Skip to comments.Unexpected Health Insurance Rate Shock-California Obamacare Insurance Exchange Announces Premiums
Posted on 05/26/2013 11:24:17 AM PDT by HawkHogan
Yesterday, Covered Californiathe name given to the healthcare exchange created pursuant to the Affordable Care Act that will serve the largest population of insured citizens in the nationreleased the premium rates submitted by participating health insurance companies for the three health insurance program categories (bronze, silver and gold) established by the Affordable Care Act, along with the catastrophic policy created for and available to those under the age of 30.
Upon reviewing the data, I was indeed shocked by the proposed premium ratesbut not in the way you might expect. The jolt that I was experiencing was not the result of the predicted out-of-control premium costs but the shock of rates far lower than what I expectedeven at the lowest end of the age scale.
So, why the all too popular narrative that Obamacare would mean unaffordable healthcare premium costs for so many Americans?
Setting aside the never-ending nonsense peddled by the opponents of healthcare reform, everyone from the Congressional Budget Office to numerous private actuaries have warned that premium shock could be expected to set in once the public began to see the reality of what Obamacare would mean to their pocketbooks. And yet, the only real jolt to the system being felt by these public and private prognosticators today is utter amazement over just how reasonable the California prices have turned out to be.
(Excerpt) Read more at forbes.com ...
Seriously, do these people live in an alternate universe?
I don’t believe the numbers. Let’s see all the 3 plans’ levels and costs. Farce-butt + Forbes = BS.
All the numbers seem to be for a single person. What about a family of four?
The devil is always in the details..what do you get for a bronze, silver and gold?
It’s easy - they’ll do with ObamaCare what they did with Social Security Trust Fund. They’ll take every dime out as it comes in and NOT put aside money for future costs. Then in a few years they’ll refer to it as an ‘entitlement’... and try to ‘means test’ it.
I’m sure the numbers that are being reported in California are being heavily manipulated, that’s why they fly in the face of every other study done on the costs of implementing Obamacare.
The devil is in the details. What is covered and what is the deductible? If the premium is less than $300 a month, I suspect not much is covered and the deductible is likely $5,000.
thanks to the large influx of customers as a result of Obamacare . . . For the 2.6 million Californians who will receive federal subsidies, the price is a good deal less expensive . . .
if the IRS turns over all those fines paid to skip coverage AND the federal subsidies increase? Is that how low premiums are obtained?
This is the truth despite the source. It's the same marketing strategy cable companies, cell phone providers etc. , use-- low priced introductory offers, then they'll get you later, once you've signed the contract. And once those that are new to insurance , not having used health care services much, actually start using it, the premiums skyrocket. This Ungar is a hack trying to wlak Obama past the 2014 elections.
Since Sebelious babe is out there solicitating for donations to fund Obama care and promotion of...that should be a huge heads up that whatever costs “they” reveal are completely phony!....double or triple the costs no matter what numbers they give.
Ungar appears to be the Forbes token commie lib. A lot of his pro-Kenyan articles have been posted here recently.
>>All the numbers seem to be for a single person. What about a family of four?
Why should there be rates for a family? A citizen is a citizen. Everyone should pay individually. If the purpose of ObamaCare is to distribute the costs of medical insurance across 100% of the population, then each “population unit” should pay.
Perhaps the “chilluns” can work in a factory or something to pay their mandatory health care + national debt service. It’s only faaaaaaaaaairrrrrr.
There’s the ‘U’ word again! It never goes out of style with the Left.
Last OMB report I heard was $20-21,000 “avg for family of 4”. Still doesn’t tell us what level and plan that is. That may be 1st year, entry level, but could rise astronomically after that.
IRS example of Bronze Plan for family of four. ($20,000/year. Cheap, eh?)
Certainly raised a red flag for me, but the details were never given. They were scrubbed for the story.
Might explain why many potential providers opted out.
unexpected? by who?
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If you can find the “California Covered” PDF you’ll find details on pricing, probably more than you want; I saw it yesterday. For standard definitions and benefit comparisons of “bronze, silver, gold, platinum” you’ll probably have to go elsewhere.
I found the CA rate document again:
I used to have Kaiser P; hardly any wait time; that will change with all the added patients.
So your "financial exposure level" is the 100% minus the above percentage
Naturally, premiums are least for the bronze plans and most for the platinum plans.
I read an article the other day that stated.....the lowest plan right now if you look on the internet is $111 but under California’s new plan for all goes to $200. That would be quite an increase.
Me thinks this author is full of BS.
