Fewer Americans Will Need Health Insurance Subsidies in 2014: eHealth Analysis Finds Subsidy Eligibility Starts Below $41,500

Fewer Americans Will Need Health Insurance Subsidies in 2014: eHealth Analysis 
Finds Subsidy Eligibility Starts Below $41,500 per Year
(Approx. 361% of the Federal Poverty Level) 
MOUNTAIN VIEW, CA -- (Marketwired) -- 11/04/13 --  With the cost of
qualified health plans lower than expected under the Affordable Care
Act, fewer people could be eligible for government subsidies designed
to make health insurance affordable. This analysis was prepared by
eHealth, Inc. (NASDAQ: EHTH) which operates eHealthInsurance.com, the
nation's first and largest private online health insurance
marketplace for individuals and families. The lower premiums may
result in fewer Americans being eligible for government subsidies.
Under the law, those who apply for health coverage without a subsidy
have the option to apply for coverage through government-sponsored
health insurance exchanges, or through traditional enrollment
channels, across all 50 states.  
In the 36 states where the federal government is operating health
insurance exchanges, the average single American adult earning over
$41,479 a year (361% of the FPL) will not be eligible for a
government subsidy to purchase health insurance.  
Younger adults will benefit more from lower costs, according to the
eHealth analysis. The average single 27-year-old, earning over $30,
449 per year may not be eligible for a government subsidy to purchase
health insurance. For this age group, Qualified Health Plans do not
become unaffordable until their income falls below 265% of the
Federal Poverty Level (FPL).  
The Affordable Care Act makes health insurance more affordable for
persons earning between 133% - 400% of the FPL by providing
government subsidies that limit these consumers' share of the plan
premiums to a range between 3% and 9.5% of their income.  
For example, a single woman with an income of just under $46,000
(about 400% of the FPL) may be eligible for subsidies that would
limit her share of the plan premium to 9.5% of her income for the
benchmark plan in her area. If, however, the benchmark plan costs
less than 9.5% of her income, the coverage is deemed affordable under
the law, and she will not be eligible to receive a government
subsidy.  
This table outlines a partial view of the premium affordability
guidelines under the Affordable Care Act 


 
-----------------------------------------------------------------
-----------
                               Monthly Income As Percentage of              
                         Estimated 2014 Federal Poverty Level (FPL)**       
             ---------------------------------------------------------------
                     133%        150%        200%        300%        400%   
                     FPL         FPL         FPL         FPL         FPL    
----------------------------------------------------------------------------
  Household                                                                 
    Size 1          $1,273      $1,437      $1,915      $2,873      $3,832  
----------------------------------------------------------------------------
     ACA            3% of       4% of      6.3% of     9.5% of     9.5% of  
Affordability      taxable     taxable     taxable     taxable     taxable  
    Limit           income      income     income      income      income   
                  (Premiums   (Premiums   (Premiums   (Premiums   (Premiums 
                  less than   less than   less than   less than   less than 
                   $38* per    $57* per   $121* per   $273* per   $364* per 
                    month)      month)      month)      month)      month)  
----------------------------------------------------------------------------
* Benchmark plan is the second least expensive silver level plan available  
in the individual or family's area.                                         
** Estimated Federal Poverty Levels for the 48 contiguous states and        
Washington DC                                                               
----------------------------------------------------------------------------

 
"The relative affordability of qualified health plans is a win for the
Affordable Care Act," said Gary Lauer, Chief Executive Officer of
eHealth, Inc. "This is also a big win for consumers, not only because
the plans are more affordable than anticipated, but because fewer
consumers will need to go through the lengthy process of applying for
a government subsidy when enrolling in a health insurance plan."  
According to eHealth's analysis of premium data for qualified health
plans released by the Department of Health and Human Services on
September 25, 2013: 


 
--  Nationally, individuals at an income of less than $41,500 in 2014 will
    be eligible to apply for a government subsidy - The national average
    monthly premium for the second-lowest-cost silver plan (the benchmark
    plan for any given area) is $328. At that price, subsidies would be
    available for single consumers earning less than 361% of the Federal
    Poverty Level -- approximately $41,500 in annual adjusted gross income
    (National average, may not be the case in all states).
--  Nationally, individual young adults (age 27) at an income of less than
    $30,500 in 2014 will be eligible to apply for a government subsidy -
    The national average monthly premium for the second-lowest-cost silver
    plan is just $216 for a single 27-year-old. At that price, subsidies
    would be available for those earning less than 265% of the Federal
    Poverty Level -- approximately $30,500 in annual adjusted gross income
    (National average, may not be the case in all states).

