Obamacare Deductibles 26% Higher Make Cheap Rates a Risk

[Purveyor]

By Alex Nussbaum - Nov 15, 2013

Americans seeking cheap insurance on the Obamacare health exchanges may be in for sticker shock if they get sick next year, as consumers trade lower premiums for out-of-pocket costs that can top $6,000 a person.

Expenses for some policies can reach $6,350 for a single person and $12,700 per family, the most allowed by the health-care law, according to a survey by HealthPocket Inc. of seven states, including California and Ohio. That’s 26 percent higher than the average deductible in the seven states, and a scenario likely repeated across the country, said Kev Coleman, head of research and data at Sunnyvale, California-based HealthPocket.

Private employers have been raising deductibles and co-pays for years to help control costs on health coverage for their workers. Now insurers are using the tactic to lower premiums on the government-run exchanges. While that has allowed President Barack Obama to tout the affordability of plans, it poses a choice: Do consumers gamble they won’t face a major medical bill, or boost monthly premiums just in case?

“If you have to pay $5,000 upfront” when illness hits, “you might as well not have any insurance at all,” said Larry Saphire, 82, of West Orange, New Jersey, who shopped for coverage for his wife and two children, ages 16 and 21. “That’s not insurance.”

On California’s state-run exchange site, the standard low-premium “bronze” plan carries a $5,000 deductible per person, a $60 co-pay to see a doctor and a 30 percent fee, known as coinsurance, on hospital care. In Rhode Island, Blue Cross Blue Shield’s bronze plan has a $5,800 deductible while Missouri’s U.S.-run exchange offers plans by Anthem Blue Cross with the maximum-allowable $6,350 in out-of-pocket costs.

more...

http://www.bloomberg.com/news/2013-11-15/obamacare-deductibles-26-higher-make-cheap-rates-a-risk.html

[Fumesucker]

1. An 82 year old has a 16 year old child?

Awesome..

[JVS]

11. Maybe he got lucky at his retirement party.

[Nite Owl]

2. Finally someone is saying

exactly what is happening. These plans are in no way a good deal when you have to pay the premium and don't dare use it.
How can anyone pay this upfront?
The ACA isn't a good deal for us.

[geek tragedy]

3. Then pay more for a plan with lower deductibles.

I daresay this 82 year old chap wasn't finding better options on the individual market.

People are shocked, shocked! that lower cost plans have weaker benefits and coverage.

[Purveyor]

4. So there are still going to be 'junk' plans available then, eh? eom

[geek tragedy]

5. No, bronze plans provide a minimum of coverage that exceeds the junk plans currently

being scrapped by insurers.

[SoCalDem]

14. Yes.. the bronze plans are for young, single, healthy folks

who are probably not going to get sick.

For people with kids, or who are past 40, the actuarial tables, and reality almost forces them to be a bit more realistic, and to upgrade their policies.

[JVS]

16. In defense of the bronze plans and young, single, healthy folks...

who seem to get portrayed as freeloaders here at DU for not buying massive amounts of expensive coverage, forcing silver plans onto young people who are still dealing with student loan debt and are still not earning much as they get their careers started (if they're lucky enough to even have a job in this climate of high unemployment among the young in particular) is not a good solution.

[SoCalDem]

17. No "defense" necessary. They don't need more expensive plans

until they actually need them...

That's why there are SEVERAL options..

[JVS]

13. I'm thinking that the reason that this article interviews such an old man who still has kids is...

that at his advanced age his options for earning are limited yet he still has responsibilities to his children. Just as an 82 isn't going to find better options on the individual market, neither would an 82 year old be able to pay more for better insurance.

[geek tragedy]

22. At 82 years old, he's eligible for Medicare so this seems like a weird premise

to begin with.

It makes little sense--economic or otherwise--for men in their late 60's to be fathering children.

[Arugula Latte]

6. Well, my current deductible blows

and it won't go up under Obamacare.

[woo me with science]

7. The predatory system has been entrenched.

ACA manipulates the public by offering the illusion that people pay less. The real problem of predatory middlemen, skyrocketing costs, and obscene profits has not been addressed.

