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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Sticker Shock

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Question: In January, 2014, I will be 60, my husband 63. Neither has insurance thru an employer and we currently pay for a private health insurance policy. According to the Kaiser Family insurance calculator, since our joint family adjusted gross income is around $63,000, we would not be eligible for any subsidy. As we live in the Los Angeles area, I’m assuming we are in the higher health cost area. If we each have to pay the full $12,206 premium, that will come to almost 40% of our income. It will more than double our current payments and will be impossble to maintain. Am I calculating this correctly? This is really frightening.

Answer: You are correct that your income will make you ineligible for a premium subsidy. But I can calm your fears a bit. Your premium next year will be somewhat higher but closer to what it is now than the “unsubsidized premium” used in the subsidy modeling charts and the subsidy calculators. The main reasons are (1) these are projections done years ago and they are overestimated and (2) these estimates are national averages. California premiums are well below the national average because of our long term commitment to managed care leading to lower medical utilization rates.

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