Well, first, the writer says that Aetna has not been a player in the California individual insurance market. Well, my wife has an individual plan, and Aetna was quoting her coverage.
As to United Health Care, they do not write individual policies, at least not in CA. They write group policies, including Medicare supplemental policies via AARP.
As to the rates, I say baloney. She has an individual Blue Cross policy with a $5,000 a year deductible on medical and a separate deductible on drugs. The monthly premium is $488. We pay nearly $11,000 a year between premiums and deductible before she gets to collect one cent. The good news is she goes on Medicare in January.
Notice there is no detail of the coverage offered under these policies. Just wait until claims start coming in and then watch how fast the premiums rise.
Plus yes the benefits on the silver and bronze plan are pretty limited.
How old is the insured?
If Obamacare is so great and wonderful, why did Congress exclude themselves from it?
Thanks; saved it to HD folder. It’ll take some time to get thru and cross-reference with other states’ docs, if I can find them.
Correction: it wasn’t an OMB report, it was CNS article:
I guess that insurers are free to design their own benefit packages as long as the required (including immoral) benefits are included. Then the customer picks the insurer and the package (as has been done all along) and finally the metal level. This is in addition to completing the paperwork/online forms for the subsidy. This is going to be quite complicated for the consumer and I can see even a pretty high-info person like myself making a selection mistake and having to live with it for at least a year.
I'm pretty sure based on reading the last few minutes that the metal level doesn't refer to what benefits are included but to what level of financial exposure the customer has.
High out of pocket maximums for the lower tiered offerings.. Higher maximums than you see in most bottom end current plans. Imagine for the express purpose of having “teaser” rates.
It is a sucker rate. Next year it will zoom
Meant to add that PPO vs HMO seems fairly evenly divided to me. Depends somewhat on the region.
That is what I meant by the benefits. The metal levels set up a specified actuarial value, the individual insurance plan then chooses the specific benefits that satisfy that metal level.
Here are the ten "essential" benefits all the individual and small groups plans must include:
Ambulatory patient services
Maternity and newborn care
Mental health and substance use disorder services
Rehabilitative and habilitative services and devices
Preventive and wellness services chronic disease management
Looks like Co Pays and annual out of pocket charges are based on income. This will make sure that waiting rooms are always full of low income folks.
According to the comments, the individual fee and the subsidies (which we pay) add up to $1200 per month or so. Much higher than before obamacare. While it is true the individual pays less out of pocket, overall costs actually go up. For some reason, this is not mentioned in the article. Can you say agenda?, I knew you could.
Even “gold” is at 4k per year out of pocket maximum. Most current Cadillac offerings are at around $500 to $1000 out of pocket maximum.
Actually this is only for the insured individual (age not specified) who is in the highest income bracket of 250%-400% of the Federal Poverty Level (FPL) those under 150% FPL have 94%.
I wonder if standard operational definitions for the ten essential benefits are stated somewhere or if the categories are just names.
For example, a plan could include “prescription drugs” but the actual included list is so restrictive as to be useless, or no better than what Walmart offers at $4 anyway.
It’s really going to be treacherous for the consumer to make their decisions. I’m not looking forward to it. Fortunately, I do have basically full time to research.
This is the same state that, if you have a medical issue and cannot afford to get anything done about it (no insurance) - just go out there, live with a friend or family for a month or two, and you qualify for MediCal - and they will pick up the tab for you...
I speak from indirect experience - my brother-in-law’s own inlaws... went to visit family in California, a little over a month after arriving, his back troubles (had been having issues already - and indeed had a history of back trouble and surgery) got bad again. Having no insurance, they were worried. Family said “no problem” - he signed up for MediCal and had the surgery a couple weeks later. No question asked, other than how long have you been California... They told the truth.
Even more interesting - his mother-in-law got a surgical consult about maybe getting lap-band surgery done (she is very overweight). And found out that MediCal would pay for that too... Foot- most insurance wont do those procedures....
Nothing if you're over 65.
I agree that it does not take the subsidy into account if that’s what you mean.
You are correct. I was also surprised at how low the introductory rates were. Kind if like 0% interest on a credit card for six months, then 19.9%. It won’t last, especially when reality hits about actual costs. It also seems these are just individual premiums. If you have children, especially if you have more than one or two, paying by individual is going to be horrible.
is there any way to opt out of this?
Sure, join a union or pay a penalty are a couple of ways (actually, most unions have not been given a waiver, but they sure do want one!).
Boston’s “Big Dig” project: Government estimated coat $2.8 billion. Actual cost: over $14.6 billion
Nearly 7x what we wee told. Why should this be any different?