Posted on 10/14/2018 10:47:51 AM PDT by yesthatjallen
It’s a good thing Democrats made health insurance “affordable” when they passed the Patient Protection and Affordable Care Act in 2010. I’d hate to see how much health insurance would cost if it were expensive.
The Kaiser Family Foundation just released its annual survey of employer-sponsored coverage, finding that the average premium for family coverage increased 5 percent to $19,616.
To put that in perspective, the real median household income in 2017 was $61,372. Thus family health coverage costs nearly a third of the median family’s income.
But citing the average family premium of nearly $20,000, as high as that is, can be misleading. A small employer, especially a one with older-than-average employees, likely blew through $20,000 a few years ago. The premium for a couple in their 50s with a teenager can easily run $25,000. Bump that up by $4,000 or more for each additional child.
However, those outrageously high premiums would be even higher if employers and health insurers hadn’t taken a number of steps to contain the cost explosion by adjusting benefits and exposing employees to significantly higher out-of-pocket costs.
The Kaiser survey points out that since 2008, annual deductibles for covered workers have increased 212 percent — eight times the rate of inflation. And to think Democrats used to call high deductible coverage “junk insurance.” Yet, under ObamaCare deductibles have exploded.
Insurers are also taking steps to increase out-of-pocket spending in less-noticeable ways. For example, in years past insurers charged one copay for a generic drug, say $10, and a slightly higher copay for a brand name drug, say $25.
Then insurers moved to three copay tiers or more. The generic might still require a $10 copay, while some brand name drug copays could run between $25 and $250.
In addition, some insurers now require co-insurance of 20 percent to 40 percent of a drug’s cost for some of the newest and most expensive drugs. If a drug costs $5,000 a month — and some cancer drugs cost that much or more — 40 percent co-insurance could cost the patient several thousand dollars a month. And that comes on top of other health care-related expenses and premium costs.
Imposing such high co-insurance rates on specific drugs has raised concerns that insurers were trying to discourage some of the sickest patients from enrolling in their plans. As Kaiser Health News noted a few years ago:
In 2016, Harvard Law School's Center for Health Law and Policy Innovation filed complaints with the U.S. Department of Health and Human Services’ Office for Civil Rights alleging that health plans “offered by seven insurers in eight states are discriminatory because they don’t cover drugs that are essential to the treatment of HIV or require high out-of-pocket spending by patients for covered drugs.”
Consulting company Avalere Health found that several insurers’ silver plans had been adversely targeting some of the sickest populations with higher drug costs. “An analysis found that in the case of five classes of drugs that treat cancer, HIV and multiple sclerosis, fewer silver plans in 2016 placed all the drugs in the class in the top tier with the highest cost sharing or charged patients more than 40 percent of the cost for each drug in the class.” Pulling some of the most expensive drugs from the top tier was likely due to protests and threats of legal action.
To be fair, insurers and employers felt they had to take steps in order to control their costs, otherwise premiums would likely have been even higher than they are.
Other factors are also playing a role in the premium increases. Hospital systems were consolidating prior to ObamaCare, but the ACA put that trend on steroids, enabling hospitals to demand higher reimbursements from insurers.
Consulting firm Kaufman Hall reported in January there were 115 hospital and health system mergers and acquisitions in 2017, up 13 percent from 2016, and the largest number in recent history. For comparison, there were 50 hospital M&A transitions in 2009, the year before ObamaCare passed.
Unfortunately, options for containing premium increases and coverage reductions are limited. The Trump administration is trying to provide as much insurer and state flexibility as possible under ObamaCare, but it’s unclear yet as to how much those efforts can achieve.
And there’s a new proposal, the Health Care Choices Proposal, backed by a number of health policy analysts. It seeks to block grant current federal health care spending on Medicaid and ObamaCare to the states along with some regulatory reductions.
Since Washington has done such a terrible job trying to make health insurance affordable, maybe it’s time to give the states a chance. How much worse could they do?
Merrill Matthews is a resident scholar with the Institute for Policy Innovation in Dallas, Texas. Follow him on Twitter @MerrillMatthews.
More like Not Affordable and We Democrats Don’t Care act.
After you are dead. Then you might say ..it will be dirt cheap.
And to think we had a shot at fixing this cluster Obama but for one vile man. But he’s gone now so what the hell are we waiting for?
