How Can Obamacare Premiums Be Higher And Lower At The Same Time?


VictoryI just read another article where people on the left are claiming victory because they think that health insurance premiums are not increasing as much as the “naysayers” predicted.

Once again, these same politicians are using the same tactics they used in 2009-2010 to pass Obamacare.  They are only giving out partial information.

Like a magician, whose job it is to use misdirection to fool people, the politicians are emphasizing information that supports their objectives and hiding information that does not.

In this post I want to point out some of the facts that are not being said by those who claim victory.

BAIT AND SWITCH

Bait and switch is a sales technique where someone advertises one thing but delivers something else.  It is considered unethical and a “deceptive sales practice” by state departments of insurance.

However, it is apparently an accepted practice for supporters of Obamacare.

Millions of Americans are currently paying for a health insurance plan that pays 80% of medical costs after they pay their deductible.  When Obamacare supporters rejoice over lower priced plans, they are rejoicing over the costs of “Bronze” level plans that pay 60% of “Actuarial Value” for health care.

When Americans with 80% plans enroll in Essential Health Plans during the National Open Enrollment they will need to accept less coverage than they currently have in order to lower their premiums.  If they wish to keep a plan with coverage similar to what they have now, they are going to have to pay significantly more.

The politicians are correct when they point out that there will be plans that cost less than expected, but they fail to point out that in order to get those plans, many Americans will be required to accept less insurance protection for relatively minor hospitalizations and outpatient treatments.

INDIVIDUAL VS. WORK

Supporters of Obamacare are proud to say that the majority of Americans get their health insurance at work.  Technically, they are correct.  Anything over 50% is considered a majority.  The last statistics I read said that just over 60% of Americans get health insurance at work.

Unfortunately, not every American works at a company that offers health insurance.   While the majority of Americans do get health insurance at work, a large minority (40% of Americans) do not.

In the past, when insurance policies were regulated by the states, Americans were able to eliminate some benefits that were mandated for group plans if they were responsible to buy their own health insurance.

For example, one of the most costly benefits is maternity coverage.  Many states require employers to offer that type of coverage if they are going to offer group Major Medical.

Most individual health insurance plans do not automatically cover routine maternity.   In my state, individual Major Medical plans must cover only “complications of pregnancy.”  People who want insurance coverage for routine maternity and delivery costs must buy a separate maternity rider.

That way, single men and women who are not able to have babies are not required to pay for maternity bills from the hospitals and doctors.  Those costs are paid entirely by the people who use the benefits.

However, Obamacare forces a change on Americans.  Regardless of age or gender, every American is mandated to purchase an Essential Benefit Plan that includes maternity coverage.

The result of the mandated coverage, at least in my state, is that the cost break that people got, because they worked for a company that does not provide group health insurance and had to get their own Major Medical insurance, will disappear with Obamacare.

When plans are mandated to include full maternity and substance abuse benefits, they will be priced closer to what group policies are currently than the large discount that people in my state currently enjoy by eliminating some mandated benefits.

(I recognize that the same “discounts” are not available in every state.  However, in my opinion, the problem should be addressed in your state house rather than forced on all Americans through the federal government.  I do not understand why conservatives in Texas should pay for the insurance mandates of liberals in California and vice-versa.)

 After reviewing all the plans and facts, I have come to the conclusion that while the Democrats are technically correct, there will be plans available with premium increases less than expected, the Republicans are also correct.

In order to keep the same level of Major Medical coverage you have now for most out-patient procedures, you will need to pay significantly more than what you are paying now.

The other option is to accept the lower cost “Bronze” plan and purchase supplemental insurance policies that will help with the additional expenses.

Click where indicated to read the entire brochure.
Click where indicated to read the entire brochure.
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