SALT LAKE CITY — Heidi Westfall’s home feels warm and cozy, but her life is anything but.
When you ask her favorite hobbies, she’ll tell you it’s being in a stream or a mountain. She leads what one would consider a healthy lifestyle, but Westfall's health has been tested.
She survived cancer.
“It definitely challenges you every day to make different choices — not only just in lifestyle, but how you show up for your day,” Westfall said.
And as a wealth adviser and business owner, Westfall works to show up for herself and her employees.
But with the threat of marketplace premium payments more than doubling next year if enhanced premium tax credits expire, that makes things more complicated.
FOX 13 News asked Westfall how much more she could potentially be paying.
“For me, that looks like anywhere from $900 to $1,400 a month, depending on what insurance plan I choose and whether I choose to start a small group plan and include my employees, who are also looking at substantial increases to help them, as well as really figure out what is going to be most beneficial,” Westfall said. “It’s kind of robbing Peter to pay Paul.”
That price hike is sure to put a dent in anyone’s budget.
“That’s at least two to three weeks’ worth of groceries,” Westfall said. “A car payment per month, half of the rent or mortgage payment for most of us here in the Salt Lake area. It’s going to be impactful.”
Here’s a recap of what led us here:
When the pandemic hit, the government intervened to expand access to insurance. Enhanced tax credits were the temporary solution to expand access to health care, and they are set to expire this December.
Prior to the COVID-19 pandemic, if you made more than 400 percent of the federal poverty level, even one penny over, you had to pay back everything the government gave you. But during the pandemic, if you made four times the amount of the federal poverty level — this year, that’s about $62,600 — you were still eligible for help on a sliding scale.
That’s been the case since 2020, when that 400 percent cliff was non-existent, until maybe now.
Though the tax credits aren’t going away altogether, they will look like the pre-pandemic tax credits.
“A lot of people are going to have massive sticker shock. That’s going to be, for some of these people, several hundred percent increase,” said insurance broker Rebecca Yates.
Yates says this year, the letters that insurance carriers sent out were delivered before rates were finalized at the Department of Insurance, which now renders them inaccurate.
The legislation and regulations surrounding those rates have been changed multiple times this year. Typically, changes would only be made once in the fall.
Yates says the information contained in those letters is not going to be what happens when your plan renews.
“This is not a year to do what we call a soft renewal, where you just ignore all the letters and continue and then call me in February because you’ve got a really big bill,” says Yates. “We need to do a proactive renewal. You need to get in there and find out how much it’s going to cost, get a broker, because having a broker who knows what they’re doing is going to be more important than ever.”
Another reason to not leave your plan to chance: a change in networks.
For someone like Westfall, the carrier you know is better than the carrier you don’t know.
“I want to stay with the same health care providers,” Westfall said. “I would like to have the same level of care. I know that there is a possibility that I could revisit my cancer journey, and I want to be as proactive as I possibly can, while still being able to cover my other expenses.”
“Carriers like Aetna are leaving the state entirely, and for people that are on an Aetna plan, they’re going to map you to whatever they think is going to be best, which is probably going to be mapping to Select Health,” said Yates. “Select Health is a great carrier; they’ve got the biggest market share, all of that, but it’s a completely opposite network of doctors and hospitals of what Aetna has had in the past.”
What’s next is uncertain. But armed with the right knowledge, you can stay ahead of the curve.
“It is a challenge, and I think in order to get through it, we actually have to work together and continue to learn together how to navigate the system,” Westfall said.
Here are some things Yates says to keep in mind as open enrollment continues:
- Check with your employer to see if they offer insurance or are going to offer insurance.
- Consider working with a local insurance broker — they can work with you to tailor a plan according to your needs (don’t be quick to call an 800 number; they may not know Utah’s insurance specifics).
- If you own your own business, consider a group plan; group plans in Utah will be 20-21 percent lower than individual plans.
