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Healthy Indiana Plan 2.0

Vonnie Baranko, InReach coordinator for NorthShore Health Centers, helps a patient sign up in February for coverage under the Healthy Indiana Plan 2.0, an expansion of Medicaid under Obamacare.

When Gina Rue went from full- to part-time work in 2014, she was suddenly left without employer-sponsored health insurance.

She kept the same health plan but paid about $1,000 a month for coverage, dipping into her and her husband’s savings to afford it.

For 2016, she decided to check out HealthCare.gov, also known as the Obamacare marketplace. With a monthly tax credit of more than $800, she now pays roughly $300 a month for insurance.

“It really changed my life,” said Rue, 58, of Valparaiso. “I was brought to tears when they told me what I was going to be eligible for.”

Not a lot will be different for Rue in 2017. Her insurer, MDWise, is still offering plans in Indiana. Any price increase will pale in comparison to the $700 more a month she was paying last year at this time.

But, overall, Northwest Indiana residents shopping on the Obamacare marketplace will encounter fewer, more expensive options when open enrollment for 2017 begins Tuesday.

In Lake, Porter and LaPorte counties, a 27-year-old making $30,000 a year will pay an average monthly premium of $263 for a bronze plan, $262 for a silver plan and $361 for a gold plan in 2017, compared to $209, $242 and $303, respectively, in 2016. That means the average premium increase in Northwest Indiana is 17.7 percent.

He will also have 14 bronze plans, 21 silver plans and three gold plans to choose from for 2017, compared to 20, 23 and seven this year in Lake County (and even more than that in Porter and LaPorte counties).

“There are going to be a lot of upset people,” said Jeff Sopko, a Steger insurance agent. “The premiums have gone up quite a bit this year.”

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The Obama administration contends that marketplace customers won’t feel the brunt of the increases because tax credits are rising along with the premiums. In addition, more Americans have health coverage than ever before, with the 9.1 percent uninsured rate the lowest ever recorded by the U.S. Census Bureau.

Four insurance companies have left the Indiana marketplace for 2017. UnitedHealthcare, the nation’s largest insurer, pulled out of the exchanges in Indiana and most other states because of increasing financial losses from the exchanges (even so, the company reported a profit of nearly $2 billion in the third quarter of 2016). United had offered the only wide-network PPO (preferred provider organization) plan in Northwest Indiana. IU Health Plans, which sold in parts of Northwest Indiana, has also exited the marketplace for 2017.

The remaining insurers for Northwest Indiana are Anthem (average premium increase: 29 percent), MDWise (11.5 percent increase) and Ambetter (5.3 percent decrease). When it comes to local hospitals, Community Healthcare System — Munster Community Hospital, St. Catherine Hospital in East Chicago and St. Mary Medical Center in Hobart — is not part of the MDWise and Ambetter networks.

“It’s a little bleak,” said Rob Adlard, an insurance agent with the Meyers Glaros Group in Schererville. “In Northwest Indiana, one insurer had a decrease, one had an increase and one had a big increase.”

Because of the limited options, he has been looking into alternative options for his clients, like bill-sharing ministries and short-term insurance plans.

The plan selections for next year include HMOs (health maintenance organization), where the primary care doctor coordinates the patients’ care, and one POS (point-of-service) plan, which doesn’t cover out-of-network providers but doesn’t require referrals from the family physician. No Chicago teaching hospitals are included in the Obamacare marketplace plans in Indiana.

The fine for not having health insurance in 2017 will be at least $695 per adult and $347.50 per child, or 2.5 percent of household income, whichever is greater.

The Department of Health and Human Services released a report last week that the average Obamacare premiums were going up 22 percent in 2017 (based on the second-lowest-cost silver plan for a 27-year-old). That same report showed that the average such Indiana plan was decreasing by 3 percent. Premiums depend on factors like a person’s age, location, income and smoking status.

In response, Indiana’s insurance commissioner, Stephen Robertson, released a report stating that, if the same number of Hoosiers enroll for 2017 as did this year, the average overall premium increase will be 18.6 percent.

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Health Reporter

Giles is the health reporter for The Times, covering the business of health care as well as consumer and public health. He previously wrote about health for the Lawrence (Kansas) Journal-World. He is a graduate of Northern Illinois University.