But for Deb Hornbacher, 58, the high deductibles are just too much for her and her husband. While she's enrolled in her employer's plan, the Colorado couple can't afford to extend the coverage to her husband, a self-employed carpenter.
So she was hoping to sign them both up for a plan on the exchange if they qualify for a federal subsidy. She found a bronze-level plan for roughly $357 a month, after their subsidy, which they could swing. But it comes with a $12,600 family deductible. (If they don't qualify for a subsidy, they would pay nearly $1,275 a month on the exchange for that policy.)
from CNN Money 2013
***************************
Michael Yount of Charlotte, N.C., is one such unhappy customer. He and his wife, retired and in their late 50s, have been buying their own health insurance from Blue Cross and Blue Shield (BCBS) in North Carolina, paying about $380 a month with an $11,000 deductible. BCBS is offering them a new plan for three times the cost, $1,124.50 a month, still with an $11,000 deductible.
“We are an insurance company’s dream,” Mr. Yount tells the Monitor. “We pay our bills, we hardly ever get sick, no prescription drugs. And now this.”
Reluctantly, he says, they plan to drop out of formal health insurance, pay the penalty, and “self-insure.”
“No question, there’s risk there,” Yount says. “The question is, how much are you willing to pay someone else to mitigate that risk?”
He also understands that the law is meant to help those who have not been able to buy insurance because of preexisting conditions. But he objects to how it’s being done.
“If the only way to get it to them is forcibly taking it from everybody else, how is that any better?” Yount says. “I’m struggling with what is the greater evil and injustice. I don’t think it’s any more right to take it from one person forcibly. It’s coercion.”
from Christian Science Monitor 2013
*************************
A California couple said that the Obamacare policy suggested to them included a 40 percent increase in their doctor's office co-pay. “Our co-pay skyrocketed from 0 percent to 40 percent and the maximum out-of-pocket increased an additional $2,300,”
from The Fresno Bee 2013
*******************************
Alexis C. Phillips, 29, of Houston, is the kind of consumer federal officials would like to enroll this fall. But after reviewing the available plans, she said, she concluded: “The deductibles are ridiculously high. I will never be able to go over the deductible unless something catastrophic happened to me. I’m better off not purchasing that insurance and saving the money in case something bad happens.”
People who go without insurance next year may be subject to a penalty of $695 or about 2.5 percent of their household income, whichever is greater.
Karin Rosner, a 45-year-old commercial freelance writer who lives in the Bronx, pays about $300 a month, after a subsidy, for a silver insurance plan with a $1,750 deductible and a limit of $4,000 a year on out-of-pocket expenses.
She is extremely nearsighted and has an eye condition that puts her at risk for a detached retina, but has put off visits to a retina specialist because, she said, she would have to pay the entire cost out of pocket.
“While my premiums are affordable, the out-of-pocket expenses required to meet the deductible are not,” said Ms. Rosner, who makes about $30,000 a year.
Mr. Fanning, the North Texan, said he and his wife had a policy with a monthly premium of about $500 and an annual deductible of about $10,000 after taking account of financial assistance. Their income is about $32,000 a year.
The Fannings dropped the policy in July after he had a one-night hospital stay and she had tests for kidney problems, and the bills started to roll in.
Josie Gibb of Albuquerque pays about $400 a month in premiums, after subsidies, for a silver-level insurance plan with a deductible of $6,000. “The deductible,” she said, “is so high that I have to pay for everything all year — visits with a gynecologist, a dermatologist, all blood work, all tests. It’s really just a catastrophic policy.”
Another consumer, Anne Cornwell of Chattanooga, Tenn., said she was excited when Congress passed the Affordable Care Act because she had been uninsured for several years. She is glad that she and her husband now have insurance, because he has had tonsil cancer, heart problems and kidney stones this year.
But with a $10,000 deductible, it has still not been easy.
“When they said affordable, I thought they really meant affordable,” she said.
NYT 2015
***********************
In 2014, the only person with a financial incentive to “purchase” coverage would be the person making 133 percent FPL. This remains the same in 2015. Only in 2016 does it become financially advantageous for another person, this time making 175 percent FPL, to purchase insurance. For all other income ranges during the coming years, the cost of purchasing subsidized health insurance is far greater than the cost of the mandate penalty, in two instances topping 10 times the cost of the penalty. Across the next three years, the cost of subsidized insurance is, on average, around 4 times the cost of the penalty.
Although an inexact science, the numbers clearly illustrate a problem for the Affordable Care Act, the individual mandate, and the exchange system. Premiums for those required to subsidize the system have risen too much and the mechanisms meant to defray those costs and encourage people to participate in the system are too weak. As such, a significant portion of the uninsured “young invincible” population will purposefully choose to remain without coverage. Should this be the case, the American insurance market will experience widespread premium spiral.
