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The fiction of Obamacare 'rate shock'

[bold] Politicians want to scare us, but early returns indicate Affordable Care Act will save money for many [/bold]

It’s been a while since you’ve seen a lot of stories in the media about Obamacare “rate shock,” hasn’t it?

“Rate shock” stories were all the rage several months ago, like this one from Forbes last December: “Aetna CEO (Mark) Bertolini: Get ready for ‘Rate Shock’ as Some Insurance Premiums to Double in 2014.”

Health insurance executives were hoping we’d swallow their scare campaign on rates, and thus get behind efforts by their friends in Congress to repeal the Affordable Care Act.

Many of those friends, like Rep. Marsha Blackburn, R-Tenn., are members of the House Energy and Commerce Committee, which sent out a press release on March 14 with the headline: “Obamacare Oversight: The Looming Premium Rate Shock.”

The next day, that committee held a hearing entitled: “Unaffordable: Impact of Obamacare on America’s Health Insurance.” During that hearing, at which I testified, Blackburn read a long list of what she claimed were names of businesses in her district that had experienced Obamacare rate shock.

Skeptical, I sent Rep. Blackburn a letter asking if I could see those letters and help her determine if Obamacare was really the blame or if, possibly, and more likely, those businesses’ insurance carriers were just gouging them. Five and a half months later, I’m still waiting on a response. Even though I’m from Tennessee too.

Since that hearing, the headlines have diminished because there’s little evidence that the “rate shock” allegations were based on anything other than assertions made by insurance company CEOs and lobbyists and their buddies on Capitol Hill.

The number of rate shock stories declined as state after state disclosed over the summer what insurance companies will actually charge for policies next year. Those disclosures have shown that not only will premiums not skyrocket when Obamacare’s most important consumer protections kick in on January 1, most Americans who buy coverage on their states’ online marketplaces will get better deals than they can today.

A study published last week by the Rand Corporation, a research group, is also helping to show that the rate shock hype was just that: hype.

Rand researchers said that although prices will vary from state to state, Obamacare will not increase premiums overall. Yes, some people, smokers in particular and folks enrolled in policies with benefits so meager they will be outlawed next year, will have to pay more. But most Americans who will be buying coverage in the marketplaces (also known as exchanges) will be eligible for tax credits that will make their coverage more affordable and, in many cases, cheaper than what is available today. Don’t expect a press release from the House Energy and Commerce Committee about that.

Another study released earlier this month also indicated that Obamacare has not been the cause of recent rate increases. The Kaiser Family Foundation’s annual survey of employer-based insurance showed that over the past year, premiums for family coverage increased just 4 percent. While 4 percent is still a hefty increase for many workers, it’s far less than the double-digit increases that were common in previous years.

So what happened to the rate shock scare?

Politicians and the media were all too willing to repeat what CEOs of big for-profit insurance corporations were saying without analyzing their motives or taking into account the fact that the marketplaces will force real competition in the health insurance world.

What the insurance company executives were actually “disclosing” several months back was what they would like to charge for their policies on the marketplaces, not what they actually would be able to charge. Aetna, for example, might have liked to be able to charge $500 a month for a certain policy but it won’t because its competitors will charge less than that for the exact same coverage.

by Anonymousreply 3409/11/2013

Unfortunately Obama who's done good with health care may do ill with warfare

by Anonymousreply 309/03/2013


by Anonymousreply 509/03/2013

Canadians are the far superior habitants to the rest in American continent.

Canada >>>>>>>>>> America >> Mexco ヾ(`□´)ノ〃

by Anonymousreply 609/03/2013


by Anonymousreply 1209/06/2013

My rates have leveled off. My insurance company has sent me a 'please stay with us' letter and is for the first time in a decade, actually treating me like a human being. They are fearful that I'll go with the exchange policies, which may be a viable option for me, the rates are quite a bit less and there are no pre-existings.

My Massachusetts clients only have good things to say about their, now established, state-wide health care laws.

by Anonymousreply 1309/06/2013

[quote]is that the insurance company is mindful of the competition to come from the new insurance exchanges. The company has also cut me a rebate check the last two years because it didn't spend enough on health care as opposed to salaries and marketing.

HA! It's about fucking time!

