Health Care Plans Under Obamacare Will Cost Even Less Than Expected

[ProSense]

Health Care Plans Under Obamacare Will Cost Even Less Than Expected

By Sy Mukherjee

A new analysis of health care premiums proposed under the Affordable Care Act concludes that health plans will cost even less than originally expected. That’s likely because the insurance marketplaces will encourage more competition between insurers.

Avalere Health looked at insurers’ proposed rates for Obamacare’s statewide insurance marketplaces in nine different states, and found that premiums for a 40 year old non-smoker on a mid-level health plan will cost anywhere from a low of $205 (in one Oregon region) to a high of $413 (in one Vermont region). That high-end price is actually lower than what the Congressional Budget Office (CBO) predicted the average mid-level plan cost would be in 2016.

<...>

Avalere’s report comes with some important caveats: the analysis is limited to 2014 premiums, whereas CBO’s projections deal with 2016 rates. Critics may argue that insurers are offering deceptively low rates to attract consumers in the health law’s first year of implementation, but plan on jacking those charges up once they have a larger customer base.

But insurers wouldn’t necessarily be able to do that under Obamacare, since the law subjects any premium hike over 10 percent by insurers selling plans on a marketplace to review. Furthermore, sicker Americans are expected to take advantage of the law’s protections before healthier and younger Americans enter the individual insurance market, meaning that future rate increases could be mitigated by a less costly pool.

- more -

http://thinkprogress.org/health/2013/06/20/2185811/premiums-obamacare-lower-expected/

Kaiser tracking poll: Young Adults Want and Value Health Insurance
http://www.democraticunderground.com/10023050470

[cbdo2007]

1. Yep!

[BenzoDia]

2. I hope the multistate plans really take off and keep existing insurers honest on rate hikes.

[ProSense]

3. Yup. n/t

[AllyCat]

4. My family is anxiously awaiting the federal exchange rates since WI won't comply with the law

My employer has decided that it wants to completely jack-up the rates for insurance even for union employees (bargaining). The monthly premium for just my portion of the premium will cost more than the average I see among these 8 states. I am confident the federal exchange will be similar or maybe even less. We will jump ship immediately if this is the case because in addition to raising our rates, the coverage is less and we cannot see top-notch specialists right here where we live.

Keeping my fingers crossed, but this is good information!

[strikeforce]

30. al

from what i understand with obamacare is that if your employer is offering a health insurance plan for it's employees then those employees can't qualify for obamacare plans. i think i saw it at the kaiserfoundation.com article.i hope i am wrong.i too live in wisconsin(platteville).walker and the teabags are a disgrace here.

[AllyCat]

39. But if it doesn't meet a minimum standard

We could switch while they get in trouble. Bummer because our insurance used to be top notch.

[hue]

5. Keep getting the word out!!! K&R!!

[ucrdem]

6. KnR, this should be front page news

and hey it is!

[Motown_Johnny]

7. The 80/20 rule applies

So even if they want to hike the cost it won't do them much good. They still need tp spend 80% of what they charge on medical procedures. They can't just roll the excess into bonuses anymore.

[alc]

28. 80/20 goes both ways

Raising medical costs is the only way to increase profit/bonuses.
No more negotiating with hospitals for cheap rates. No more denying procedures. No more preferring generics over name-brand. Providers will be more than happy to make more profit for medical care.

After they make a big deal publicly of how medical costs have skyrocketed and they need to raise premiums, we'll see just how good the regulators are. Will they call out the insurer's tactics? Or be more like the financial and BP regulators? If the regulators "win" the first battle they'll make sure everyone knows why they have to start denying procedures and requiring generics (the gov't made them)

[emmadoggy]

8. What is a "mid-level" policy?

$1500 deductible? $2500 deductible? Deductibles are insane these days. You are supposed to pay hundreds every month for the "pleasure" of having insurance and then pay thousands more each year if you actually USE the insurance and need care.

My family can't afford even those rates - and of course, those rates are for only ONE person! We have a $2500 deductible right now and can't afford to go to the doctor. At least we were able to put our two kids on a state-run low-income plan that only costs $20/month, so at least we can take them to the doctor. But hubby and I? Forget it. And we are both at an age where we need a bit more care, but it is not happening.

It was only about 6-8 years ago that we had a $500 deductible and only a few years before that we had a $250 deductible. Will those ever return?

