Sunday, July 7, 2013

WSJ: Obamacare can double or triple premiums for the healthy

You can keep your insurance. Your premiums will not rise. Blah blah blah.  Louis Radnofsky reports in the Wall Street Journal  there will be some nasty cases of sticker shock under Obamacare:




Healthy consumers could see insurance rates double or even triple when they look for individual coverage under the federal health law later this year, while the premiums paid by sicker people are set to become more affordable, according to a Wall Street Journal analysis of coverage to be sold on the law's new exchanges.

The exchanges, the centerpiece of President Barack Obama's health-care law, look likely to offer few if any of the cut-rate policies that healthy people can now buy, according to the Journal's analysis. At the same time, the top prices look to be within reach for many people who previously faced sky-high premiums because of chronic illnesses or who couldn't buy insurance at all.

Several big provisions in the law taking effect in six months affect rates for the estimated 20% of Americans who don't have coverage through an employer, Medicare or Medicaid. Plans must be available to consumers regardless of their health and must cover certain items such as hospitalization, maternity care and prescription drugs. The exchanges are set to open Oct. 1 selling plans effective Jan. 1.

A review of rates proposed by carriers in eight states shows the likely boundaries for the least-expensive and most costly plans on the exchanges. The lower boundary is particularly important because the government wants to attract healthy people to the exchanges, and they may choose to pay a penalty and take the risk of going without coverage if they believe they can't get an acceptable deal

For a 40-year-old single nonsmoker—in the middle of the age range eligible for exchanges—a "bronze" plan covering about 60% of medical costs will be available for about $200 a month in most places, the proposals show.

Though less generous than "silver" and "gold" plans on the exchanges, a bronze plan would still include fuller benefits than many policies available on the individual market today.

The challenge for the law is that healthy 40-year-olds can typically get coverage for less today, especially if they are willing to accept fewer benefits or take on more costs themselves. Supporters of the law say tighter regulation on insurance practices gives consumers more protection and is worth the extra cost, but they have to persuade people who don't have an immediate need for health care of that. If only sick people buy into the new insurance pools, prices could shoot up....

Virginia is one of the eight states examined by the Journal and offers a fairly typical picture.

In Richmond, a 40-year-old male nonsmoker logging on to the eHealthInsurance comparison-shopping website today would see a plan that costs $63 a month from Anthem, a unit of WellPoint Inc. That plan has a $5,000 deductible and covers half of medical costs.

By comparison, the least-expensive plan on the exchange for a 40-year-old nonsmoker in Richmond, also from Anthem, will likely cost $193 a month, according to filings submitted by carriers.

The law is likely to offer a benefit to those who have difficulty getting insurance now or are pushed out of the market because they have had illnesses. Under the current system, the rate on the $63-a-month plan could be revised higher if a consumer indicates prior health problems in a medical questionnaire that must be filled out before buying the plan. The application also could be rejected entirely based on specific answers given.

Under the new health exchanges, plans are available regardless of health status, and a price can't change once it is offered. Top-of-the-line plans on the exchanges that cover 80% of medical costs and have a wider network of doctors and hospitals are likely to be available for about $400 a month for a 40-year-old single person.

That is a lot of money for the lower-to-middle-income Americans who are expected to be the main customers on exchanges, but it could be less than some people currently encounter after a carrier considers their medical history.

Those without coverage face out-of-pocket medical bills in the tens of thousands of dollars if they get sick.

"The quality of the coverage is transparent, so you know what is covered and that you can count on it, without having to worry that your coverage will end when you need it the most," said Joanne Peters, a spokeswoman for the Department of Health and Human Services.

Consumers in states that aren't creating their own health exchanges will use an exchange run by the federal government. Americans who already get health coverage on the job or through Medicare or Medicaid are likely to be affected more by other elements of the 2010 Affordable Care Act, such as those encouraging doctors and hospitals to cut back on inefficient care.On the exchanges, not everybody will have to pay the prices in full, because the law offers some income-based subsidies toward the cost of premiums.

A 40-year-old with income near the poverty level—currently $11,490 a year for a single person—would likely qualify for a subsidy of as much as $234 a month toward the cost of premiums in Virginia, potentially covering the entire cost of a bronze plan.