The gravy train for these overpaid assholes is done. Finally. But don't expect them to go quietly - no, they'll scream and stomp their collective feet because now their fat bonuses will be cut. Don't be fooled. They aren't concerned about "lack of quality" they're only worried about their cut of the pie shrinking.

by Anonymousreply 1409/06/2013

A new report from the Kaiser Family Foundation confirms this:

Marketplaces premiums are coming in below initial estimates, said the nonprofit, nonpartisan Kaiser Family Foundation in a new report released Thursday.

The expected monthly premium for a 40-year-old adult purchasing a silver-level plan (the baseline, which covers 70 percent of costs) on a marketplace had been $320, according to previous projections from the Congressional Budget Office. But in 15 of the 18 regions studied by Kaiser, the average premium will be below that — thus the study’s conclusion that the prices are going to be lower than anticipated.

by Anonymousreply 1509/06/2013

On the flip side corporations are all claiming Health care is going up in cost and cutting all but the basic HDHC plans (High deduct able Health Care). Mine is cutting all choices but one, even when their own website shows the PPO is a much better option for employees per year if they get sick or not.

Forever 21 put all it's employees on part time status to avoid paying for health insurance.

by Anonymousreply 1609/06/2013

R16, the reality is that health care costs ARE going up... but they're going up a lot less quickly than they were before ObamaCare. So blaming ObamaCare for increases is beyond stupid.

These are merely greedy corporate CEOs and boards screwing their employees in order to pad their own compensation. Put the blame where it belongs: On the greedy corporate management.

by Anonymousreply 1709/06/2013

Oh I was not blaming ACA I know it's my company being cheap as shit. Same company that has not given raises in 6 years while the managers directors and above get 35% bonuses and the CEO got a 8 million dollar bonus, 25 million in stock options and a 401k payout in the millions.

by Anonymousreply 1809/06/2013

R18, we need to publicize that shit more. Working people should be OUTRAGED at how they're being cheated.

And stop voting Republican in response.

by Anonymousreply 1909/06/2013

Doctors and hospitals are retaliating by billing for higher rates of care-a cyst is now charged as emergent care, a boil an in house operation.

by Anonymousreply 2009/06/2013


by Anonymousreply 2109/06/2013

Yes, we know premium prices under Obamacare... time to stop the fear-mongering.

This long (wonkish, detail-rich) article details how ObamaCare marketplace plans are pricing out. And it's almost all good news for most people.

by Anonymousreply 2209/06/2013

bump for cheap insurance

by Anonymousreply 2309/07/2013

I know many married gay men do like my husband and I do and keep our finances separate. At the link is a Kaiser Permanente calculator to see how much your Obamacare premium will be.

Because I have to list my husband's income, my premium will be 411 dollars a month for 70% coverage. Which means my out of pocket will still be huge after I give over 25% of my monthly income to this.

I can't afford that and my husband and I don't share expenses. I am totally screwed. Do NOT get married!

by Anonymousreply 2409/11/2013

How much would the premium have been before? Since you're married, can't you be on his policy? Or are you both self-employed?

If you're married, why keep your finances separate?

by Anonymousreply 2509/11/2013

R24, Why is your out of pocket expense going to be huge? Unless you have an expensive chronic condition, your out of pocket is going to be minimal.

There will be small co-pays for a doctor visit, like $40, and small co-pays for prescription drugs. In fact, annual physical exams are going to be FREE under the ACA, as are other basic preventative services like immunizations. The only time you'll have to pay co-insurance is when you have a major medical procedure done, i.e. surgery.

by Anonymousreply 2609/11/2013

truth is they don't I look at my visits and billing you seen a cost then a negotiated rate - a 2000 mri has a negotiated rate of 130 bucks..which means that is how much insurance will pay for it and the doctor agrees to accept that much for the procedure. You know why they did that? Lifetime caps (which are now gone) . Used to be most Health insurance had a lifetime cap. Mine was 5 million dollars before aca passed. Sounds like a lot but when you see the funny math it is not. That 2000 dollar cost that no one paid? That would come out of my lifetime cap. Get a catastrophic illness? You can hit that cap. Say someones kid got cancer. Treatments have a "cost" of up to 100K per treatment. Now that is not the "negotiated" payment but the 100K came out of your lifetime benefit.