Fuck it. I don't want those to return. WE NEED SINGLE-PAYER!!!!!

[strikeforce]

31. emma

consider going to the free clinics in your area. you probably qualify.it is not charity. you pay for it either from your taxes or it's a tax against your employer for not paying you a living wage. a well ness physical does not go towards your deductible.that is the law also.

[Iliyah]

9. When the Democratic Party congress

passed Medicare, Ronny Reagan said (not actual quote)........

"This program will end DEMOCRACY as we know it"

[HappyMe]

10. k&r

[ErikJ]

11. My insurance rate dropped $90 a month with OCare.

I buy my own health insurance and my old pre-OCare plan was about $210 a month and my OCare compatible plan was only $120 a month. The deductible was a bit higher but at least it gave me that option.
I still hate it compared to single-payer "Medicare for All" but it does back up what this article says.

[flamingdem]

12. I found out that Medicare isn't free either

Somehow I thought after 65 we don't pay a dime but if you want more than bare bones most elders seem to pay $200 a monthish. Wish I knew more but am not there yet!

So Obamacare does compare well with Medicare.

[ErikJ]

15. Thats from Republicon meddling with Medicare with privatizing options

Basically they have whittled away at Medicare and replaced those cuts with private insurance options like Medicare Advantage. THeir end game is total privatization of health care for seniors with vouchers.

[h2ebits]

17. Medicare is a complicated subject. . .

I turned 65 in March. Long before I got to that point I was receiving copious amounts of junk mail from many different insurance companies. By the time I enrolled I had collected a stack approximately 18-20" thick. (Not an exaggeration.)

So here is my advice to you:

Do NOT respond to any insurance brokers until after you have enrolled in Medicare Part A and Part B. The cost for Part A is zero and the cost for Part B for most people is currently $104.00/month (there are exceptions to this). You still have time after enrolling in Medicare Parts A&B to enroll in Medicare Part D so hold off on doing it TEMPORARILY until you decide your direction.

Once enrolled in Medicare, you will receive a booklet called: "Medicare & You", which is the official U.S. Government Medicare handbook. PLEASE take the time to read it from cover to cover and if you don't understand terms or need more information make phone calls and, if you can find one at your local rec center or elsewhere, take a class that explains it. I CAN'T STRESS THE IMPORTANCE OF THIS ENOUGH!

Here's a really basic summary:

Medicare does NOT cover everything 100%

Most people elect to take out additional insurance and there are two basic types:

1. Medicare Supplement Plans: Most of the insurance brokers are trying to sell you a supplement plan (sometimes called MediGap) and most of them are trying to sell you the Cadillac Plan--called Plan F. These plans sit on top of the regular Medicare and you will pay the premium for the MediGap policy AND the regular Medicare Part A&B. The supplement plans run from Plan A thru Plan N--ALL of them have been designed by the Feds and all of them are identical--regardless of which insurance carrier you choose. While Plan F is identical regardless of which insurance company is offering it; the insurance company can charge whatever premium they choose and the monthly premiums vary from high to very high. In addition, if you choose a supplement plan, you will need to enroll in Medicare Part D for prescriptions. Finally, you will need to administer two separate plans. For example: If you go into the hospital, the hospital will need to bill Medicare separately from the supplement plan. You will need to carry both cards with you in order for the billing to be done correctly.

2. Medicare Advantage Plans: Most of these plans are HMO's and operate like standard insurance plans. Most, but not all, include prescriptions so you will need to monitor if you decide to change your policy. (You may need to separately enroll in Medicare Part D if your new policy doesn't include prescriptions.) Coverage on these policies is at the discretion of the insurance company so the policy premiums change based on coverage, etc. and comparison shopping is important. The policies each have different deductibles and out-of-pocket limits. If you choose an Advantage plan, the insurance company will issue you a member card and all billing for services will go thru the insurance company. You will still have to pay for the Medicare Part A&B in addition to any premium for the Advantage plan but everything will process thru the insurance company so they handle the administrative details directly with Medicare rather than you.

One last thing. If you need Medicare Part D for prescriptions, go to the Medicare website before making your decision. They have an online program where you plug in your prescriptions and the computer program calculates which policy will be the most cost efficient for you in your area.