Not affordable, now lost. Ours went from under $500 to around $2,000 per month. We’ve lost it. Self-pay and bankruptcy if someone gets seriously sick. Sad state to be in.
Republicans in Congress demonstrated that this was outside-the-beltway campaign rhetoric to raise money and get votes, but not their inside-the-beltway action. They lied to us.
There’s no way to “fix” this. Americans can’t afford the standard of health care they’ve come to expect as their God-given right, and any public official who tells them that will be voted out of office. It’s really that simple.
Amen! It is so expensive it is ridiculous! These politicians in the house and senate are useless mostly.
There is no free lunch. The goal was to provide 30 million people who did not have health insurance with health insurance (they already had healthcare since anyone can show up a hospital emergency room and get healthcare, plus many communities have free clinics for the indigent). Medicaid was expanded to cover some of those without insurance with 100% government paid health care. The remainder were given high subsidies and force to buy on the exchanges in order to get subsidies.
Where did the money come from? Obamacare was a wealth transfer scheme. Those with medical insurance saw premium increases so the insurance companies could cover the costs government did not cover of adding millions of people to the health care system. When Jane bought her subsidized policy on the exchange, John paid higher premiums on his employer plan or individual private insurance plan.
Thank you Senator McCain and the GOP Congress for perpetuating this fraud.
“The goal was to provide 30 million people who did not have health insurance with health insurance . . “
. . . . and they still ended up with 30 million or more who opted out of getting health insurance due to the cost.
Health Care does not need to be that expensive. Health insurance companies are raping the American People.
If you pay cash you can get health care at a fraction of the cost that is listed on your insurance claims forms. It is health insurance that is expensive not health care.
Just keep on wishin and hopin and dreamin,
Just do it and after you do...
You’ll still have to pay those increasingly high premiums...
:)
It’s not supposed to be affordable.
If you think it was supposed to make health care affordable you’re a dumbass.
But you’ll keep voting for it so what do yo want me to say?
We’ve all been robbed. Paying HOW MUCH more for health insurance and unable to go to the doctor or fill prescriptions because it’s too expensive? How many thousands more are out of your pocket over the last 9 years? Disgusting.
Hubs lost his job and insurance in June. I have been basically unemployed since 2009. I have 3 monthly meds I need to live, so we decided to buy on the NYS Exchange. What a load of sh!t.
Going with Capital District Physicians Health Plan, we pay $800 a month premium. Each of us has a $5500 deductible. “After” that, our copay is 50% for any/every thing.
My 3 meds - submitting them through insurance for no coverage yet - cost 3x the amount I’d pay out of pocket, so I just pay out of pocket and use whatever discount I can.
However, the one med is $600 out of pocket and $1900 through insurance. The pharmacy enlightened me that the extra goes back to the insurance plan. Eff them. Effing EFFF them.
Last year I was able to stockpile that one, so i have 4 months left, and have not bought it at all since June.
In the meantime, we’re draining our savings on premiums for basically an expensive catastrophic plan. My gall bladder is acting up but I won’t go to the doc unless it becomes surgical. I’ve cancelled my endo appointments because blood work will not be covered and be hundreds of bucks.
Would it just be better to cancel the damned non-insurance plan and save the $800 a month? I really think maybe so.
And here in this wonderful NYS Albany area there are no jobs for either of us to be found. I’m panicked beyond belief. We’re screwed every which way.
But anyway, I sure pray PDJT finds a way to get us out the ‘ACA” mess and make insurance affordable again. Please God, help.
Why don’t private insurance companies run commercials stating what their coverage would cost.....they do with life and auto and homeowners.....?????
Its affordable to the leeches. that is all that matters
The only way to get out of this situation (IMHO) is to get employees and government out of financing the health care system...
Some folks believe a doctor’s visit REALLY costs $10, $20, $50...it doesn’t...
My auto insurance does not pay for my oil changes or brake maintenance...
It pays for when something REALLY bad happens...
Let the free market do its work
The official name is Patient Protection & Affordable Care Act. The “Affordable” comes right after the PP.
Grateful I did the 20+ years in the military and now have TriCare For Life...About $2500 Medicare a year for me and the wife pays about everything..if we get some prescriptions from Walmart instead of going to the base, we might rack up a couple hundred extra...much of which, I hear, is refundable if one wants to go that route on tax returns.
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