Baby Boomers benefit most from Affordable Care Act

Which age group stands to benefit the most from the Affordable Care Act’s open enrollment period, which ends for 2015 on Feb. 15?

According to Cindy Hermes, health care consumer ombudsman and director of public outreach with the Kansas Insurance Department, it’s the “baby boomers,” who continue to face rising out-of-pocket health care costs. But there is something in ACA’s Insurance Marketplace for every age group not already eligible for Medicare, Hermes said.

“If you are Medicare-eligible, 65 and older, it is illegal for anyone to sell you an ACA policy, except through your work,” Hermes said. “If you’re 65 and older, it’s safe to say the ACA just doesn’t apply to you.”

But for those approaching that 65-year threshold, the Marketplace offers an alternative. The AARP Public Policy Institute recently reported that nearly one in three adults in the 50-64 age group spends at least 10 percent of their after-tax income on health care, and affordable health insurance was not available for those with “pre-existing conditions.”

“We have lots of aches and pains, and if we had tried to go get insurance five or six years ago, we wouldn’t have been able to because we had pre-existing conditions,” Hermes said. “Today, it’s a guaranteed issue. We would get it.”

As for those who took the option of retiring in the few years before they turn 65, Hermes noted that health insurance policies are guaranteed to be available for them through the Marketplace as well.

“It’s important to note that they may not be able to afford it,” she said. “But they would be able to buy it.”

Getting back to younger people who have not yet turned 30 but can no longer be covered under their parents’ insurance at age 26, an insurance coverage plan called a “catastrophic plan” is available. It’s less expensive than regular ACA plans, but the only drawback to catastrophic coverage, Hermes said, is the plan’s deductible. 

“It covers three office visits and your preventive services, then you have to meet your deductible and it covers 100 percent,” she said. “But the deductible is high. It could go as high as $6,300. But if you’re under 30 and you’re not sick, that’s a good deal.”

Another drawback of the catastrophic plan, she noted, is that those who purchase the plan cannot get premium tax credits or lower out-of-pocket costs based on their income.

For more information, visit or or call the Marketplace Call Center at (800) 318-2596.

The Holton Recorder

109 W. Fourth St.
Holton, KS 66436
Phone: 785-364-3141

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