Obamacare Gap Traps Millions With Coverage Who Can’t Afford Care

"While the Affordable Care Act has succeeded in slicing down the uninsured rate to historic lows, many Americans--mostly the working poor--still can’t afford health coverage and are delaying medical treatment".

http://finance.yahoo.com/news/obamacare-gap-traps-millions-coverage-103000203.html

While many people now have health insurance, the cost of that insurance vs the amount of coverage provided is so high that many people do not seek medical treatment. Personally, I am experiencing this situation myself.

Before the ACA, I had health insurance that cost my wife and I about $300 a month, had a $1000 per person deductible, paid 85% after the deductible was met, had a $25 prescription co-pay, and all wellness doctor visits were covered 100%.

Today, my insurance cost $600 a month, has a $3000 per person deductible, pays 60% after the deductible is met, prescription medicine is applied to the deductible then pays 50%, and wellness visits pay at 80%.

Before ACA, I had no issue going to the doctor when I felt it was needed as I did not feel I would be financially burdened.

Today, I risk my health by not going to the doctor as the financial burden could become too great.

The medical coverage no longer justifies the monthly premiums that I pay. Not only am I paying an extra $3,600 a year, I now have to come up with $3000 a year for any deducible. That is not affordable for me. I have health concerns that I really should see a doctor about, but I know that the doctor will want to have tests done to determine exactly what my health issue is. I can not afford to pay an extra $3000 to meet my deductible if those tests become numerous and expensive.

 

Yes. The ACA is nowhere near what we need to fix healthcare for the poor. Mostly because states opted out of the medicaid expansion. More needs to be done for sure.

 

While I do agree that the health insurance system does need to be "fixed", the ACA is not the solution....neither is a single payer system. The problem that needs to be fixed is within the medical profession itself and the outrageous fees charged to provide medical treatment. Unfortunately, the AMA has too many politicians in their pockets for that to change.

 

On the bright side, anything that increases the number of insured, (even those on Medicaid) will eventually lower the charges by hospitals for their services by increasing the number of bills that actually get paid or at least partially paid.. Another good thing is insurance companies are forced to keep profits with in a certain range making it virtually impossible to jack rates up any more than necessary. Of course, they can no longer deny coverage to those with prior medical conditions. It eliminates lifetime caps on coverage too. There are some good things there. Certainly better than doing nothing imo.

 

That is all based on the assumption that medical rates WOULD be kept lower. The standard "supply and demand" system does not apply to the medical profession. In fact, in some ways it works opposite of that system. The reason is because people need medical treatment when they need it and eventually their health gets to the point where costs no longer are the priority.

More people in the system could overburden it, especially if more people are seeing doctors for less than serious reasons because they can......because it is free (medicaid). The people paying for medicaid will just be paying more in either health insurance and/or taxes. The middle class could quickly disappear.

Yes, there are some "pros" No lifetime caps, pre-existing conditions no longer a factor. However, those factors that effected a small percentage of people now burden a very large percentage of the populous.

The system before ACA was not perfect, but it was not completely broken. IMO, it is now broken. It would be interesting to see how much money health insurance companies have donated to politicians, to whom and how much. I am starting to believe that ACA had nothing to do with providing affordable care to the poor as it did to line the pockets of insurance companies. Yes, they are not allowed to increase their % of profit, but with more people paying for insurance and with the large rate increase, that really does not matter.

 

I know the Community Health Center I go to ,they take Medicaid Plan patients, is having issues meeting a big increase in demand they may have to stop adding people and I know the providers they don't want to say no but may have to do so. They are allowed to if they get approval and they did ask to limit adding more people.

 

the only solution is more govt intrusion up to and including the nationalizing of the entire health industry including pharma and equipment.

 

Hell yeah, because the solution to all the problems created by more government power and control over our health care is even more government power and control over our health care.

If that sounds insane you're a racist and a homophobe.

 

Healthcare costs money.

End of story.

All this did was transfer that cost from those who have subsidized care, to the rest of us. Unfortunately, those who could barely afford care before, can't afford it now.

Its always the same story. Wealth redistribution. Nothing more, nothing less.

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How can you change that?

Procedures cost a lot of money, because we have some of the best healthcare in the world. Constant development of new treatments, and limited number of doctors.

Should doctors not earn a comfortable living after 10 years of higher education?

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How is that any different than say... food?

Supply and demand is not a economic theory that only applies to elective purchases.

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Dear lord.

 

I wish I had access to all the numbers, which don't seem to add up. I too have gone from $300 a month (not subsidized) that covered pretty much anything pretty well, to $500 a month (before subsidy) that's basically a wellness visit and nothing else until after I've paid $6500 in deductibles. AND next year the insurers have won the right to increase premiums by up to 71% for platinum coverage, and 25% for bronze.

About all I can think of is, people have taken advantage of the ACA by actually getting medical attention, and medicine is expensive. So the new strategy seems to be, price all these sickies out of the ACA market as well. The OP is exactly correct - if you cannot afford the basic testing just to see what's wrong, you won't seek care and the insurers can keep the premiums.

 

I have no issue with doctors making a comfortable living. After all, most do have extensive education that comes with a cost and they often work long hours.

My issue is charging $50 for an aspirin....or something similar. Today, many hospitals are ran like corporations. They have shareholders that must be satisfied. They know that many people are not in a position to negotiate the cost of their healthcare, so they are able to charge just about anything they want.

