JACKSON, Miss. (AP) — Mississippi is one of the poorest and unhealthiest states in the nation, and its residents will face some of the highest premiums under a health insurance exchange, an online marketplace that will be run by the federal government.
The U.S. Department of Health and Human Services released information Wednesday showing the estimated cost of a mid-range plan will be $448 a month in Mississippi. That compares to an average of $328 in 47 states and the District of Columbia.
HHS said the only states with higher monthly premiums than Mississippi are Wyoming at $516 and Alaska at $474, the price of a midlevel plan before tax credits. Information was not provided for Hawaii, Kentucky and Massachusetts because they hadn't released premium information as of Sept. 16.
Costs can be significantly lower when tax credits are applied for those who are eligible — one person with an income of up to $45,960 or a family of four with an income of up to $94,200. The subsidies are paid directly to insurance companies from which consumers will buy plans.
For example, a 27-year-old in Mississippi with an income of $25,000 would pay $295 a month before tax credits or $145 a month after tax credits for a midrange plan. The averages in 36 states where the federal government is running an exchange are $214 and $145.
A Mississippi family of four with an income of $50,000 (two adults and two children younger than 18) would pay $1,069 a month before tax credits or $282 a month after tax credits for a midrange plan; the averages for the 36 states are $774 and $282.
Mississippi Insurance Commissioner Mike Chaney, who has no role in running the exchange, said the state's rates are high because there's no competition in the exchange in most parts of the state and because residents have a litany of health concerns.
"There are few companies offering plans. That's number one," Chaney told The Associated Press on Wednesday. "And, we have high instances of diabetes and other health care problems ... high blood pressure."
He also said Mississippi has a relatively high cost of health care because it's a largely rural state with too few physicians and other health care providers.
Under the federal health overhaul that President Barack Obama signed into law in 2010, Americans are required to have some sort of health insurance or pay fines. Tax credits are available only through the government-run exchanges. People can buy plans through health exchanges starting Oct. 1, with coverage starting Jan. 1.
Only two companies will participate in the exchange in Mississippi.
Magnolia Health Plan, a unit of St. Louis-based Centene Corp., will offer plans in 46 of Mississippi's 82 counties. Humana, based in Louisville, Ky., will offer plans in 40 counties. The two companies overlap in four counties — Hinds, Madison and Rankin in the metro Jackson area and DeSoto just south of Memphis, Tenn.
HHS said in the 36 states where the federal government is operating an exchange, rates are lower where there's more competition. In the states with the lowest premiums, there are, on average, eight companies selling plans. In states with the highest premiums there are, on average, three.
Chaney gave HHS a proposal for a state-run exchange, but the federal agency rejected it in February, citing opposition by Gov. Phil Bryant. Chaney and Bryant are both Republicans.
Mississippi Health Advocacy Program, a group that supports the federal health overhaul, said in a statement Wednesday that people can find bargains on the health exchange. It cited the lowest figure on the HHS charts: A 27-year-old with a $25,000 income in Jackson would pay $8 a month for the least expensive, and least comprehensive, plan.
"For the first time in decades, hardworking Mississippians can have quality, affordable health care that will provide them a measure of financial security from crushing medical costs," the Heath Advocacy Program said in a news release.
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