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Second Year of Obamacare Offers More Choices for Hoosiers, but Costs Could Rise

Structure of premium tax credit could raise net cost even if premiums drop

Hoosiers who want to enroll in the second year of the federal health-insurance exchanges will have more choices, but could face higher costs.

Indiana Department of Insurance general counsel Tina Korty says nine insurers will offer nearly a thousand different plans among them when enrollment for next year opens in November. That's six more networks and more than three times as many benefit options as this year.

But because of the way the premium tax credit is calculated, Korty says your actual out-of-pocket cost could shoot up -- possibly by as much as double. The credit is based on the pricing for midrange benefit plans. If a cheaper plan comes on the market, it could sharply reduce the amount of the credit, even if your own premium rises only a little. Korty says the department plans an information campaign to caution Hoosiers to compare all their options rather than blindly renewing the plan they had this year.

Korty says the Pence administration may offer legislation to ensure participating health networks are broad enough. She says some Indiana counties have had health networks which failed to cover the county's only hospital. In Monroe County, Korty says one plan included Bloomington Hospital -- but not for maternity care.

Korty says the National Association of Insurance Commissioners is working to draft a model law on network adequacy, possibly prohibiting extra charges for out-of-network providers if the network isn't considered "reasonable." The group is also looking at narrower measures, such as requiring notice to patients if a doctor drops out of the network. Indiana is waiting to see the final product before signing on.

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