While I am normally against Government involvement in our lives, a large part of me feels it does need to get involved in the cost of medical treatment. Maybe in the way of regulating prices or possibly having all hospitals/treatment center as being Government owned. They can contract with the doctors and/or their staff, but the costs are set where hospitals are basically non-profit (after overhead). I am concerned with what this would do to research, though. It would be different from single payer as people (insurance?) would still pay. Hospital employees would not be government workers, but contract workers.

 

People can grow their own food....or have many many options for price comparison. Very few areas have different pricing for medical costs.

 

I'll stop short of calling you a liar, but your old policy at $300 a month for two people and a $1000 deductible doesn't sound very believable.

UNLESS it was paid largely by your employer.

My story is almost exactly the opposite, and my FAR better policy is unsubsidized.

 

I went from having a company-sponsored plan at $120 a month to the ACA as a contractor at $300 a month. I have minimal coverage, my one prescription isn't covered (and went from $10/3 months to $160/3 months), and none of my practitioners are on my plan any longer. This is all I can reasonably afford on my current salary.

To be honest, I've been very frustrated with the ACA. I can't afford to have basic care from those who have known my personal health records for decades (due to having to pay uninsured rates), and I have no clue which of the few local practitioners I can trust to do an excellent job. (A degree does not a good doctor make.) I understand the President's intent. However, I think he went about it the wrong way. We shouldn't be attacking the affordability problem, because that simply throws extra money after bad money. I think we need to attack the costs of healthcare; the other end. Why does healthcare cost so much? How can we lower it? No need for a multi-million dollar study for this; get a couple dozen people in a room for a day and talk it out. This isn't rocket science. Then figure out how to solve small parts of the problem while working on the larger parts.

Oh, and take the profit motive out of healthcare. There should not be profit in people's health and ability to live. (Extraneous services like cosmetic surgery that do not have medical need are in a different category. I'm solely talking about medically necessary care.)

 

It was a group policy through my employer, but it was not subsidized by them. I paid 100%. I excluded the amount I paid for my children, as they are no longer on my policy and it would be comparing apples and oranges.....so, yes, for the WHOLE family, it did cost more than $300/month. However, for a policy for the wife and I, it was around $300 with a $1000 per person deductible. Before ACA kicked in, it was increasing by about 5% each year and was reaching close to $400. After ACA kicked in, our company had to search for a new carrier as our old plan was no longer available. The best overall policy costs $612 a month with worse coverage and higher deductible.

 

Okay, appreciate your clarification. I am aware that ACA-complient policies can vary widely from state to state. Here in Idaho i'm still disappointed that they didn't expand Medicaid, but was lucky that they did set up a state exchange and i had a choice of about 7 different competing insurers offering compliant policies for self employed folks.

My policy is about $500 for just me. They went up only 15% the second year where my old policy was going up 20-30% per year. I'm self employed.

Old policy: $3000 deductible and just as expensive.
New policy: $1000 deductible, a sweet co-pay arrangement, free generic drugs, and they can't cancel me if i get sick.

I would suggest checking with a broker in your area who specializes in ACA compliant insurers. Have them get you a quote, and if it's better than what you have now, ask your employer if they will simply pay you the employers monthly cost and switch.

Most i know who hate their policies haven't put in the research needed. Tough to do on your own.. try the broker approach!

 

Whonwas your carrier? Every major insurance company requires an employer to contribute at least 50% of the premium in a group plan.

 

We had many carriers over the years. Lifewise, Blue Cross, Pacific Source, etc. I am one of the owner of the company and we would shop for the best coverage and cost that fit our employee's needs (about 20 employees) each year. While there was a time when our company paid 50% of the premium for the employee, we stopped that practice somewhere around 2007 as it became too expensive. The company does pay the administration fees for the group policy, but it is not even close to 50%. More like 10%. We were never REQUIRED to pay 50% of the premiums for our employees. Oh, and our company did pay the fee for our underwriter that searched for the best policies each year.

 

Well, therein lies the true beauty of ObamaCare, Nunya. If people can't afford to see the doctor they won't go and that puts less strain and costs on our HC system, and best of all, "progressives" get to declare that a success! Hey look - the ACA is working!

Who needs rationing and death panels when the unACA's lack of affordability keeps people from seeking health care?

Mission Accomplished.

 

If you had blue cross you were reauired to pay 50%. I can't speak for the other 2 you listed as I've not heard of or done business with them. Aetna, United healthcare, BCBS, medical mutual, Summacare all require employer contributions.

 

and republicans have ideas that would lower medical and insurance cost from allowing insurance to be bought across state lines to TORT reform which neither made it into the ACA law

 

Blue Cross (actually Regence) might have been when we did pay 50% of the employee costs.

 

Neither lower costs of care or insurance. Tort expenses are less than 1% of the cost.

And since when did small government states rights conservatives want to force states to admit insurance companies into their states, not subject to their state departments of insurance?

What happened to states rights?

 

The more I think about this, I believe we were able to get around any 50% requirement by having a certain number of our employee participate. Our rates were also determined by the average age of the participating employees.

 

interstate commerce is a right reserved for the federal government if you would have read the constitution you would know that

and once again an misinformed liberal