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 ...
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.