ACA Arkansas

[Floralscent]

Does anyone have insights on varying ACA costs in Arkansas and Missouri?

We are ER this year and will be relocating to either AR or MO. I have visited the ACA website numerous times and input our estimated income and info for both of these states. It seems MO offers a larger tax credit and more cost effective options (deductible, MOOP) than AR. Costs in AR are significantly higher IMO.

Is this the case across the US and does anyone know reasoning? Is it because of the county we are considering or

Maybe this is for another thread but wondering if this holds true for Medicare as well- we are 8 years away.

Thank you.

 

[MichaelB]

Yes, health insurance premiums vary substantially around the US. Each state regulates health insurance, one reason for the range of prices is provider networks are different, and bigger / broader networks have higher premiums.

There is also a difference in Medicare Supplemental plan premiums. Medicare Part B has the same base premium for everyone.

 

[PaunchyPirate]

Does anyone have insights on varying ACA costs in Arkansas and Missouri?

We are ER this year and will be relocating to either AR or MO. I have visited the ACA website numerous times and input our estimated income and info for both of these states. It seems MO offers a larger tax credit and more cost effective options (deductible, MOOP) than AR. Costs in AR are significantly higher IMO.

Is this the case across the US and does anyone know reasoning? Is it because of the county we are considering or

Maybe this is for another thread but wondering if this holds true for Medicare as well- we are 8 years away.

Thank you.

The quality of plans offered and the base price of the premium are entirely driven by market dynamics, profits, and in some states, government insurance rate controls. Generally, the insurance companies are free to charge whatever they want (unless restricted by the states). They can also offer different coverage levels in different plans, if they wish. There is a core set of requirements that they must meet in order to be sold on ACA exchanges.

The amount of subsidy you will get is determined by your income estimate, whether you smoke or not, number of people insured, and your zip code. The ACA exchange will look at the 2nd lowest cost silver plan (SLCSP) offered to you in your zip code and base your subsidy on that. Once the subsidy is determined, you are free to use that subsidy to buy a less expensive or more expensive plan if you wish. But the subsidy will not change.

So, yes, if a count in MO has a lower cost SLCSP than the county in AR, there will be a difference in your subsidy. These numbers are all determined at the zip code level. If you have the flexibility of location, and are considering an area near a county/state border, you should run the numbers in each zip code to help you decide. I'm 9 miles from a county line (within the same State) and the plans offered and pricing are different on each side of the border. One side of the border is considered more urban than the other side, so this would be a common characteristic that insurers might use when they set their prices.

 

[Floralscent]

The quality of plans offered and the base price of the premium are entirely driven by market dynamics, profits, and in some states, government insurance rate controls. Generally, the insurance companies are free to charge whatever they want (unless restricted by the states). They can also offer different coverage levels in different plans, if they wish. There is a core set of requirements that they must meet in order to be sold on ACA exchanges.

The amount of subsidy you will get is determined by your income estimate, whether you smoke or not, number of people insured, and your zip code. The ACA exchange will look at the 2nd lowest cost silver plan (SLCSP) offered to you in your zip code and base your subsidy on that. Once the subsidy is determined, you are free to use that subsidy to buy a less expensive or more expensive plan if you wish. But the subsidy will not change.

So, yes, if a count in MO has a lower cost SLCSP than the county in AR, there will be a difference in your subsidy. These numbers are all determined at the zip code level. If you have the flexibility of location, and are considering an area near a county/state border, you should run the numbers in each zip code to help you decide. I'm 9 miles from a county line (within the same State) and the plans offered and pricing are different on each side of the border. One side of the border is considered more urban than the other side, so this would be a common characteristic that insurers might use when they set their prices.

Interesting. Based on your example in the last paragraph, do you feel rates are more costly the closer to a major city you are or is it when farther out? Thank you

 

[PaunchyPirate]

Interesting. Based on your example in the last paragraph, do you feel rates are more costly the closer to a major city you are or is it when farther out? Thank you

I honestly don't know. Mine are slightly less in the more urban county. But it's still a pretty small, low-cost of living location. All you can do is put in various zip codes and compare.

Of course, the number of physicians and hospitals and other providers will be higher in a more urban area, but so too will be the number of people trying to see them.

 

[cmc333]

I live in Southern MO and found that the cost of ACA was very high, with high deductible and OOP. Last time I was on it, 2023, I paid over $400/mo for a deductible of $8k and OOP of $9k. And we are not rich; income was approximately only $60k. I think the prices of ACA where we are is based upon the fact that most people around here are on Medicaid and someone has to make up the money the services lose by accepting Medicaid. The cheapest plan I could have had was still over $250 a month and had a $3000 deductible and I think a $7500 MOOP.

Definitely take the time to fill in different zip codes to see how the prices differ. Also be aware that in parts of MO/AR, there are very few doctors/clinics/hospitals. Doctors around here are taking almost 8 months to see a new patient.