Read more: https://www.americanactionforum.org...nder-the-aca-and-the-impending/#ixzz4tWHc6guI
So she was hoping to sign them both up for a plan on the exchange if they qualify for a federal subsidy. She found a bronze-level plan for roughly $357 a month, after their subsidy, which they could swing. But it comes with a $12,600 family deductible. (If they don't qualify for a subsidy, they would pay nearly $1,275 a month on the exchange for that policy.)
from CNN Money 2013
***************************
Michael Yount of Charlotte, N.C., is one such unhappy customer. He and his wife, retired and in their late 50s, have been buying their own health insurance from Blue Cross and Blue Shield (BCBS) in North Carolina, paying about $380 a month with an $11,000 deductible. BCBS is offering them a new plan for three times the cost, $1,124.50 a month, still with an $11,000 deductible.
“We are an insurance company’s dream,” Mr. Yount tells the Monitor. “We pay our bills, we hardly ever get sick, no prescription drugs. And now this.”
Reluctantly, he says, they plan to drop out of formal health insurance, pay the penalty, and “self-insure.”
“No question, there’s risk there,” Yount says. “The question is, how much are you willing to pay someone else to mitigate that risk?”
He also understands that the law is meant to help those who have not been able to buy insurance because of preexisting conditions. But he objects to how it’s being done.
“If the only way to get it to them is forcibly taking it from everybody else, how is that any better?” Yount says. “I’m struggling with what is the greater evil and injustice. I don’t think it’s any more right to take it from one person forcibly. It’s coercion.”
from Christian Science Monitor 2013
*************************
A California couple said that the Obamacare policy suggested to them included a 40 percent increase in their doctor's office co-pay. “Our co-pay skyrocketed from 0 percent to 40 percent and the maximum out-of-pocket increased an additional $2,300,”
from The Fresno Bee 2013
*******************************
Alexis C. Phillips, 29, of Houston, is the kind of consumer federal officials would like to enroll this fall. But after reviewing the available plans, she said, she concluded: “The deductibles are ridiculously high. I will never be able to go over the deductible unless something catastrophic happened to me. I’m better off not purchasing that insurance and saving the money in case something bad happens.”
People who go without insurance next year may be subject to a penalty of $695 or about 2.5 percent of their household income, whichever is greater.
Karin Rosner, a 45-year-old commercial freelance writer who lives in the Bronx, pays about $300 a month, after a subsidy, for a silver insurance plan with a $1,750 deductible and a limit of $4,000 a year on out-of-pocket expenses.
She is extremely nearsighted and has an eye condition that puts her at risk for a detached retina, but has put off visits to a retina specialist because, she said, she would have to pay the entire cost out of pocket.
“While my premiums are affordable, the out-of-pocket expenses required to meet the deductible are not,” said Ms. Rosner, who makes about $30,000 a year.
Mr. Fanning, the North Texan, said he and his wife had a policy with a monthly premium of about $500 and an annual deductible of about $10,000 after taking account of financial assistance. Their income is about $32,000 a year.
The Fannings dropped the policy in July after he had a one-night hospital stay and she had tests for kidney problems, and the bills started to roll in.
Josie Gibb of Albuquerque pays about $400 a month in premiums, after subsidies, for a silver-level insurance plan with a deductible of $6,000. “The deductible,” she said, “is so high that I have to pay for everything all year — visits with a gynecologist, a dermatologist, all blood work, all tests. It’s really just a catastrophic policy.”
Another consumer, Anne Cornwell of Chattanooga, Tenn., said she was excited when Congress passed the Affordable Care Act because she had been uninsured for several years. She is glad that she and her husband now have insurance, because he has had tonsil cancer, heart problems and kidney stones this year.
But with a $10,000 deductible, it has still not been easy.
“When they said affordable, I thought they really meant affordable,” she said.
NYT 2015
***********************
In 2014, the only person with a financial incentive to “purchase” coverage would be the person making 133 percent FPL. This remains the same in 2015. Only in 2016 does it become financially advantageous for another person, this time making 175 percent FPL, to purchase insurance. For all other income ranges during the coming years, the cost of purchasing subsidized health insurance is far greater than the cost of the mandate penalty, in two instances topping 10 times the cost of the penalty. Across the next three years, the cost of subsidized insurance is, on average, around 4 times the cost of the penalty.
Although an inexact science, the numbers clearly illustrate a problem for the Affordable Care Act, the individual mandate, and the exchange system. Premiums for those required to subsidize the system have risen too much and the mechanisms meant to defray those costs and encourage people to participate in the system are too weak. As such, a significant portion of the uninsured “young invincible” population will purposefully choose to remain without coverage. Should this be the case, the American insurance market will experience widespread premium spiral.
Read more: https://www.americanactionforum.org...nder-the-aca-and-the-impending/#ixzz4tWHc6guI