Suddenly saving your child's life meant you could never get healthcare least not covered healthcare.

ACA did away with all that. No lifetime caps and you cannot be turned down for pre-existing conditions.

by Anonymousreply 2709/11/2013

R25/26, it says that the Silver plan covers 70% of expenses. IT doesn't say "just copay". (I'm referring to the Kaiser link I posted).

My employer employs 4 people so we don't have insurance. His job pays for his insurance and our children but not me because that would be another 500 a month and we don't have it. We insure the kids just to be safe but we already go hungry sometimes because of it.

I'm a 48 year old male, healthy, nonsmoker. I don't know why my premiums come out so high.

Our finances are separate because he makes more than I do and, well, resents it frankly.

I don't make enough to go out on my own, nor do I want to break up our home. After I pay my share of things, I have about a thousand dollars a month to live off of (food/gas/clothing, etc.) Now roughly half of that is going to mandated insurance.

by Anonymousreply 2809/11/2013

[quote]There will be small co-pays for a doctor visit, like $40, and small co-pays for prescription drugs. In fact, annual physical exams are going to be FREE under the ACA, as are other basic preventative services like immunizations. The only time you'll have to pay co-insurance is when you have a major medical procedure done, i.e. surgery.

Kaiser Permanente seems to be unaware of that.

by Anonymousreply 2909/11/2013

Here is the breakdown for an Obamacare Silver Plan. After you've paid the premium, your deductible will be around $2000 before coverage kicks in, and after that you still pony up 30% of the cost after that up to a max out-of-pocket of over $6000. There's a whole lot between the annual checkup and major surgery that will come out of your pocket in addition to the premium.

70/30 split, with you paying 30% for healthcare expenses Deductibles expected to be around $2,000 2nd lowest monthly premium $45 for Office Visits $0 for Preventive 65 for Specialist $25 or less for Generic $45 for Lab Work $65 for Xray $90 for Urgent Care $6,350/$12,700 Ind/Fam Out-of-Pocket Max

by Anonymousreply 3009/11/2013

For instance: suppose your "silver" 70/30 plan has a $2,000 deductible. (Keep in mind, I'm not using any specific plan, just throwing numbers around to illustrate the point). A family member has a nasty cough that won't go away, so you schedule an appointment. You'll pay the co-pay - probably a fixed amount like $25. The plan picks up the rest of the cost. No 70/30 split here, and your deductible DOES NOT come into play. On the down side, the co-pay doesn't count toward either your deductible or OOP limit.

The doc prescribes something for the cough, which is available in generic. You'll most likely pay a flat $ for that, too, maybe $4. Again, no 70/30 split, but the $4 does count towards your deductible and OOP limit.

In fact, the 70/30 split will only come into play for "major medical" items - labs and procedures. For example: someone in your family needs a surgical procedure. The hospital's "retail" rate is $45,000, but the plan has negotiated that rate down to $10,000. You would be billed for the deductible ($2,000, or less if you've already had some medical expenses previously in that year), plus 30% of the rest ($2,400).

Is $4,400 a lot of money? you betcha. But you'll work out a payment plan with the hospital, and all will be well.

Let's go one step further, and suppose you need an organ transplant. Total medical expenses for a transplant, and aftercare and recovery, would cost hundreds of thousands of dollars. You'll pay (or agree to pay) $6350(or $12,700 family) - gladly; you get life-saving treatment, and you don't go bankrupt.

It's not a perfect system. I had hoped for something better, but it's a damn sight better than what we have now.

by Anonymousreply 3109/11/2013

I pray you are right R31. You seem knowledgable about it, I'm hoping for the best.

by Anonymousreply 3209/11/2013

It's too early to tell what the impact will be. The law is way too complicated to know. Check a year after it is implemented. Then if a truly impartial assessment can be made, we'll see what the change is.

by Anonymousreply 3309/11/2013

The first year after it passed health insurance premiums rose 7% and there was hue and cry in the media. But then the hue and cry stopped. At one point someone admitted that in 2011, medical prices did not increase at all for the first time since the 1960s. So now we are hearing diversionary tales.

by Anonymousreply 3409/11/2013
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