Any subsidy in Virginia would vanish once an individual reached annual income of about $33,150.

Tom Perriello, who voted for the law as a Democratic House member from Virginia and who now works for the left-leaning Center for American Progress. called the costs of premiums "a work in progress" and added, "Over the next few years, we should see that cost curve bend."

Prices may change slightly in some states before the fall, and the picture for 2015 and beyond is fuzzy.

Some carriers have been more cautious in judging the risks of the new market, and several large insurers are mostly sitting out the exchanges for the first year to see how they work.

UnitedHealth Group Inc. and Humana Inc. both currently sell a range of products in Richmond but haven't proposed to sell through the exchange, according to the Virginia State Corporation Commission.

The companies declined to comment on the commission's list of proposals.

16 comments:

Anonymous said...

Ten years ago, the monthly premium for a healthy , single 23 year old was $360 a month with a $1000 deductible with BCBS.
Since she'd never had that much cost for medical care in any year of her life and catastrophic coverage also exceeded her annual medical average. She went uncovered until her second job.
So, the amounts above seem good to me.
It's interesting to me that we always get information on how much insurance companies pay out but we never get figures on how much they take in and have to invest on the healthy. Could it be the bill passed just before Clinton took office that allows insurance companies to report what they want us to know rather than what we need to know?

Anonymous said...

um, I now pay around $1100.00 for a4 person "Group" policy with BCBS of MS...triple you say? I guess I will have to take the ambulance to the ER, stand in line all night because I have a cold and not pay anything. You must be proud to be alive in these times to witness just how great this country has become.....a nation of baby making deadbeats!

Anonymous said...

If someone said to you that you could have INSIDE knowledge about the stock market and know what Warren Buffet and the BIG guys on Wall Street know, That would be great wouldnt it. Now what if i told you that you could have INSIDE knowledge on what is going on in CONGRESS! THATS RIGHT...SECRET KNOWLEDGE only they know...YOU READY? THEY ALL WANTED TO BE EXEMPT FROM OBAMA-CARE! Thats your INSIDER tip people...OBVIOUSLY CONGRESS KNOWS WHAT WILL HAPPEN AFTER ITS IMPLEMENTED AND THEY WANT NOTHING TO DO WITH IT!

Anonymous said...

7:00 am, is that your contribution with your employer or your total? And, how large is your pool? My rates haven't gone down with BCBS. That $360 was for our daughter when she was no longer eligble to be on our group as she had graduated from college and it was a decade ago.

Even if all four of you are 40 and smoke, then that's $800 with the figures cited in the article so a $200 savings for you.

50 million are on Medicaid out of a population of over 313 million. About 29 million of the 50 are unemployed and still seeking jobs.

44 million working Americans don't have health insurance.

Anonymous said...

Your employment of CAPS did nothing to augment your point.

Anonymous said...

Here is no one has been able to answer for me. I am the widow of a DAV. I still get my healthcare from the military Tricare program. How is Obamacare going to effect this program.

Anonymous said...

just an fyi on something else going up. Got my cable bill today (Comcast). If you are in Mississippi, there's a new tax added onto your bill "Internet sales tax".

Anonymous said...

8:42 - using 44 million as a base and multiplying it by $1000 monthly premium. I calculate a cost to the gov't of half a trillion dollars annually, if these policies for the uninsured had been purchased in the open market instead of processed by the gov't. Instead our leaders decide to bankrupt the nation...nice.

Anonymous said...

If I work hard and make more money, I may be taxed proportionately higher for no other reason than I made more money.

If I eat right, exercise and take seriously my personal responsibility to be healthy, I will still pay proportionately higher health premiums as a healthy individual.

My question is how were the exchanges ever supposed to keep the healthy premiums where they were when you are increasing the risk pool mainly with pre-existing conditions and then with citizens who chose not to be insured even when they could? This increase for the healthy shouldn't be a surprise, it was always at their expense.

That said, I think the pre-existing cond. should have more opportunities for insurance. I'm not saying this is the right/wrong way, but it may benefit us all in the long term.

None of this solves the real health crisis, which is that a majority of Americans have no clue how to maintain their health. I will begin to feel better when I stop seeing gallons upon gallons of sugar drinks in front and behind me every time I check out of the Kroger.

