HR/BENEFITS

Obamacare Olympics: Go for the Copper?

A proposed Senate bill aims to add an even lower tier to Obamacare plans.
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Last week, the Wall Street Journal reported on proposed legislation that would expand the range of health plans permitted under the Affordable Care Act. Specifically, the article discussed a bill--Senate Bill 1729--co-sponsored by Democrat senators Mark Begich of Alaska and Mark Warner of Virginia. The bill, introduced back in November, proposes adding a "copper" level of coverage to the tiered plans already offered under Obamacare: platinum, gold, silver, bronze, and "catastrophic."

The tiers are basically a measure of so-called plan generosity: a platinum plan covers roughly 90 percent of a policyholder’s health care costs, while a bronze plan covers only 60 percent of total costs. The more generous the coverage, the more you pay up front in premiums. Though people with lower-tier coverage pay lower monthly premiums, they can be on the hook for much higher out-of-pocket expenses when they actually use services. The proposed copper plans would cover just 50 percent of total health care costs, leaving the policyholder to pick up the other half in copayments, coinsurance, and other service-related fees. Begich and Warner, Democratic senators in red states, say that the lower cost of entry for copper plans would lure in more of the young people who are seen as essential to Obamacare’s success.

Right now, the only comparable option is a so-called catastrophic plan, which is available only for people up to age 30 who can prove that buying pricier plans would be a hardship. Catastrophic plans, which have much lower premiums than the "metal" plans, cover minimal medical services until the policyholder hits an individual deductible of about $6,400. After the deductible is met, the catastrophic plan covers many of the same services that the other plans do. Catastrophic plans, however, usually don’t provide coverage for services like prescription drugs or shots, and they are not eligible for government cost-sharing subsidies. People purchasing the proposed copper plans, however, could qualify for subsidies, based on income.

It’s not clear exactly why the right-leaning Journal and Fox Business News are reporting this “news” now. Most media organizations reported on the bill when it was introduced late last year. But it seems like a case of piling on in the wake of the February 10 announcement that the employer mandate was being delayed another year, to 2016, for businesses with fewer than 100 employees. Another reminder to Obamacare critics that even erstwhile supporters of the ACA now see it as unworkable in its details.

The Council for Affordable Health Coverage, a coalition of employer groups and insurers including Aetna and Cigna, is also backing the proposal of copper-level plans. (By offering lower-priced plans to workers, employers would conceivably be able to get away with making smaller total contributions toward their premiums.) The White House has said it is weighing the proposal. It’s hard to say whether workers who are covered under employer plans will welcome copper plans as a bargain, or see them as a big-time blow-off that simply shifts more costs onto them. So far, 62 percent of people who have obtained individual coverage have opted for silver plans; only 19 percent chose bronze plans.

What do you think--would a plan with even lower premiums appeal to you and your employees? Or does too much nickel-and-diming ultimately send the message that you care, but just not very much? Let us know in the comment box below.

IMAGE: Getty Images
Last updated: Feb 18, 2014

ADAM BLUESTEIN

Adam Bluestein is a frequent contributor to Inc., writing about health care, innovation, and new technology. He lives with his wife and two children in Burlington, Vermont.




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