Truly a brief touchdown into the black hole (and most of which I learned the hard way). In the end I settled on a United Healthcare policy that has a -0- additional premium and includes prescriptions. I feel that I can handle the annual out-of-pocket and it's cheaper for me than paying a supplemental plan premium plus prescription plan.

Hope this helps.

[flamingdem]

19. wow! That's complicated. I will save this for future reference

This is very useful, thanks!

[Recursion]

20. The full unsubsidized part A & B premium is like $900 / month

But for most people, a lot of that is covered by payments from the Trust Fund. This should probably be made simpler and more transparent.

[dawg]

13. The best thing about Obamacare is the way it empowers consumers.

Under current law, many people were shut out of the insurance market based on pre-existing conditions or other such bullshit. Others were duped into purchasing low cost plans that don't actually cover anything.

Even for those healthy and rich enough to afford coverage, doing and apples to apples comparison of plans was impossible because of the various differences in coverage, lifetime limits, copays, and networks.

Under the new system, people will be able to make informed intelligent choices. And no one will be shut out of the system because they, or a family member, are already sick.

Will the mandated coverage be expensive for some? Hell yes. And we need to work to make whatever changes need to be mad to the subsidy to make sure it is affordable for all. But it is a start.

I think that the ACA will be the President's (positive) legacy, provided the Republicans don't manage to dismantle it or otherwise sabotage it.

[SoCalDem]

14. Great news ...BUT

It could be so much better with a single-payer/universal plan that EVERYONE pays into based on their ability to pay (taxes), and administered "blindly".. As long as there are qualifications that affect price, there will always be people for whom the fine for not having it will be cheaper....and they will opt for it.

What about the 40 yr old who has only recently become a non-smoker?

And now with the AMA declaring obesity a disease, will weight become a deciding factor for coverage?

Universal care just provides medical care for those who need care...when they need it.. It's a prepaid feature of being a citizen...without the morality/worthiness factor.

A good plan would INCLUDE education/remedial features for those who want to/need to "clean up their act", but whatever the personal "habits" of an individual, they should not be excluded from affordable care or forced to jump thru flaming hoops of disapproval in order to prove their worthiness.

This is a republican plan..created by republicans, then disavowed when a black guy became president ...but still a republican plan, chock-full of "qualifications & requirements"..with loads of worthiness-testing to go around.

It's better than nothing, but not as good as it could/should be.

[Iliyah]

16. Single payer will eventually

be bought in hopefully without opposition.

[Recursion]

21. That's hardly the only model that works

I don't think getting stuck on the idea of socialized insurance as the only acceptable end result is a good idea; there are a lot of ways different countries have made this work.

[Iliyah]

22. Maybe so

but here in the US many want the single payer and are still upset with Pres O. I personally believe it is the stepping stone to it but Obamacare have a hard uphill battle, many of the GOP base hates it just to hate it, and many Liberal's are still mad about single payer.

[Recursion]

33. That's why I didn't say "socialized medicine"

I said "socialized insurance", which it is.

[dflprincess]

35. Whoops

one of many failings is a tendency to read too quickly - saw the "socialized" and given the topic, filled in my own blank.

My apologies.

[sheshe2]

18. K&R!

Some healthier, young Americans may see their premiums go up compared to current rates. But, as many analysts have pointed out, current plans on the individual market aren’t really comparable to the plans that will be available on Obamacare’s insurance marketplaces. Individual health plans tend to have outrageous out-of-pocket deductibles, skimpy coverage, and Americans don’t receive any help for paying their monthly premiums. That won’t be the case once the health law’s health insurance subsidies kick in. Even bare-bones plans on Obamacare’s marketplaces must cover “essential health benefits” such as mental health care services, prescription drug coverage, and maternity care.

Excellent news, ProSense!

[dflprincess]

34. The barebones plans on Obamacare's marketplaces also have outrageous out of pockets.

There may be "must cover" items but, with the exception of some screening tests, the deductible limts must be met before those items will be paid for by the insurance company. And really, what's the point of having a "free" mammogram if you don't have a way to pay for any follow up treatment that might be needed? It can cost several thousand dollars just to find out that odd spot is benign and under the "Affordable Care" Act you can be on the hook for just over $6K (annually) before you insurer coughs up a dime.

People may be able to get insurance but they still won't be able to afford care. Oh, and the help paying the monthly premium? Not quite - those who qualify have to find a way to pay the premium then apply for a credit when they file their income taxes.

