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With UnitedHealthcare and Aetna leaving the state’s exchange, Blue Cross Blue Shield of North Carolina and Cigna will be the only carriers offering coverage there. Consumers insured by the exiting carriers will need to select plans offered by another insurer for 2017, which means they may also need to find new in-network healthcare providers and pay more in monthly premium.
North Carolinians who live in Mecklenburg County, which includes Charlotte, and enroll in coverage through HealthCare.gov, the state’s federally facilitated exchange, will see their options drop from 27 plans, 9 of them bronze, to 10 plans, 4 of them bronze. They may also see rate increases that are twice the national average before any subsidies have been applied.
Under the Affordable Care Act, if the only health insurance plans available to someone exceed 8.16 percent of their income (this is the amount for 2017), then they may qualify for a hardship exemption from the individual shared responsibility provision and thereby can avoid the tax penalty.
In Mecklenburg County, the annual premium for a 35-year-old who purchases the lowest-cost bronze plan is $5,421. That individual would need to make between $50,000 and $65,000 per year to qualify for a hardship exemption, which would be claimed on their federal tax return. If that person’s annual income were $1 less than the 400 percent FPL cut-off for premium tax credits, they would pay $3,400 for the same plan.
To see how rate hikes could impact middle-class individuals and families who buy Obamacare plans and do not qualify for subsidies, we obtained quotes for the lowest-cost bronze plans available in Mecklenburg County through HealthCare.gov in 2016 and 2017. With Aetna leaving, Blue Cross and Blue Shield of NC will offer the lowest-cost bronze plan for 2017.
In comparing finalized rates from 2016 and 2017, we found premium increases of 54.82 percent across the board for the brackets we quoted: a 35-year-old male nonsmoker; a 45-year-old male nonsmoker; and a family of four with a two male and two female members, all of them nonsmoking.
We then broke down these rates and increases, and then compared them with other household expenses.
Even with an exemption, consumers may want to consider some form of healthcare benefits to help lower out-of-pocket exposure to medical bills. Anyone who claims an exemption or shops for individual and family health plans in North Carolina’s private market or through HealthCare.gov may want to consider working with a local, licensed health insurance agent. These individuals can help you navigate coverage options, including Obamacare plans as well as supplemental coverage such as critical illness, dental, hospital indemnity, and medical gap products to help lower out-of-pocket healthcare costs.
Originally posted Nov. 4, 2016.
 Gaba, Charles. “North Carolina: Approvide *Unsubsidized* Avg. 2017 Indy Mkt Rate Hikes 24.3%.” ACASignups.net. Oct. 14, 2016. http://acasignups.net/16/10/14/north-carolina-approved-unsubsidized-avg-2017-indy-mkt-rate-hikes-243
 Alonso-Zaldivar, Ricardo. “Obama Health Plan Hit by Double-Digit Premium Hikes.” AP. Oct. 25, 2016. http://bigstory.ap.org/article/4e2846e6f17a4c4482d5b8c1243b85dd/obama-health-plan-hit-double-digit-premium-hikes
 Internal Revenue Service. 26 CFR 601.105: Examination of returns and claims for refund, credit, or abatement; determination of correct tax liability. https://www.irs.gov/pub/irs-drop/rp-16-24.pdf
 Rates acquired through HealthCare.gov and INSXCloud on Oct. 31, 2016. 35-year-old male, nonsmoker, 2016 Aetna Leap Basic HSA – Carolinas HealthCare System (HMO Bronze) premium: $291.80; 2017 Blue Cross And Blue Shield Of NC · Blue Value 7150 (Limited Network) Bronze, POS $451.75 per month; 45-year-old male, nonsmoker, 2016 Aetna Leap Basic HSA – Carolinas HealthCare System (HMO Bronze) premium: $341.81; 2017 Blue Cross And Blue Shield Of NC · Blue Value 7150 (Limited Network) Bronze, POS premium: $533.82; nonsmoking family of four, including two parents (a male and a female, both 45 years old), a 7-year-old daughter, and a 13-year-old son, 2016 Aetna Leap Basic HSA – Carolinas HealthCare System (HMO Bronze) premium: $992.88, 2017 Blue Cross And Blue Shield Of NC · Blue Value 7150 (Limited Network) Bronze, POS premium: $1,537.14
This document is for general informational purposes only. While we have attempted to provide current and accurate information, this information is provided "as is" and we make no representations or warranties regarding its accuracy or completeness. The information provided should not be construed as legal or tax advice or as a recommendation of any kind. External users should seek professional advice from their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.
THIS PLAN IS NOT CONSIDERED TO BE MINIMAL ESSENTIAL COVERAGE AS DEFINED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA). ENROLLING IN AND MAINTAINING THIS PLAN WILL NOT EXEMPT YOU FROM THE SHARED RESPONSIBILITY PAYMENT (TAX) THAT MAY APPLY IF YOU DO NOT HAVE A PLAN WITH ACA-COMPLIANT COVERAGE.
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA) LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
THIS PLAN DOES NOT MEET MINIMAL ESSENTIAL COVERAGE REQUIREMENTS FOR PEDIATRIC DENTAL SERVICES IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) PROVISIONS.
A CRITICAL ILLNESS INSURANCE PLAN PAYS OUT LUMP-SUM CASH BENEFITS UPON DIAGNOSIS OF CERTAIN COVERED ILLNESSES AS SHOWN IN THE CERTIFICATE. THIS PRODUCT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA).
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