they collect from a 24-year-old. The logic behind that is that older people use health care more and generate more expensive claims than younger customers, so insurers need to collect more to help pay their bills.

But the overhaul will narrow that ratio to 3-to-1. That alone could cause the premium for a 24-year-old who pays $1,200 annually to jump to $1,800, according to AHIP. Meanwhile, the 60-year-old who currently pays $6,000 will see a 10 percent drop in price.

Gender also can be a factor in whether premiums go up or down. The law will prohibit insurers from setting different rates based on gender – something they currently do because women generally use more health care. That means premiums for some men could rise, while they fall for women.

Prices also may change depending on a person’s current coverage. Many policies on the individual market (coverage not sold through employers) exclude maternity coverage, but that will be considered an essential health benefit under the overhaul. That could mean higher prices for some.

Vikki Swanson, 49, of Newport Beach, Calif., resents that the added benefit may lead to higher costs for her. “I had a hysterectomy, I have no need for maternity coverage, but I have to now pay for it,” she said.

As a self-employed accountant and financial analyst, Swanson has paid for her insurance coverage on the individual market for about 13 years. She watched her monthly premium climb from around $136 in 2001 to more than $600 before she could find cheaper coverage. She’s frustrated that the overhaul may add to her bill.

“I have to pay not only my own premium but I have to subsidize everybody else,” she said.

CUSHIONING THE BLOW

While insurers forecast instant premiums hikes starting next January, the overhaul also is expected to tame health care costs for many.

Starting next year, the law will require insurers to cover everyone who applies. That means health care costs could fall dramatically for people who have been unable to find coverage due to a chronic condition like diabetes or high blood pressure.

There also will be tax credits, or subsidies, given to people with incomes that fall within 400 percent of the federal poverty level. For 2013, 400 percent of the poverty level for all states except Alaska and Hawaii would be $94,200. These credits won’t lower premiums, but they can ease the insurance bill depending on a person’s income.

The credits should help the 20-something customers that insurers warn will see big premium hikes, said Linda Blumberg, an economist with the Health Policy Center of the Urban Institute, a nonpartisan policy research organization. She noted that people in that age range are more likely to be either working for an employer that doesn’t offer coverage or earning low wages that would entitle them to a sizeable credit.

“While these folks are potentially facing some premium increases due to all these reforms, they also are the ones most likely to get the financial help from the exchanges,” she said.

There are other changes that will benefit young and poor people. Some may qualify for coverage under the state-federal Medicaid program for the poor and disabled, which will expand in many states next year.

Additionally, people under age 30 who face big premium hikes will be able to buy plans that charge low premiums and just provide coverage for big or catastrophic costs. Those plans also will be available to people required to pay more than 8 percent of their income for coverage.

Plus, people who are age 26 and under are eligible to receive coverage under a parent’s plan, thanks to another overhaul provision that already started.

In addition to those changes, insurers will have to compete for business on the exchanges, which could restrain price hikes, said Larry Levitt, a private health insurance expert with the Kaiser Family Foundation, which analyzes health policy issues. He noted, for instance, that some are already creating narrow networks of low-cost providers to help keep costs in check.

“Plans are very focused on trying to get these premiums down,” he said.

But Robert Laszewski, an industry consultant and former insurance executive, said that theory assumes there is no competition in the marketplace now. He noted that a small company may get quotes from as many as 10 insurers competing for business when it tries to find coverage through a broker.

“I haven’t had one person in the industry remark to me, ‘Gosh, I wonder what the other guy’s charging,'” he said. “They’re worried that all this stuff is so expensive, they’re not going to get the pricing right.”

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