ObamaCare, out of pocket
By: John Hayward
9/26/2013 11:30 AM
A growing amount of attention is falling upon a new wrinkle in ObamaCare: a lot of those Affordable Care Act policies look even less affordable when you consider the size of the deductibles. Politico reports on an Avalere Health study of six states that shows “consumers could face steep cost-sharing requirements – like co-payments, co-insurance, and deductibles – layered on top of their monthly premiums.”
The health law sets exchange enrollees’ maximum annual out-of-pocket costs at $6,350. But many people won’t get near that limit, and deductibles for typical exchange plans can run twice as high as the average employer-sponsored plan.
It’s a reminder that despite news trumpeted Wednesday by the White House, suggesting exchange premiums will be lower than expected, consumers will have additional numbers to crunch.
Those buying coverage on the exchanges will have a choice of three levels — bronze, silver and gold — each offering increasingly generous benefits at correspondingly higher premiums. Enrollees who earn less than 400 percent of the federal poverty level will have access to tax credits to help offset their premium cost. There are also some cost-sharing subsidies available on a sliding scale for people earning less than 250 percent of the poverty level.
But the report estimates that a silver plan would have a deductible ranging from $1,500 to $5,000, which is higher than the average deductible ($1,135) for an employer-sponsored plan.
There’s nothing wrong with people choosing to purchase a low-premium plan with high deductibles. Such an individual would presumably be banking on continued good health, with insurance to cover unexpected catastrophe.
But that’s not what is happening here. This is a cynical effort to hide the costs of ObamaCare – which is already driving premiums up – by shifting the consumer cost into deductibles and co-payments. Those lower-deductible private plans also tend to have considerably lower premiums, especially in the pre-ObamaCare era, when people were not required to purchase benefits they didn’t want or need… to say nothing of the benefits they had strenuous moral objections to.
What about those fabled “pre-existing condition” folks? The entire disastrous ObamaCare takeover of the insurance industry was sold largely as an effort to help them get insurance. But what good is a pricey policy with huge deductibles to someone whose pre-existing conditions guarantee those out-of-pocket costs will indeed be departing from their pockets? How long before we hear that those poor people need even more government subsidies to defray those crippling co-payments? It won’t be hard to line a few dozen of them up for a photo op.
Politico quotes Caroline Pearson, vice president of Avalere Health, worrying about the risk that “patients could forgo needed care when faced with high upfront deductibles.” Once again, we see ObamaCare’s boasts about more people getting coverage running afoul of the reality that people are going to get less treatment.
The actual effect of ObamaCare on the number of “uninsured Americans” remains a highly contentious question, as does the current number of people who are truly “uninsured” – a number that changes a great deal when illegal aliens are excluded. The President loves to mislead audiences with statements like, “If you’re one of the 30 million Americans who don’t yet have health insurance, starting in 2014, this law will over you an array of quality, affordable, private health insurance plans to choose from.” Leaving the dubious claims about quality and affordability aside, what the President isn’t telling his gullible audience is that his probably bogus 30 million figure is projected over the next eight years, not some wonderful explosion of insurance opportunities set to blossom in 2014.
According to the latest Congressional Budget Office report, summarized by CNS News, we’ll still have 30 million non-elderly Americans without insurance in 2022. Why, that’s the same number Barack Obama touted as currently uninsured when he was pushing ObamaCare! But of course, he had to stop including illegal aliens in that figure, which is itself inflated by various questionable methods of counting people as “uninsured.” Throw in the illegal aliens and you get to a maxed-out number of 53 million uninsured – a number that has begun reappearing in Democrat mythology as they eyeball those sour public-opinion polls.
Which brings us to this curious passage from the report:
“CBO and JCT [Joint Committee on Taxation] now estimate that the ACA, in comparison with prior law before the enactment of the ACA, will reduce the number of nonelderly people without health insurance coverage by 14 million in 2014 and by 29 million or 30 million in the latter part of the coming decade, leaving 30 million nonelderly residents uninsured by the end of the period,” the report said.
“Before the Supreme Court’s decision, the latter number had been 27 million,” states the report.
Soo… ten years of gigantic government spending and job-killing burdens on American business will change the number of uninsured from 27 million to 30 million? And could we hear some more about the effect “prior law before the enactment of the ACA” was having on the ranks of the uninsured, so we know exactly how much of the improvement is coming from the Affordable Care Act, which is going to cost us at least $1.3 trillion by 2023? How excited are we supposed to be about a program that spends $56,000 a head to reduce the total number of uninsured Americans by 24 million people? Does it matter that the reshuffled population of uninsured will include a large number of individuals who paid the tax/penalty for the privilege of not buying insurance? What’s going to happen to all these best-case projections when insurance providers and medical clinics close up shop? And how much use is “coverage” with massive out-of-pocket expenses to many of the people who are currently having difficulty obtaining health insurance?