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Biden Administration Is Making Health Insurance Cheaper, Easier To Entice Enrollees

MARY LOUISE KELLY, HOST:

Health insurance for 10 bucks a month or less. The Biden administration says 4 out of every 5 people enrolled in a plan on healthcare.gov is eligible for a $10 premium plan, and enrollment is open now. So how can you get one of these plans? NPR's Selena Simmons-Duffin is here to walk us through it. Hey, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi, Mary Louise.

KELLY: So $10 a month sounds great, sounds unbelievably affordable. How does that work?

SIMMONS-DUFFIN: Yeah. So remember the $2 trillion pandemic relief bill that passed earlier this year? There was $35 billion in there that is going to offset health insurance costs for people. So people who are already insured and getting subsidies through healthcare.gov plans can get more subsidies. And there's a whole new group of people, higher-income people, who can now get help with their premium costs who couldn't before. And there are even several groups that can get plans for $0 a month.

KELLY: Wow. OK, so what are the parameters for these plans?

SIMMONS-DUFFIN: Well, people who are just a bit over the poverty line, like 150% of poverty, can get $0 premium plans. And I should say that in a lot of states, people in that income bracket can get Medicaid for free as well. But if you're not in a state that expanded Medicaid, this is especially key. So if you are a family of four and your income is $39,000 a year or less, you qualify.

And there are some other people who qualify for $0 premium plans, too, like people who went on COBRA, the program that allows you to continue your employer-based coverage after a layoff. They can get 100% of their premiums covered. And if you received unemployment benefits in 2021, starting in July, you will be able to get $0 a month plans, too.

KELLY: All right. So they're cheap. A zero or $10-a-month premium sounds great, as we noted. But are these actually good plans?

SIMMONS-DUFFIN: Right. They actually are. I mean, the experts I've been talking about this are really stunned by some of the deals that are available on the exchanges right now. Some of them give platinum-level coverage. That's the highest tier of coverage. It means that your insurance covers almost all of your health care costs across the board. And all ACA plans are required to cover the 10 essential benefits, if you remember those - mental health care, hospitalization, maternal health, some really key benefits that you want to have covered.

KELLY: OK. Is there a place I can go to see, if I'm trying to check, do I qualify for the $10-a-month or $0-a-month...

SIMMONS-DUFFIN: Right.

KELLY: ...Plan? How does this work?

SIMMONS-DUFFIN: Right. So the first place to go is healthcare.gov. That's where enrollment is open for most states, and it will stay open until August 15. One tip is to gather your documents, like your Social Security card, immigration documents, tax returns, to make signing up faster. If you have any favorite doctors or prescription drugs you know you're going to take in the coming year, heathcare.gov has a tool where you can select them and make sure that they're covered in your plan to help you choose. And then finally, I would say just get help. There are these people called navigators all over the country who can help you enroll, and they're free, which is great because this stuff is complicated.

KELLY: Yeah.

SIMMONS-DUFFIN: So try to find a navigator where you live, and get a virtual appointment with them, and they can be a huge help.

KELLY: I'm sitting here thinking, Selena, this is being rolled out because there's a huge need for it. The need is really huge. I was just looking. There's something like 29 million uninsured people in the United States. How big of a dent is this going to make?

SIMMONS-DUFFIN: I mean, that is such a huge question. One analysis I saw from the Kaiser Family Foundation found that just under half of the people who are currently uninsured could receive free coverage, either through Medicaid or through one of these $0 premium ACA plans. So they were estimating about 13 million people with $0-a-month plans. That would make a huge dent in the uninsured population.

So this special enrollment period has been open since February 15. And so far, enrollment has been good. It's been steady, but not 13 million people good. So we will have to see if the Biden administration is able to really get the word out to people who could benefit from these savings and see how many people jump in and get coverage.

KELLY: NPR's Selena Simmons-Duffin, thank you.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

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