  
In addition to analyzing premium data for states where exchanges are
being run, at least in part, by the federal government, eHealth also
completed a similar analysis for some of the states building their
own exchanges.  
According to this analysis:  


 
--  California: For a single 27-year-old in California, the average
    monthly premium for the second-lowest-cost silver plan is $242. At
    that price, an individual would become eligible for a government
    subsidy if he/she earns less than$32,400 in annual adjusted gross
    income (282% of the Federal Poverty Level).
--  New York: For a single 27-year-old in New York, the average monthly
    premium for the second-lowest-cost silver plan is $349. At that price,
    an individual would become eligible for a government subsidy if he/she
    earns less than $44,100 in annual adjusted gross income (384% of the
    Federal Poverty Level).
--  Washington (premium data from Seattle): For a single 27-year-old in
    Seattle, Washington, the average monthly premium for the
    second-lowest-cost silver plan is $204. At that price, an individual
    would become eligible for a government subsidy if he/she earns less
    than $29,600 in annual adjusted gross income (258% of the Federal
    Poverty Level).
--  Maryland (premium data from Baltimore): For a single 27-year-old in
    Baltimore, Maryland, the average monthly premium for the
    second-lowest-cost silver plan is $197. At that price, an individual
    would become eligible for a government subsidy if he/she earns less
    than $29,070 in annual adjusted gross income (253% of the Federal
    Poverty Level).
--  Washington D.C.: For a single 27-year-old in Washington D.C., the
    average monthly premium for the second-lowest-cost silver plan is
    $180. At that price, an individual would become eligible for a
    government subsidy if he/she earns less than $27,921 in annual
    adjusted gross income (243% of the Federal Poverty Level).

  
Under the Affordable Care Act, in most states, insurers can only
increase a non-tobacco user's premiums based on their age. As such,
in most states, younger people pay less than older people. In New
York, all plans are priced the same, regardless of an individual's
age.  
The table below details subsidy eligibility data for tobacco-free
individuals in five states that are building their own exchanges. The
chart estimates the "Breakeven Federal Poverty Level (BFPL)" -- the
point at which an individual's income makes insurance unaffordable,
under the law, at age 21 and age 27. The chart also shows the age at
which the average individual premium becomes unaffordable, under the
law, at 400% FPL (Unaffordable at 400% FPL).  


 
-----------------------------------------------------------------
------
          State           Age  Silver Premium  Breakeven FPL%   Income 
-----------------------------------------------------------------------
           CA*             21      $231.20           276        $31,712
                        -----------------------------------------------
                           27      $242.29           282        $32,402
-----------------------------------------------------------------------
Unaffordable at 400% FPL   48      $378.00         > 400       >$46,000
-----------------------------------------------------------------------
           MD              21      $187.57           247        $28,380
                        -----------------------------------------------
                           27      $196.57           253        $29,070
-----------------------------------------------------------------------
Unaffordable at 400% FPL   52      $366.14           401       >$46,000
-----------------------------------------------------------------------
     Washington DC*        21      $180.50           243        $27,921
                        -----------------------------------------------
                           27      $180.50           243        $27,921
-----------------------------------------------------------------------
Unaffordable at 400% FPL   51      $369.16           401       >$46,000
-----------------------------------------------------------------------
           NY*             21      $349.00           384        $44,122
                        -----------------------------------------------
                           27      $349.00           384        $44,122
-----------------------------------------------------------------------
Unaffordable at 400% FPL   64      $349.00           384        $44,122
-----------------------------------------------------------------------
           WA              21      $195.22           252        $195.22
  (Seattle Metro Area)  -----------------------------------------------
                           27      $204.59           258        $204.59
-----------------------------------------------------------------------
Unaffordable at 400% FPL   51      $364.08           401       >$46,000
-----------------------------------------------------------------------
*Tobacco use is not used for underwriting purposes in New York,        
California and Washington DC.                                          

 
The table below details subsidy eligibility data for non-smokers in
the 36 states that are not building their own exchange. The chart
estimates the "Breakeven Federal Poverty Level (BFPL);" the point at
which an individual's income makes insurance unaffordable, under the
law, at age 21 and age 27. The chart also shows the age at which the
average individual premium becomes unaffordable, under the law, at
400% FPL (Unaffordable at 400% FPL). 


