In a little over two months, open enrollment begins. If you don’t have health insurance, you’ll be able to go on the New York Affordable Care Act portal and choose a plan.

A viewer wrote in with an interesting question about New York’s program versus other states.

Lisa wrote in part, “Obamacare was supposed to help make health insurance costs affordable. We are paying almost $900 in premiums per month for myself, and we’re paying over $900 a month for my husband. … We just visited with family from Pennsylvania who it sounds like have the same plans (just have a different title) and they pay less than $200 a month each.”

Lisa wants to know if insurance programs through the Affordable Care Act are actually more affordable in other states. That is a fantastic question.

First, let me provide some background. The Affordable Care Act is now federal law. It requires every state to have a health insurance marketplace. Insurers on that marketplace can’t discriminate against you because you have a pre-existing condition or charge women more than men.

States could choose to either run their own marketplaces, partner with the Feds, or rely on the federal government to operate the state’s marketplace. And yes, the price you pay for premiums depends, in part, on the state in which you live.

An exhaustive study by the Urban Institute found that states that were operating their own marketplaces had lower-cost premiums. That’s because those states usually had more insurers participating, and competition drives down the price of premiums.

The institute analyzed the average premium in each state for a 40-year-old non-smoker. It found only 12 states with an average premium of more than $500. They are Alabama, Alaska, Connecticut, Delaware, Louisiana, Nebraska, New York, North Carolina, South Dakota, Vermont, West Virginia, and Wyoming.  Nine out of the 12 do not have state-run marketplaces, and as expected, have higher premiums.

But Connecticut, New York and Vermont all have state-run marketplaces but have some of the highest health insurance premiums in the country. Let’s take out Connecticut; it’s an anomaly. But New York and Vermont have something in common.  Both have a community rating mandate for health insurance which does not allow insurance companies to use age or tobacco use as well as gender, health status, or pre-existing conditions to determine the price of your premiums. Instead of personal risk factors, prices are based on the average cost of all the insured people according to medical and hospital costs in a community.

The reason for community pricing is to assure we all pay the same thing, and you’re not charged more because of individual risk factors, like your age.  But critics say community pricing may have unintended consequences by ultimately driving up pricing for everyone because young, healthy people choose not to be insured.

The average premium for a non-smoking-40-year old in New York is the sixh highest in the country at $621, and Vermont is fourth at $738.

Your income also factors into your price for premiums because the premiums for lower income folks are subsidized.

So, Lisa, that’s the long answer to your question.  Yes, you’re paying more because of where you live and how much you make.

If you have an idea for a consumer investigation, email us at consumer@whec.com.