'Obamacare' enrollment opens this week in Arizona with higher costs, fewer choices

• The Affordable Care Act enrollment period begins Tuesday

Thousands of Arizona residents who begin shopping for an Affordable Care Act health-insurance plan on Tuesday will find fewer options and higher costs compared with one year ago.

Residents of every county in Arizona except Pima County will have one marketplace insurer offering plans, each with different coverage tiers. Pima County residents will have two insurance carriers to chose from: Health Net/Ambetter or Blue Cross Blue Shield of Arizona.

Despite less choice and higher costs that have been a talking point in political campaigns, experts encourage consumers to visit the marketplace's website, healthcare.gov, or reach out to an enrollment "assister" for more information during the three-month enrollment period that begins Tuesday. Consumers can connect with a Cover Arizona assister by visiting the website coveraz.org and clicking on the "find local help" link.

"We're telling Arizonans to toss the rhetoric aside and look at the facts," said Diane Brown, executive director of the Arizona Public Interest Research Group Education Fund. "Many Arizona residents will find affordable, high-quality plans to meet their needs."

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Arizona's marketplace was once among the nation's most competitive, with 11 insurers selling plans in 2015 and eight insurers this year. But six major health insurers, some citing financial losses accumulated during the first three years of the Affordable Care Act, exited the state's marketplace for 2017.

Phoenix-based Blue Cross Blue Shield of Arizona's average rates will increase 51 percent. St. Louis-based Centene Corp. will sell its "Ambetter from Health Net" plans in Maricopa and Pima counties.

The Arizona Department of Insurance, which regulates health-insurance companies but does not have authority under state law to reject rate increases, approved Centene's Ambetter from Health Net filings that will raise rates an average of 74.5 percent next year.

The amount consumers will pay depends on factors such as age, coverage levels and income levels. Consumers who earn up to four times the federal poverty level are eligible for tax-credit subsidies that offset the monthly cost of premiums.

Phoenix resident Ken Hoag is covered by Medicare, but his wife, Margo, is enrolled in a marketplace plan that will be discontinued as of Dec. 31. He logged on healthcare.gov to use the website's preview that listed plan details before the Nov. 1 start of enrollment. He was surprised to find only four plans, all from Ambetter/Health Net.

"There are no choices, really, for anybody in Maricopa County," Hoag said. "The lack of choice is like having empty shelves (and) no food in a third-world country. Do I live in Cuba?"

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Nevertheless, Hoag's wife will choose a silver-level plan that has a similar deductible and out-of-pocket costs to her current coverage. She is eligible for subsidies, but her monthly premium will increase by $50 to $122.

Although average plan costs are more expensive, insurers expect more Arizona residents will qualify for subsidies. The Affordable Care Act subsidy levels are based on the cost of the "benchmark" plan, or the second-lowest-cost silver plan in a community.

Arizona had among the lowest subsidy levels in the nation during the first two years of the Affordable Care Act because the benchmark plans were priced so low. The cost of the benchmark plans will increase substantially in 2017, but the subsidy levels will also increase.

"With the subsidy level going up in Arizona, there will be an opportunity for more people to qualify for subsidies, including people who may not have been eligible in the past," said Jeff Stelnik, Blue Cross Blue Shield's senior vice president of strategy, sales and marketing.

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Still, middle- and upper-middle income earners won't qualify for any subsidies, and they will pay the entire amount of the higher insurance premiums.

Valley resident Jon Munson said he now pays nearly $900 month for a Humana plan that covers himself, his wife and two college-age children.

Munson is preparing for a substantial rate hike this year because he earns too much to qualify for subsidized rates.

"I'm bracing for a much higher number," said Munson, a financial adviser. "We are a healthy family, but I know that you can't go without health insurance. I need to protect myself and my dependents from (the potential of) a huge hospital bill."