 
-----------------------------------------------------------------
----------
          State            Age   Silver Premium   Breakeven FPL%    Income 
---------------------------------------------------------------------------
           AK               21       $297.71           328%        $37,687
                        ---------------------------------------------------
                            27       $312.00           343%        $39,411
---------------------------------------------------------------------------
Unaffordable at 400% FPL    35       $363.80           400%        $45,960
---------------------------------------------------------------------------
           AR               21       $229.96           275         $31,598
                        ---------------------------------------------------
                            27       $241.00           282         $32,402
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $375.99           401        >$46,000
---------------------------------------------------------------------------
           DE               21       $226.15           272         $31,253
                        ---------------------------------------------------
                            27       $237.00           279         $32,057
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $369.75           
401        >$46,000
---------------------------------------------------------------------------
           GA               21       $210.88           263         $30,219
                        ---------------------------------------------------
                            27       $221.00           269         $30,908
---------------------------------------------------------------------------
Unaffordable at 400% FPL    50       $376.63           401%       >$46,000
---------------------------------------------------------------------------
           ID               21       $179.39           242         $27,806
                        ---------------------------------------------------
                            27       $188.00           248         $28,495
---------------------------------------------------------------------------
Unaffordable at 400% FPL    53       $365.95           401%       >$46,000
---------------------------------------------------------------------------
           IN               21       $252.86           289         $33,206
                        ---------------------------------------------------
                            27       $265.00           296         $34,010
---------------------------------------------------------------------------
Unaffordable at 400% FPL    45       $365.13           401        >$46,000
---------------------------------------------------------------------------
           LA               21       $237.60           280         $32,172
                        ---------------------------------------------------
                            27       $249.00           286         $32,861
---------------------------------------------------------------------------
Unaffordable at 400% FPL    47       $371.36           401        >$46,000
---------------------------------------------------------------------------
           MI               21       $192.75           251         $28,840
                        ---------------------------------------------------
                            27       $202.00           257         $29,529
---------------------------------------------------------------------------
Unaffordable at 400% FPL    52       $376.24           401        >$46,000
---------------------------------------------------------------------------
           MS               21       $281.49           310         $35,619
                        ---------------------------------------------------
                            27       $295.00           325         $37,343
---------------------------------------------------------------------------
Unaffordable at 400% FPL    41       $366.50           401        >$46,000
---------------------------------------------------------------------------
           NC               21       $231.87           276         $31,712
                        ---------------------------------------------------
                            27       $243.00           283         
$32,517
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $379.11           401        >$46,000
---------------------------------------------------------------------------
           NE               21       $196.56           253         $29,070
                        ---------------------------------------------------
                            27       $206.00           259         $29,759
---------------------------------------------------------------------------
Unaffordable at 400% FPL    51       $366.59           401        >$46,000
---------------------------------------------------------------------------
           NJ               21       $248.09           286         $32,861
                        ---------------------------------------------------
                            27       $260.00           293         $33,666
---------------------------------------------------------------------------
Unaffordable at 400% FPL    46       $372.14           401        >$46,000
---------------------------------------------------------------------------
           OH               21       $202.29           257         $29,529
                        ---------------------------------------------------
                            27       $212.00           263         $30,219
---------------------------------------------------------------------------
Unaffordable at 400% FPL    51       $377.27           401        >$46,000
---------------------------------------------------------------------------
           SC               21       $212.79           264         $30,334
                        ---------------------------------------------------
                            27       $223.00           270         $31,023
---------------------------------------------------------------------------
Unaffordable at 400% FPL    49       $363.01           400         $45,960
---------------------------------------------------------------------------
           TN               21       $153.63           225         $25,853
                        ---------------------------------------------------
                            27       $161.00           230         $26,427
---------------------------------------------------------------------------
Unaffordable at 400% FPL    55       $378.03           401        >$46,000
---------------------------------------------------------------------------
           UT               21       $146.04           219         $25,163
                        ---------------------------------------------------
                            27       $203.00           257         $29,529
---------------------------------------------------------------------------
Unaffordable at 400% FPL    52       $378.11           401        >$46,000
---------------------------------------------------------------------------
           WI               21       $227.10           273         $31,368
                        ---------------------------------------------------
                            27       $238.00           280         $32,172
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $371.31           401        >$46,000
---------------------------------------------------------------------------
           WY               21       $326.34           359         $41,249
                        ---------------------------------------------------
                            27       $342.00           376         $43,202
---------------------------------------------------------------------------
Unaffordable at 400% FPL    29       $365.17           401        >$46,000
---------------------------------------------------------------------------
           AL               21       $199.43           255%        $29,300
                        ---------------------------------------------------
                            27       $209.00           261%        $29,989
---------------------------------------------------------------------------
Unaffordable at 400% FPL    51       $371.93           401%       >$46,000
---------------------------------------------------------------------------
           AZ               21       $158.40           228%        $26,197
                        ---------------------------------------------------
                            27       $166.00           233%        $26,772
---------------------------------------------------------------------------
Unaffordable at 400% FPL    56       $369.54           401%       >$46,000
---------------------------------------------------------------------------
           FL               21       $208.02           261         $29,989
                        ---------------------------------------------------
                            27       $218.00           267         $30,678
--------------------------------------------------------------
-------------
Unaffordable at 400% FPL    50       $371.52           401%       >$46,000
---------------------------------------------------------------------------
           IA               21       $180.34           243         $27,921
                        ---------------------------------------------------
                            27       $189.00           248         $28,495
---------------------------------------------------------------------------
Unaffordable at 400% FPL    53       $367.90           401%       >$46,000
---------------------------------------------------------------------------
           IL               21       $179.39           242         $27,806
                        ---------------------------------------------------
                            27       $188.00           248         $28,495
---------------------------------------------------------------------------
Unaffordable at 400% FPL    53       $365.95           401         $365.95
---------------------------------------------------------------------------
           KS               21       $163.17           231         $26,542
                        ---------------------------------------------------
                            27       $171.00           237         $27,231
---------------------------------------------------------------------------
Unaffordable at 400% FPL    55       $363.86           401        >$46,000
---------------------------------------------------------------------------
           ME               21       $252.86           289         $33,206
                        ---------------------------------------------------
                            27       $265.00           296         $34,010
---------------------------------------------------------------------------
Unaffordable at 400% FPL    45       $365.13           401        >$46,000
---------------------------------------------------------------------------
           MO               21       $209.92           262         $30,104
                        ---------------------------------------------------
                            27       $220.00           269         $30,908
---------------------------------------------------------------------------
Unaffordable at 400% FPL    50       $374.92           401        >$46,000
---------------------------------------------------------------------------
           MT               21       $198.47           254         $29,185
                        ---------------------------------------------------
                            27       $208.00           261         $29,989
---------------------------------------------------------------------------
Unaffordable at 400% FPL    51       $370.15           401        >$46,000
---------------------------------------------------------------------------
           ND               21       $221.37           269         $30,908
                        ---------------------------------------------------
                            27       $232.00           276         $31,712
---------------------------------------------------------------------------
Unaffordable at 400% FPL    49       $377.66           401        >$46,000
---------------------------------------------------------------------------
           NH               21       $226.15           272         $31,253
                        ---------------------------------------------------
                            27       $237.00           279         $32,057
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $369.75           401        >$46,000
---------------------------------------------------------------------------
           NM               21       $177.48           241         $27,691
                        ---------------------------------------------------
                            27       $186.00           246         $28,265
---------------------------
------------------------------------------------
Unaffordable at 400% FPL    54       $378.92           401        >$46,000
---------------------------------------------------------------------------
           OK               21       $166.98           234         $26,887
                        ---------------------------------------------------
                            27       $175.00           239         $27,461
---------------------------------------------------------------------------
Unaffordable at 400% FPL    55       $372.38           401        >$46,000
---------------------------------------------------------------------------
           SD               21       $224.24           271         $31,138
                        ---------------------------------------------------
                            27       $235.00           278         $31,942
---------------------------------------------------------------------------
Unaffordable at 400% FPL    48       $366.63           401        >$46,000
---------------------------------------------------------------------------
           TX               21       $191.79           250         $28,725
                        ---------------------------------------------------
                            27       $201.00           256         $29,414
---------------------------------------------------------------------------
Unaffordable at 400% FPL    52       $374.38           401        >$46,000
---------------------------------------------------------------------------
           VA               21       $210.88           263         $30,219
                        ---------------------------------------------------
                            27       $221.00           269         $30,908
---------------------------------------------------------------------------
Unaffordable at 400% FPL    50       $376.63           401        >$46,000
---------------------------------------------------------------------------
           WV               21       $208.02           261         $29,989
                        ---------------------------------------------------
                            27       $218.00           267         $30,678
---------------------------------------------------------------------------
Unaffordable at 400% FPL    50       $371.52           401        >$46,000
---------------------------------------------------------------------------

