Posted on 12/27/2013 12:27:31 PM PST by SeekAndFind
Oh, not up front — although the bronze plan premiums do cost more than many paid before ObamaCare’s mandates went into effect. No, McClatchy and Kaiser Health News worry about the big hike in overall cost that will hit consumers who choose the so-called “affordable” low-tier plans in the ObamaCare exchanges. They may not cover what people think — or anything at all, until those consumers pay thousands of dollars out of pocket first (via Gabriel Malor):
If you buy one of the less expensive insurance plans sold through the new health law’s marketplaces, you may be in for a surprise: Some plans won’t pay for doctor visits before you meet your annual deductible, which could be thousands of dollars.
“This could be the next shoe to drop, as people don’t realize that if they’re buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny,” said Carl McDonald, senior analyst with Citi Investment Research, speaking at a conference last month in Washington.
Comprehensive plans with deductibles usually cover wellness checks from the start (especially in group plans) — or at least they did until ObamaCare made the entire risk pool a lot more costly. In order to trim costs, especially with millions of new policyholders expected to flood the risk pools, insurers have shielded themselves against the larger risk. Unfortunately, that will have a dampening effect on what Democrats said would be the biggest benefit of ObamaCare — heightened access to routine care:
Experts are worrying that some new enrollees will be discouraged from seeing doctors if they have to pay the full charge, rather than simply a copayment. In Miami, for example, 40 percent of bronze plans require consumers to pay the full deductible before coverage kicks in, according to an analysis by online broker eHealthinsurance.com, a private online marketplace, for Kaiser Health News. The average deductible among the examined bronze plans in Miami is $5,735.
Patients in those plans who haven’t yet met their annual deductibles would have to pay the full cost of the visits, unless they were for preventive services mandated by the law. A typical office visit can run $65 to $85, while more complex visits may cost more.
Put it this way: If the average deductible is $5,735 and a doctor visit is $85, it would take sixty-eight doctor visits before the insurance kicked in — more than one visit per week. And it would start all over again every year.
In one sense, Karl is right:
.@gabrielmalor @EdMorrissey BTW, that's not necessarily bad policy. But it's not what people were led to believe ACA would be like.
— Just Karl (@justkarl) December 27, 2013
A proper reform of the health-insurance sector would eliminate (or at least greatly reduce) the footprint of third-party payers in most routine care, as well as transform health insurance into what it should be — a protection against catastrophe, not a club for medical care. That would introduce price transparency to the consumer, relieve most providers of a ridiculous amount of overhead, and reduce premiums to a realistic level for catastrophic coverage.
This, however, is the worst of both worlds. The law forces people to pay higher premiums for largely unnecessary comprehensive coverage — especially the middle class — and then forces them to pay for the routine care out of pocket anyway. Health-savings accounts that might have shielded consumers from the pain are now being discouraged, which means this comes out of their checking accounts, right along with the higher premiums.
The result? People will pay more for less coverage, and then spend thousands of dollars before seeing the first dollar in benefits, except for certain preventive tests that HHS deemed mandatory. This will discourage people from getting normal wellness care and quick intervention on illnesses, forcing them to wait until they’re very sick to see a doctor. And even that might be not so bad, considering how often people fill waiting rooms for cold and flu symptoms that could easily be handled with over-the-counter treatment, but it’s not what the Obama administration and Democrats promised. And it’s certainly not “affordable care.”
This is just one reason why the unfolding of ObamaCare in 2014 will be the biggest longterm political issue. It will drain American bank accounts every day, all year long, and each unexpected cost will rub a little more salt in the wound of betrayal. Just wait until the employer mandates take effect, and businesses kick employees out of group-plan coverage and into the ObamaCare exchanges … right before the midterms.
Only a fool would expect monopoly pricing to be cheap.
Did you include the new tax on health insurance premiums in your calculation?
In California’s exchange policies, the ones designated “catastrophic coverage” were the ones that had limited primary care. Because they had all of the other federally mandated coverage, though, the premiums were, as you described, only a few bucks less than the regular plans.
