The exchanges set up under the Affordable Care Act open tomorrow. While there were initially problems when the exchanges opened last year, these were quickly fixed, allowing millions to obtain health care coverage, including those who previously could not obtain coverage due to preexisting conditions or cost. A Gallup poll found that most people who obtained coverage through the exchanges last year were satisfied:
Over seven in 10 Americans who bought new health insurance policies through the government exchanges earlier this year rate the quality of their healthcare and their healthcare coverage as “excellent” or “good.” These positive evaluations are generally similar to the reviews that all insured Americans give to their health insurance.
These findings are consistent with previous polls showing how people benefited from Obamacare.
Insurance coverage has been made more affordable by the exchanges, with eighty-three percent of enrollees qualifying for subsidies last year. Those who qualified payed an average of $82 per month in premiums. Those obtaining Silver plans paid an average of $69 per month.
Three was some sticker shock on the part of many who did not realize that they qualify for subsidies along with those of us who do not qualify for subsidies. While we pay the full premiums, the coverage is far better than was available on the individual market in the past, including guarantees that we cannot lose our coverage if we get sick and caps on maximum annual out of pocket expenses. Some people, especially those who were not familiar with the individual insurance market were expecting lower premiums. Despite conservative claims that Obamacare is a right wing take over of health care, the insurance is sold through private companies and their rates have always been high, and frequently increased by double digit amounts annually.
Conservatives also complain about the deductibles, especially on the plans with lower premiums. These plans have higher deductibles and a lower premium, with Medical Savings Accounts available to help with these out of pocket expenses. Plans on the individual market have typically had higher deductibles than employer plans. The attacks from conservatives regarding this are also rather hypocritical as conservatives have long been advocating high deductible plans paired with MSA’s as a way to reduce costs. Now that they have what they advocated, they are suddenly complaining. I guess we shouldn’t be surprised as many other components of Obamacare have long been advocated by conservatives, including the individual mandate and selling insurance through exchanges.
While there may be higher deductibles, there are also total caps on out of pocket costs which we did not have before. The Affordable Care Act has eliminated the old maximums on coverage. Republicans never mention this, but these factors could result in lower out of pocket costs for many, along with eliminating the risk of bankruptcy for those with expensive diseases who outspend their coverage. All plans cover preventative services with no deductible. Some plans now being sold will provide some other forms of coverage before the deductible is met, including office calls and prescriptions.
While premiums in 2014 were consistent with previous premiums, instead of seeing double digit increases in 2015 most people are seeing comparable rates due to the increased number of insurance companies offering coverage and the larger risk pool as more people have coverage. Many people will even see lower insurance rates:
In preliminary but encouraging news for consumers and taxpayers, insurance filings show that average premiums will decline slightly next year in 16 major cities for a benchmark Obamacare plan.
Prices for a benchmark “silver” or mid-priced plan sold through the health law’s online marketplaces aren’t all moving in the same direction, however, a report from the Kaiser Family Foundation (KFF) shows. (Kaiser Health News is an editorially independent program of the foundation.) In Nashville, the premium will rise 8.7 percent, the largest increase in the study, while in Denver it will fall 15.6 percent, the largest decrease.
But overall the results, based on available filings, don’t show the double-digit percentage increases that some have anticipated for the second year of marketplace operation. On average, rates will drop 0.8 percent in the areas studied.
The latest attack from dishonest opponents of the plan has been to repeat irrelevant quotes from Jonathan Gruber, an economist who worked on Mitt Romney’s plan and also made economic projections on the impact of the Affordable Care Act. He is not a part of the Obama administration, and is not the “architect” of the plan as conservatives claim. Nor did he have a role in the writing or the promotion of the legislation. His comments that the American people were stupid do not reflect the views of anyone other than himself. His claims of a lack of transparency are incorrect, with the law having been written in open hearings and with the various versions having been posted on line. The two items he brought up, the penalties for not obtaining coverage, and the transfer of wealth from the healthy to the sick, were both openly discussed prior to the passage of the law. Besides, all insurance has always represented a transfer of wealth from those who purchase insurance and do not require the benefits to those who do require insurance benefits. Apparently many conservatives fail to understand how insurance works.