Sebelius announced that, nationwide, insurance premiums will be about 16 percent lower than the government projected, with the average individual on a middle-tier plan paying $328 a month before tax credits.
The online marketplaces, or exchanges, are a major facet of the Patient Protection and Affordable Care Act Obamacare. They go live on Oct. 1, with an open enrollment period through March 31, 2014. Consumers must buy insurance by Dec. 15 if they want to be covered starting Jan. 1.
The exchanges will allow individuals and small-business owners to shop for insurance and find out whether they are eligible for Medicaid or for federal subsidies tax credits to help pay for coverage. The subsidies, which will be paid by the federal government directly to the insurance companies, will be for low- and middle-income residents who earn between 100 percent and 400 percent of the federal poverty level.
The government estimates that about seven million people will buy health insurance through the online marketplaces in the next year, and about six million of them will receive tax credits. Those who choose not to carry health insurance will face penalties, starting next year at 1 percent of their annual income or $95 per person per year, whichever is greater.
But consumers wont know until Tuesday the details of specific plans information like provider networks or co-payments.
Thats where navigators like Karen Basha Egozi come in.
Egozi, CEO of the Doral-based Epilepsy Foundation of Florida, and members of her staff are among hundreds of federally funded and trained navigators who will help Floridians in the enrollment process. They are not allowed to recommend specific plans.
If someone comes to me with epilepsy and says, I need to see a neurologist, and these are the meds I take, we would be explaining which plans will let them see a specialist, which ones support their medications and what they cost. Then they can decide whats best for them, she said.
Navigators could prove to be particularly helpful, Egozi said, to people with no experience shopping for health insurance.
Were particularly concerned with those who have never had health insurance and dont know what a co-payment is or which medications are covered by a plan and which ones arent, she said.
With all the choices in front of them, especially in South Florida, people may take their time to compare before they buy.
We expect a lot of inquiries about the exchange, but not many decision-makers until closer to Dec. 15, Egozi said. People wont want to put money out until they have to.
Miami Herald multimedia analyst Lazaro Gamio contributed to this report. This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.