Would “Copper” Healthcare Plans Actually Be Worthwhile?

Several months ago, Senator Mark Begich (D) of Alaska proposed that the Obama administration add a new tier to the Affordable Care Act’s available healthcare plans. While the administration and other legislators weigh the benefits, significant potential issues have presented themselves.

The new “copper” plans would feature lower premiums than those for bronze plans – currently the least expensive full coverage available – and would cover 50 percent of consumers’ health costs. Patients would be required to pay the balance out of pocket. Copper plan subscribers would likely have a higher spending limit on out-of-pocket expenses than the current $6,350 individual/$12,700 family cap but would also be eligible for tax credits and subsidies.

Higher out-of-pocket costs are just one major concern with the idea of copper-level plans. Another associated issue is whether copper plans would be able to offer lower prices and still offer the comprehensive coverage required by the ACA. Jay Angoff of the Department of Health and Human Services questions whether passing on half of the cost of care to consumers can legitimately constitute “decent coverage”.

Furthermore, enrollment statistics through the March 31 deadline this year indicate that consumers are not particularly fond of low premium-high deductible plans. Approximately 65 percent of consumers chose subsidized or unsubsidized silver plans in the marketplace, while only 20 percent enrolled in bronze plans. Enrollment in catastrophic plans was even lower, at only two percent.

Copper plans would also pose a threat to healthcare spending in facilities and systems, turning back the reductions in spending reported by many systems thanks to newly enrolled patients. As copper plans are meant to attract young adults and others who have found even the bronze plans to be unaffordable, the risk of defaulting on higher deductibles is akin to the risk of non-payment by uninsured patients.

If the administration allows the creation of copper plans, consumers should expect to wait until at least the 2016 enrollment period to see these plans for purchase on the marketplace.

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