 
Methodology 
The data presented in this analysis is an estimate, based on data
provided by the U.S. Department of Health and Human Services on
September 25, 2013 in the Health Insurance Marketplace Premiums for
2014 Databook located online at
http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/datasheet_home.cfm.
The Databook provides premium data for the second-lowest-cost silver
plan for individuals that are 27 years old in the 36 states that will
rely on Healthcare.gov to function as their exchange. In these 36
states, eHealth estimated the premium for all other age groups by
using the Department of Health and Human Services' default standard
age curve located online at
http://www.cms.gov/CCIIO/Resources/Files/Downloads/market-reforms-guidance-2-25-2013.pdf 
The Databook also provides statewide weighted average premium data in
four states (California, Maryland, New York, and Washington) and the
District of Columbia. In those four states, and DC, where premium
data was provided as a statewide weighted average, eHealth used the
Department of Health and Human Services' default standard age curve
to estimate premiums for each individual age group. In California,
Maryland, Washington and Washington D.C., premiums are based on an
individual's age, where the highest premium a 64-year-old can pay is
three times what a 21-year-old can pay. 
For more health insurance news and information
, visit the
eHealthInsurance consumer blog: Get Smart - Get Covered. 
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For media inquiries, please contact:  
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eHealth, Inc.
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eHealth, Inc. 
(650) 210-3115
Nate.Purpura@ehealth.com