Skip to comments.Surprise! Even the Bronze plans may cost a lot more than you expect
Posted on 12/27/2013 12:27:31 PM PST by SeekAndFind
Oh, not up front — although the bronze plan premiums do cost more than many paid before ObamaCare’s mandates went into effect. No, McClatchy and Kaiser Health News worry about the big hike in overall cost that will hit consumers who choose the so-called “affordable” low-tier plans in the ObamaCare exchanges. They may not cover what people think — or anything at all, until those consumers pay thousands of dollars out of pocket first (via Gabriel Malor):
If you buy one of the less expensive insurance plans sold through the new health laws marketplaces, you may be in for a surprise: Some plans wont pay for doctor visits before you meet your annual deductible, which could be thousands of dollars.
This could be the next shoe to drop, as people dont realize that if theyre buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny, said Carl McDonald, senior analyst with Citi Investment Research, speaking at a conference last month in Washington.
Comprehensive plans with deductibles usually cover wellness checks from the start (especially in group plans) — or at least they did until ObamaCare made the entire risk pool a lot more costly. In order to trim costs, especially with millions of new policyholders expected to flood the risk pools, insurers have shielded themselves against the larger risk. Unfortunately, that will have a dampening effect on what Democrats said would be the biggest benefit of ObamaCare — heightened access to routine care:
Experts are worrying that some new enrollees will be discouraged from seeing doctors if they have to pay the full charge, rather than simply a copayment. In Miami, for example, 40 percent of bronze plans require consumers to pay the full deductible before coverage kicks in, according to an analysis by online broker eHealthinsurance.com, a private online marketplace, for Kaiser Health News. The average deductible among the examined bronze plans in Miami is $5,735.
Patients in those plans who havent yet met their annual deductibles would have to pay the full cost of the visits, unless they were for preventive services mandated by the law. A typical office visit can run $65 to $85, while more complex visits may cost more.
Put it this way: If the average deductible is $5,735 and a doctor visit is $85, it would take sixty-eight doctor visits before the insurance kicked in — more than one visit per week. And it would start all over again every year.
In one sense, Karl is right:
.@gabrielmalor @EdMorrissey BTW, that's not necessarily bad policy. But it's not what people were led to believe ACA would be like.
— Just Karl (@justkarl) December 27, 2013
A proper reform of the health-insurance sector would eliminate (or at least greatly reduce) the footprint of third-party payers in most routine care, as well as transform health insurance into what it should be — a protection against catastrophe, not a club for medical care. That would introduce price transparency to the consumer, relieve most providers of a ridiculous amount of overhead, and reduce premiums to a realistic level for catastrophic coverage.
This, however, is the worst of both worlds. The law forces people to pay higher premiums for largely unnecessary comprehensive coverage — especially the middle class — and then forces them to pay for the routine care out of pocket anyway. Health-savings accounts that might have shielded consumers from the pain are now being discouraged, which means this comes out of their checking accounts, right along with the higher premiums.
The result? People will pay more for less coverage, and then spend thousands of dollars before seeing the first dollar in benefits, except for certain preventive tests that HHS deemed mandatory. This will discourage people from getting normal wellness care and quick intervention on illnesses, forcing them to wait until they’re very sick to see a doctor. And even that might be not so bad, considering how often people fill waiting rooms for cold and flu symptoms that could easily be handled with over-the-counter treatment, but it’s not what the Obama administration and Democrats promised. And it’s certainly not “affordable care.”
This is just one reason why the unfolding of ObamaCare in 2014 will be the biggest longterm political issue. It will drain American bank accounts every day, all year long, and each unexpected cost will rub a little more salt in the wound of betrayal. Just wait until the employer mandates take effect, and businesses kick employees out of group-plan coverage and into the ObamaCare exchanges … right before the midterms.
If you get seriously sick, the Bronze Plan may cost you everything
Why do we have to wait until this kicks in or that kicks in or employeer plans get cancelled? This is all known in advance - why is this still the ‘law of the land’?
I guess birth control is one of the required freebies. And abortion another?
All part of the big plan to get the middle class to agitate for single payer.
And don't forget "sex change" operations.
Only a card carrying idiot would believe that Obama could drop health care insurance costs by $2,500 a person while:
- Increasing the quality of health insurance and health care
- Paying for a massive, new government bureaucracy to be injected into the system between people and their health care providers
- Providing free health care insurance and health care for 30 million people
- Generating billions of dollars in new taxes for his wealth redistribution schemes
- Save the federal government billions of dollars by reducing the overall costs of health care
It makes no economic sense to pay for these high deductible b.s. plans. A rational healthy person will a) not buy or pay for the insurance b) pay the fine of 1% of adjusted gross income c) wait until they are hospitalized before they buy insurance, and d) stop paying for the insurance after they get better.
destroy the system and blame the free market, some how.
MSM (including FOX) still has not communicated to the public that they are on the hook for 40% of medical costs under the Bronze Plan AFTER deductibles. Thank You Supreme Court, Congress and Obama for royally effing us. It's time to leave these shores before you're totally bankrupt.