Obama has brought us a new series of difinitions with modifiers: we now have marriage and real marriage, and catastrophic insurance and real catastrophic insurance.
The bad part is that you have to satisfy your deductible within your network and the doctors assigned to you. I’m sure that they wouldn’t do anything to slow walk your care as you reach the deductible threshold. /sarc
Not a lot of discussion about the elimination of lifetime maximums either, probably for the same reason.
Add $1k to your in network OOP and you have the plan we have through Dec 31 of this year.
Our new plan is a horror story.
Consumer spending will absolutely crater over this.
You get federal subsidies if you select a silver plan AND are subsidy-eligible.
It would be stupid to pay out of pocket costs in a bronze plan when its not necessary.
Like I said, the cheapest option isn’t always the most appropriate one.
Depends on which OCare compliant policy you buy. Some offer only in network coverage (and some networks cover only one county), some offer in network and out of network emergency coverage, and some offer in network at one rate and out of network at another. I would imagine the nationwide companies would cover you around the country, but I’ll bet the West Lubbock Clinic Health Plan doesn’t. OOP’ll go up, because that’s now a potentially unlimited payout for the insurance company, and the premium’s most likely to be higher so you can help pay for Sandra Fluke’s friend’s social life.
I don't doubt that they would try to play politics -- but based on how this has worked out so far, it should boomerang and impact Obama "friends" even more than Obama enemies. They don't have even a clue as to what they are doing. I think of Obamacare as a giant, unguided missile.
You’re assuming that anyone would report this or do anything about it.
What’s happened to the IRS agents who persecuted the tea party groups?
Nothing.
Did the tea party groups get remunerated for their lost time and legal expenses?
No.
This go around, with healthcare, you won’t be able to bring back the time your child would have benefitted from chemo or that surgical procedure. Your child will simply be dead.
What kind of media attention do you think you’ll get?
We make exactly $450 too much for subsidies.
BTW, the subsidies aren’t manufactured out of thin air. They’re taxpayer funded.
Ie, theft.
Theft is no way to fund medical care.
/s I don’t mind paying for this new obamacare approved plan as long as Sandra Fluk gets her free birth control. I mean, that IS why this law was passed right??? \s
Oh, you'll get media attention.
You will be called a racist for complaining.
all these plans have higher deductibles and higher premiums for most people.
before obamacare passed, the dems threw the charge at republicans for “wanting high prices” for their insurance buddies. kickbacks or tit for tat, etc.
they also were labeled as doing nothing ot make plans affordable for those that weren’t covered. voluntarily or not.
well, the higher deductibles and higher premiums have made those who couldn’t afford insurance to skip it and pay the much smaller penalty. those who just didn’t want it see the big price tag for something most of them still don’t want and will pay the penalty instead. How did obamacare fix this?
now that obamacare is making insurance more for most people, if this was true, why aren’t all the evil republicans who wanted higher insurance costs for their insurance ‘buddies’, why aren’t any now supporting and promoting obamacare plans?
if we truly did want higher prices for consumers, and if we truly wanted to keep those who weren’t covered, to remain not covered, why aren’t the republicans singing the praises of obamacare? It’s supposedly doing exactly what the democrats screamed (literally screamed) the republicanss wanted. If that’s true why no republicans advocating and promoting it?
By the time the demomedia are finished with you the whole country will think they’re better off withOUT your genetically defective child anyways.
Remember the slime they threw at Palin’s way for having the audacity to KEEP her downs baby after the in-utero diagnosis?
It will be ILLEGAL to keep those babies soon enough. It already is in China and other countries with ‘lovely’ nationalized healthcare. No mention of the high rate of false positives, you can just get pregnant again or something.
I’ll hold weekly bake sales on the town square to raise money for her tubal ligation.
The fewer Sandra’s the better.
OK...I am STEALING that....”RESET”....that is very good!
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