The predation has been mandated and entrenched. The subsidies help certain individuals, but they merely hide that the obscene costs are still being demanded and paid to the corporate bloodsuckers. They guarantee that the fundamental abuses of the system, including skyrocketing costs and guaranteed double-digit profits for middlemen who contribute nothing to healthcare, persist.

We pay for the subsidies with our tax dollars. The INSURANCE companies, not the people, receive these subsidies.

Every single dollar that is funneled into the pockets of health insurance vultures is not going into education, infrastructure, or social services. And people will STILL be denied heath CARE by these outrageous out-of-pocket deductibles.

[Prism]

8. Health insurance is not health care

But now our party is married to this turd, and everyone's falling all over each other to polish it up.

The more this unfolds, the more convinced I am that we're complete toast in the midterms.

We're doing this to ourselves. Republicans aren't making us be this willfully stupid. And the complete refusal to understand that insurance will not translate to guaranteed care is a willful cruelty our side is merrily perpetrating.

This right here is why partisanship is so toxic to public good.

[politicaljunkie41910]

9. There is a tradeoff between premiums and deductibles.

The ACA allows you to decide what level you're comfortable with. Also, what is being left out of this argument is that one of the purposes of the ACA was to prevent an illness from bankrupting your family. Also not being able to get insurance if you have a pre-existing condition. So the ACA is not all perfect for all people. But it is at least better than the prior system we had and far better than what the Republicans have proposed with is NADA, nothing, zippo.

No ones going to go backrupt with a $6000 deductible if you have a major illness, and moreover, you don't have to pay the deductible all up front and prior to receiving care. People are just looking for reasons to reject the ACA and anything will do.

[Sheri]

10. sorry, but it has nothing to do with people's comfort levels.

people are buying bronze plans (if they're complying with the law at all) because they can't afford the better plans.

[SoCalDem]

12. and for MOST of them, this will be perfectly fine

especially since many/most of them had "scam" policies before..or none..

nothing is perfect...

as long as we remain a "survival of the fittest" nation, this is probably the best we can do for now..

enough people in this country send the most ignorant, craven people to DC, so it's unlikely we will ever get parity..

[TheKentuckian]

18. Pushing Republican argument with this, MOST would be fine before reform.

If most being fine is the goal then doing nothing would work just fine because the entire exercise turns out to be about a small minority but it really is about all of us and so we automatically fail because we got off track from go because we insist on maintaining the existing system and profit centers.

[SoCalDem]

21. Jesus H. Christ with a crutch.

The bronze plan is offered through ACA, and if they want to buy it.. FINE..

If it;s all they need, then so be it..

How the F is that a republican argument..

apparently the website kerfuffle has created a new syndrome for too many people who just want to argue about anything..

I'm done with this whole mess..

you all figure it out.. In 5 months I get medicare

We should have been on "socialized medicine" (a la Canada, UK, and the rest of the civilized countries) for decades...but we insist on hiring cretins to fill congress..

[TheKentuckian]

23. Your argument is that if most folks are fine then fuck the remainder

according to all accounts of impact in the debate "most" were fine as is, which is the right wing argument.

Now I'm not arguing most are fine, not even the vast majority in group plans offered through their employer because the cost are crippling and are eating up far to large a share of the economy and folk's after tax dollars to be sustainable while at the same time we get lackluster return on said investment.

[eqfan592]

15. Do deductibles work differently for folks on the exchanges?

I mean, I have a $3000 base deductible and a $7500 catastrophic deductible, but I'm still way better of with the insurance than without. A procedure that would have cost 3-4000 bucks only cost me about $600 with my insurance, and lots of things are covered at little to no out of pocket cost for me, even if I haven't hit my deductible. I pay $200 a paycheck for this insurance, or $400-600 a month.

[Mika]

19. Well, as the laboring class make more money they can afford more ... oh .. wait ...

[Puzzledtraveller]

20. That's what I was going to face if I tried to keep my premium as low as possible

favoring caution I did not go cheap and went with the 2nd best option out of about 6. I made the decision on last day of open enrollment. I had earlier went with a plan to keep my contribution lower but had large deductibles just like in the OP with up to 6k out of pocket. Glad I switched at the last minute.