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Affordable Care Act

In FL, Cost Varies by Location

www.healthcare.gov/marketplace

Health insurance coverage for the uninsured through the Affordable Care Act is more affordable in some Florida counties than others -- a lot more.  

The lowest-cost silver plan to be offered online for Floridians has a wide premium price difference depending on where you live.

A Health News Florida calculation found the premiums cost about 70 percent more in Monroe County than in Palm Beach County for two hypothetical uninsured shoppers ages 21 and 40.

The extremes were different for a hypothetical 60-year-old. The lowest-cost premium for that age group was sparsely-populated Liberty County in the Panhandle, while the highest cost was in Glades County. Again, the difference was about 70 percent.

"All politics is local, and insurance and healthcare are local as well,” Larry Levitt, senior vice president of the Kaiser Family Foundation, told Kaiser Health News. The news service is an independent project of the foundation, a nonpartisan health policy group. 

While reporters and analysts can do calculations, they won't know which plans go with which prices until Tuesday, when the online Marketplace is scheduled to be operational at healthcare.gov.

Kaiser Health News reported that Florida is one of seven states where extreme variations showed up. Its calculations, which were based on the second-lowest-priced silver plan, found a 52 percent premium-cost difference among counties in Florida. Four states had an even larger spread, led by Georgia, at 100 percent. 

(The second-lowest-cost silver plan is the one often used as a benchmark plan, to make comparisons more reliable. Health News Florida instead used the lowest-price silver plan for the comparison because it is the least expensive plan on the market that will come with not just subsidized premiums but also financial help for out-of-pocket expenses for those with household incomes under 250 percent of the federal poverty level.)

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Health-insurance price differences -- like auto insurance -- have long varied by county. But while auto premiums are highest where crashes and thefts are most common, in urban areas, the health insurance premium differences have more to do with competition, or lack of it.

Analysts often cite the number of companies that offer plans in a given region. That may be a factor in Glades and Monroe counties, although there are other counties with only one or two companies competing that are at the low end on pricing.

A larger problem could spring from the willingness of health-care providers, especially hospital systems, to negotiate with insurers on prices. As Florida has seen with commercial plans, areas that have a high concentration of ownership are often more expensive.