The big winners are the insurance companies who will have the a whole new pool of suckers to steal from and maybe the credit card companies as Americans will continue to use plastic to pay medical bills they can't afford.

[sheshe2]

36. I do not know what State that you live in, dflprincess.

However, maybe we just have better health care in Massachusetts.

A short time ago there was a near death accident in my family. I won't relate all the details. However after three weeks in critical care then several weeks in a rehab center, they were finally released. There was a month of outpatient follow up. Insurance paid for almost every cent of it.

Are we a wealthy family, the answer is no. We are what can be called middle class or what was known to be middle class. We are not magic or golden.

All of the benefits of Obamacare have yet to kick in. Too many people do NOT know the details. The polls show this.

ProSense has many posts that explain this. The details, in detail. You need to find this information, I would link some but after working all day I am far to tired.

The details and the facts are there for anyone to read!

[dflprincess]

37. There was a link here in the last few weeks

(and I'm too tired to look for it) that listed what the cost of plans that would be available with Obamacare and their varying levels of coverage and deductibles. -- It might have been the cost California plans that will be available.

However, while the actual costs of the insurance have not been available, the information about what kinds of plans will be supported/allowed by the ACA has been and it has been clear that high out of pocket (aka "consumer driven&quot plans will be allowed. It was also laid out in the ACA that premiums must be paid up front and "subsidies" applied for at the time income taxes are filed. The $6K+ annual deductible (for a single person) and at what rate it will increase annually, is spelled out in the ACA as is what expenses are not subject to the deductible.

Minnesota has had some plans for lower income people and has picked up the Medicaid extension. My mother qualified for the state's "Minnesota Senior Health Options" (MSHO) as her Medicare suppliment and never paid anything but a $3.00 copay for brand name drugs and $1 for generic - and the copays had a max amount of something like $24/month. This included a few hospital stays and one major surgery. I'm quite fortunate in that my employer still offers very good insurance. And, as I found out when I broke my wrist last fall, it is a plan that pays claims quickly and with no hassles - of course, it is a non-profit company (and, having been insured by both for and non profit companies I can attest to the non-profits generally being much easier to deal with).

I have read quite a lot of the ACA and articles about it - all it does is require a person to have insurance, it does not guarantee that they will be able to afford care when they need it.

Remember, what is now called Obamacare, was originally the Heritage Foundation's plan - doubtful that anyone there was concerned with anything but protecting profits.

[area51]

23. How interesting.

I know what would save more money, save more people, and keep people from going bankrupt, which the ACA won't do.

SINGLE PAYER.

[leftstreet]

29. Shh, don't say that. You could get arrested!

Baucus’s Raucous Caucus: Doctors, Nurses and Activists Arrested Again for Protesting Exclusion of Single-Payer Advocates at Senate Hearing on Healthcare

May 13 2009

AMY GOODMAN: Baucus’s raucous caucus. Five people were arrested yesterday at a Senate Finance Committee hearing on healthcare reform and charged with “disruption of Congress.” They were protesting Committee chair Senator Max Baucus’s refusal to include any advocates of a single-payer healthcare system in a series of hearings on healthcare. Last week, eight doctors, lawyers and activists were arrested as they sought to put a single-payer advocate at a table of fifteen witnesses. At yesterday’s hearing, none of the thirteen witnesses testifying was an advocate of single payer.

Senator Baucus, a Montana Democrat, opened the hearing on a cautionary note, warning against any disruptions.

http://www.democracynow.org/2009/5/13/baucus_raucus_caucus_doctors_nurses_and

+1

[vinny9698]

25. This was the fear the GOP has, it will work and Democrats will get a generation of voters

The fear all along was that the program is going to be as successful and as popular as Medicare. Once that happens people will realize which party is on their side.

[LWolf]

26. Yep.

That's why my premium is going up AGAIN this October.

[Scurrilous]

27. K & R

[Beartracks]

38. What accounts for reports of higher premiums thus far?

I understand that many of the important provisions of the law don't kick in until 2014, yet I always hear people complaining about how their premiums have increased, doubled, etc., in the last couple of years. Is this the private market milking people before those provisions kick in? I don't want to assume that, but that's just my theory. Does anyone have more concrete info? (I don't recall the specific situations or cost increases of the people who were doing the complaining.)

=================

[Yo_Mama_Been_Loggin]

40. Trump is probably soiling himself right now