Well, I finally managed to create an account at the Washington, D.C. health insurance exchange known as “DC Health Link.” And it worked!
Well, sort of. When I used the “Browse plans without completing an application” option and filled out the information, the confirmation screen said that I am someone who “Uses Tobacco.” Since I don’t smoke, I looked for some way to change that. Unfortunately, there doesn’t appear to be one. Thus, the premiums I’ll view on the DC Health Link apparently will be adjusted for tobacco use. Thankfully, that isn’t a problem for making a comparison with policies on ehealthinsurance.com since ehealth let’s one include tobacco use when shopping.
This time instead of starting with a comparison for 29-year-olds, I decided to begin with policies for those age 60. Here are the cheapest two policies on the D.C. exchange for a single 60-year-old who smokes:
Since there is no option to view plans on the D.C. exchange without first creating an account, here are the full results of the search. Now, here are the two cheapest plans for a 60-year-old male smoker living in D.C. on ehealthinsurance.com:
And here are the two cheapest plans for a 60-year-old woman smoker living in D.C.:
Well now, that’s a wee bit of a difference, don’t you think? If you look at the full ehealthinsurance results, you’ll count a total of 37 policies for 60-year-olds that cost less than the cheapest policy on DC Health Link—18 for men and 19 for women.
The best selling plan for a 60-year-old on ehealthinsurance.com is $321 per month. Going from that to the cheapest plan on the D.C. exchange results in an increase of 11.5%. A hefty increase, although debatable if it would qualify as “rate shock.” However, the next six best selling plans on ehealth are $240 per month or less. Going from $240 to $358 is a “shocking” 49% increase.
There is some good news on the subsidies. The subsidies do extend up the 400% Federal Poverty Level (FPL) ($45,960 for a single person) for a 60-year-old in D.C. Even people at the very top of the cut-off limit appear to be eligible for a $157 monthly subsidy*, which will reduce the cheapest plan on the exchange to a rate cheaper than many (although not all) plans on ehealthinsurance.com. However, if you earn over 400% FPL at age 60 in D.C., you will likely be in for some rate shock.
Here are the numbers for a single, 29-year-old smokers in D.C.: The cheapest Bronze policy on the exchange (see full results here) is just over $129 per month. There are 22 plans on ehealthinsurance.com (11 for men and 11 for women) for a 29-year-old smoker that are cheaper than the lowest Bronze plan. The best selling plan for that age on ehealthinsurance is $111 per month. Moving to the cheapest Bronze plan on the exchange is a rate increase of 16.2%. To get the price of the cheapest Bronze plan down to the best seller on ehealthinsurance.com requires a subsidy of $18 a month.* By my calculations, a subsidy of that amount is available to anyone making about $26,510 annually (230% FPL). If you make above that and you have the best seller, you’ll pay more for the cheapest Bronze plan.
Finally, 29-year-olds are eligible for lower cost catastrophic plans, but those plans will not appear on the “Browse plans” function on the D.C. exchange (glitch!). Thus, I can’t make a comparison to catastrophic plans.
*Technical Note: The subsidy amounts are likely too high as the premiums examined may include a surcharge for tobacco use. The subsidies are based on the second lowest-cost Silver plan for a non-tobacco user.
UPDATE: Just received a call from DC Health Link informing me that the policies do not contain a tobacco surcharage, and that the “Uses Tobacco” designation is a glitch which DC Health Link will fix as soon as possible.