The good news is it won’t drain personal bank accounts because people will just refuse to sign up. The bad news is the only people with healthcare will be those on the dole.
The purpose of Obamacare is to vacuum up the savings and assets of those people who have more than they need.
The ultimate goal is to have everybody living hand to mouth in eternal gratitude to their government overlords.
No one who was paying attention is surprised.
Why would insurance companies go bankrupt? They will be receiving premiums every month for insurance policies that don’t pay out a dime unless someone is very ill.
Not many people are paying attention. If they were Obama would not have been reelected and the Democrats would have been blamed for the shut down.
They cost so much relative to my taxable income that I’m exempt. ;-)
The best part of it is also that bronze happens to make up the vast majority of Nancy Pelosi’s forehead.
No, because of the Out Of Pocket Maximum rules...
The insurance companies and hospitals/doctors are expected to eat a lot of costs...
the out-of-pocket limit in 2014 for medical and drug costs combined will not exceed $6,350 for individuals and $12,700 per family, as the PPACA stipulates.
From what I can tell there are even some silver plans that don't cover primary care. People that haven't bought insurance before are going to get caught by this and be stuck in that policy until next year. The policies that do cover primary care cost $10-50 dollars more per month in premiums. All the attention has been on the nonfunctional website. The media have done a really poor job informing the public of these other serious pitfalls.
Correction, the hospitals/doctors and insurance companies will not eat the costs, the taxpayers will pay them.
The Democrats have delivered HIGHER taxes, fees, fines,
deductibles, copays, with fewer docs, longer waits
and death for every family except all the EXEMPT
in DC, and their families, and their staff and mistresses.
There is some beautiful symbolism the republicans could use to start the drumbeat of repeal: the reset button. So simple, so effective, so in-your-face to Hillary.
I think the “free birth control” for young people is roughly akin to the circuses in “bread and circuses”.
The Dems still defend it saying, what’s your plan for helping the uninsured?
One answer is that when this is over there will be more uninsured than there were before. Because if you couldn’t afford insurance before, how are you going to afford it now that it costs 3 times as much and still doesn’t pay for anything?
My doc charges medicare $200 for an office call. Medicare allows only $130, Of which I pay 20% ($26), medicare pays 80% ($104).
He charges for an "extended visit" every time. Some of those extended visits last 5 minutes or less, not counting the time the nurse takes to weigh me and check my b.p. and pulse.
You know that a significant number of people believe that a perpetual motion machine is possible to build, right? Also that an additive that has been quashed by the oil companies can turn water into gasoline with a few drops...
“, not counting the time the nurse takes to weigh me and check my b.p. and pulse. “
Which, of course, is required by the government.
Not comletely true. They’ll have to cough up the deductable before the insurance comany pays anything, but they’ll be paying the negotiated rate from the beginning, and the difference between “rack rate” and the negotiated rate is much of the “high cost of health care”.
Because you can’t motivate the public to do anything about it until it impacts them directly. For most, that’ll come in ‘14, with a significant amount of it arranged to happen just after the election.
As a young adult who should be supporting Obama 100% according to the MSM, I checked my states exchange website. The basic bronze plan is almost $300/month with a $6,300 deductible before insurance covers 60% of the costs.
Or to put it another way, once I spend almost $10K out of pocket, insurance begins to cover part of my expenses. I’m choosing option “a” and “c.” Hopefully I won’t be geting a refund this year so the IRS won’t be getting my “fine.”
But, but, but....
If we HOPE for CHANGE long enough and hard enough it will really happen - just like the dream.
You could have a savings account to go along with it. Or set up a Tax Sheltered Annuity that allows withdrawals without penalties.
Give a little thought to the phrase “no lifetime maximum” in terms of what it means if you apply it to a business’s expenses and you’ll have your answer.
They’re government “Hammers”.
What’d people think they would cost?
It’s cost plus....
The plans cost so much and you are still paying for your doctor visits so.......there is no money left to save.
Obamacare combines the worst of very expensive private health insurance with none of the universal coverage of single payer health care.
That’s a toxic combo.
The Bronze Plan is so laughable, Medicaid looks much better. Only suckers pay inflated premiums for skimpy coverage.
Well I was gonna post from coveredca.com where it says for me and hubby $18,400 out of pocket not counting premiums of $1200 per mnth....but the site is not working! lol
Lots of people are unaware of it. It’s not widely publicized, probably because of the inevitable question:
“Who is paying the rest of the costs if they exceed the Out of Pocket limit?”
In Ontario’s OHIP, you’re covered if you’re native to the province or 90 days after you move there.
You never pay a premium. All your doctor office visits and medically necessary services are covered.
If you believe access to health care is a human right, Obamacare is a cruel political joke. Single payer would have been much better.
Obamacare doesn’t even pretend to guarantee universal health coverage, despite the law’s official name.
Don’t the premiums come out of your pocket? :-)
True exammple: Couple in their late 50s. If they get the 2013 rates with a $5,000 deductible their monthly premium is $550. If they get the Obamacare rates after January 1st, the earliest they can start the policy is January 15 and the rate jumps to $1516 per month. Thank a Democrat! Affordable Care Act my rear-end!