Anonymous said...

@8:42- that estimate is for a 40 year old healthy, non-smoking male. A healthy, non-smoking female of the same age would be substantially more, as would teenagers and children. The unemployed (whether by choice or economy) would benefit because of the federal subsidy essentially paying their premiums for them. But anybody earning $36000 or more (MOST workers) will not be eligible for subsidy so, not only will we have to help pay for those who went uninsured until they got sick, we'll also pay for those who get it free. If a hard working family man doesn't have enough left of his paycheck after paying for health insurance to pay his rent or buy groceries, where does that leave HIM and HIS children???

Anonymous said...

no 8:42am, the $1100.0 per month is my sole monthly cost. I am the employer. The 4 people in the "group" are my immediate family. If you think for a damn second that the $13,200.00 per year I pay in health care premium's can be juggled and come out as a saving to me you are as dumb as a sack of hammers.

Anonymous said...


To many people's dismay the 200-foot giant bierwurst was not unveiled in Fondren. As a matter of course those types of large announcements are not made where the local citizenry fall noticeably short of the mark.

Anonymous said...

This is a result of the American dream, to smoke, drink, eat, screw, and do whatever you want but demand that everything be done when you finally have a problem. I suggest that we place a 20 tax on cigarettes today, add 20 bucks to liquor and beer by the case pro-rated for a can, and seriously stop subsidizing the creating of more people with HUD housing and EBT cards.

meople said...

July 8 8:29 - it's an infringement in the 28th ammendment and that is what I aim to use as leverage. And I am very disappointed no elect officials local, state and federal have not stepped up in favor of the constitution...

Anonymous said...

1:01 pm, if a 40 year old woman has to pay more than a 40 year old man, that is the first thing wrong with this picture. Women are healthier at 40 and child bearing years are over for most women by then. And, a 23 year old college graduate who is single is unlikely to fall into the unwed mother category.
Once upon a time, insurance was based on risk. There were then and are now acturarial tables.
Now the risk is supposed to be spread. But, the insurance industry has used that concept, not to dilute risk for individuals at high risk so they can afford to be insured, which should have worked just fine if integrity was in adequate supply in the industry, but to eliminate risk for insurance companies. They used for propaganda purposes examples of high payouts, failing to mention the years where those same individuals had no risk and paid in monies that should have been invested to more than cover risk when it occurred.
The industry also eliminated competition. They eliminated having to report actual statistical data to government. That is why the rates vary wildly between states. And, when it comes to Mississippi , our rates have been awful since our commissioners have not been consumer friendly but rather industry friendly.
The fact is there is no profit loss ever for insurers. Their only losses come from bad investment of profits and from paying themselves too much.
Those of you who have USAA ought to be able to see the truth of the above. Those eligible for USAA, pay a dramatically lower premium for their cars, life insurance and homes because we , in essence, own the company. Profits go to us. And, in two accidents over 45 years where we were not at fault and bogus claims were made, they defended us and those attempting to cheat went away as soon as their shysters realized what company they were up against!

If all insurance companies were run like USAA , we wouldn't be in this mess .

If most Americans weren't math challenged, the health care crisis focus would be where it should be, on actual costs! And, UMC wouldn't be having to do battle with BCBS because insurance companies couldn't be dictating medical care decisions or care value!

Anonymous said...

11:24 pm, not everything is a Constitutional issue. Sometimes it's an economic issue and those making profits at your expense try to scare you into believing it's a threat to your " rights".

A row boat doesn't go anywhere if everyone is rowing in opposite directions!

There's a supremacy clause in our Constitution for a reason. Our government nor any a free society can function if everyone is a cross purposes.

The Constitution is not just one section that exists exclusively of the other sections.

Sometimes you just have to face that not everyone wants to do it your way.

And,your highest responsibility is to be well informed. Then,it's to make sure those you support to represent you are honest and competent. If the loyalists of both parties would do that instead of be at each other's throats, we might get this Nation back on track.

Instead, we will all focus on the Kardasians or Zimmerman as that's so much more entertaining that trying to understand how the insurance industry works ( or now , doesn't)




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Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

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In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.


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If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

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