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Surprise! Even the Bronze plans may cost a lot more than you expect
Hotair ^ | 12/27/2013 | Ed Morrissey

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 law’s marketplaces, you may be in for a surprise: Some plans won’t 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 don’t realize that if they’re 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 haven’t 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.


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: bronzeplan; obamacare
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To: SeekAndFind

They cost so much relative to my taxable income that I’m exempt. ;-)


21 posted on 12/27/2013 12:58:54 PM PST by cuban leaf
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Comment #22 Removed by Moderator

To: SeekAndFind

The best part of it is also that bronze happens to make up the vast majority of Nancy Pelosi’s forehead.


23 posted on 12/27/2013 1:00:30 PM PST by Colonel_Flagg (Some people meet their heroes. I raised mine. Go Army.)
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To: Chgogal

No, because of the Out Of Pocket Maximum rules...

The insurance companies and hospitals/doctors are expected to eat a lot of costs...

Roughly:

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.


24 posted on 12/27/2013 1:02:08 PM PST by ltc8k6
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To: rdcbn
If you get seriously sick, the difference between bronze and silver will only be name on the cost. The total out of pocket caps and the premiums end up being pretty close between the two brackets. In most states total out of pocket is going to be about $22k for a family if more than one person gets really sick/injured, minus any subsidies. The chronically ill will be hitting these caps every year. Somebody that needs expensive meds (HIV) is probably slightly better off finding a plan that covers their drugs and expecting to hit the caps every year, regardless of primary coverage.

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.

25 posted on 12/27/2013 1:03:52 PM PST by USNBandit (sarcasm engaged at all times)
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To: ltc8k6

Correction, the hospitals/doctors and insurance companies will not eat the costs, the taxpayers will pay them.


26 posted on 12/27/2013 1:04:32 PM PST by ltc8k6
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To: SeekAndFind

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.


27 posted on 12/27/2013 1:07:54 PM PST by Diogenesis
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To: USNBandit

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.


28 posted on 12/27/2013 1:09:54 PM PST by NonValueAdded (It's not the penalty, it's the lack of coverage on 1 Jan. Think about it.)
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To: Jim Robinson

I think the “free birth control” for young people is roughly akin to the circuses in “bread and circuses”.


29 posted on 12/27/2013 1:10:09 PM PST by The Antiyuppie ("When small men cast long shadows, then it is very late in the day.")
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To: SeekAndFind

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?


30 posted on 12/27/2013 1:11:04 PM PST by marron
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To: SeekAndFind
Put it this way: If the average deductible is $5,735 and a doctor visit is $85

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.

31 posted on 12/27/2013 1:11:06 PM PST by Graybeard58 (_.. ._. .. _. _._ __ ___ ._. . ___ ..._ ._ ._.. _ .. _. .)
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To: Iron Munro

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...


32 posted on 12/27/2013 1:12:06 PM PST by The Antiyuppie ("When small men cast long shadows, then it is very late in the day.")
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To: Graybeard58

“, 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.


33 posted on 12/27/2013 1:13:05 PM PST by The Antiyuppie ("When small men cast long shadows, then it is very late in the day.")
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To: SeekAndFind

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”.


34 posted on 12/27/2013 1:15:33 PM PST by ArmstedFragg (hoaxy dopey changey)
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To: ltc8k6
I have not seen the Out of Pocket Maximum rules. Do you have a link?
You would make my day if you have the link. A big thank you!
35 posted on 12/27/2013 1:16:51 PM PST by Chgogal (Obama "hung the SEALs out to dry, basically exposed them like a set of dog balls..." CMH)
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To: Paulie

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.


36 posted on 12/27/2013 1:22:08 PM PST by ArmstedFragg (hoaxy dopey changey)
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To: forgotten man

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.”


37 posted on 12/27/2013 1:22:27 PM PST by matt04
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To: The Antiyuppie
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...

But, but, but....

If we HOPE for CHANGE long enough and hard enough it will really happen - just like the dream.

Won't it?


38 posted on 12/27/2013 1:23:37 PM PST by Iron Munro (Orwell: There are some ideas so absurd that only an intellectual could believe them.)
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To: rdcbn
If you get seriously sick, the Bronze Plan may cost you everything

You could have a savings account to go along with it. Or set up a Tax Sheltered Annuity that allows withdrawals without penalties.

39 posted on 12/27/2013 1:24:47 PM PST by Mike Darancette (Do The Math)
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To: sheana

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.


40 posted on 12/27/2013 1:28:52 PM PST by ArmstedFragg (hoaxy dopey changey)
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