People who lost insurance in the pandemic can regain health care coverage through a special open enrollment period for the Affordable Care Act.

Gila County has one of the highest shares of people without medical insurance in the state and also remains unusually dependent on the Arizona Health Care Cost Containment System (AHCCCS).

Statewide, 11% of Arizona residents lack health insurance — compared to 15% of Gila County residents.

The added open enrollment period started on Feb. 15 and will continue until May 15. The federal marketplace will spend $50 million advertising the open enrollment period, which can provide premium subsidies for families making up to $51,000 for an individual or $106,000 for a family of four.

To apply for coverage through the ACA, go to https://www.healthcare.gov/

The number of people without medical insurance rose by an estimated 3 million during the pandemic, as unemployment rates climbed and businesses closed.

In addition, the Biden administration has proposed several changes in coverage under the Affordable Care Act (ACA) as part of a $1.9 trillion stimulus plan now making its way through Congress.

The added provisions would cap premiums at 8.5% of family income for those who don’t qualify for fully subsidized premiums. The change would mostly help higher-income people who don’t currently qualify for premiums. The cap would make the ACA plans more affordable than some employer-provided plans. For a family of four earning $110,000, the change would reduce the average premium for a mid-level plan from about $1,529 a month to $779 a month, estimated the Center on Budget and Policy Priorities.

The second proposed change would increase the subsidy for those who already qualify. The details remain unclear, but someone earning 150% of a federal poverty line income ($20,000 for an individual) would see their premiums go from 4% of his or her income to zero.

Even before the pandemic, an estimated 11% of Arizona residents had no medical insurance, according to a national report by the United Health Foundation. That compares to a national rate of 9%. The percentage of people without insurance dropped sharply after the passage of the ACA, going from 18% in 2012 to 10% in 2016. It rose slightly through 2019, then jumped during the pandemic.

Nearly a third of residents of Gila County rely on the state’s AHCCCS program for their insurance, many of them as a result of the expansion of AHCCCS that came bundled with the Affordable Care Act.

The ACA and the related expansion of AHCCCS have already cushioned the impact of the sharp rise in unemployment.

Medicaid enrollment between February and September rose by 22% in states like Arizona that expanded their programs through the ACA, but only 11% in the states that did not.

Meanwhile, sign-ups for the ACA marketplace plans rose 6.6%.

As a result, fewer workers lost health care coverage than in past economic downturns.

The rise in unemployment and the loss of insurance during the pandemic has only worsened underlying trends in the world’s most expensive health care system.

The U.S. remains one of the few advanced industrialized nation without universal health care. The U.S. spends a 17% its gross domestic product, about twice as large a share as other industrialized nations. In 2019, the U.S. spent about $11,000 per person on health care, roughly twice as much as Germany, Canada, Japan or Australia.

Nonetheless, the U.S. fares worse than other advanced industrial countries on most health care measures, including life expectancy, maternal death rates, childhood vaccination rates, chronic diseases, suicides, obesity and other diseases. The U.S. has 5% of the world’s population, but accounts for 20% of the COVID-19 deaths.

Unfortunately, healthcare spending continues to rise at two to four times the underlying cost of inflation.

Arizona ranks No. 8 among the states in the gap between average income and average out-of-pocket health care spending. The average household income in Arizona in 2019 was $62,000 and the average out-of-pocket spending on premiums and deductibles came to about $8,364. That means Arizona residents spent 13.5% of their income on health care.

The Kaiser Family Foundation found that 17% of Americans are in plans with family premiums greater than $22,500 and that only 21% are in plans with premiums less than $15,000. On average, people with plans provided by small employers pay $1,500 more per year for family coverage than people who get coverage from large employers.

Contact the writer at paleshire@payson.com

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