Surprise! Bronze plans may cost a lot more than you expect

posted at 10:01 am on December 27, 2013 by Ed Morrissey

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:

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.


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Comment pages: 1 2

I just went shopping at my local Walmart Superstore, and the very nice cashier and I shared holiday greetings and talked about the new year to come.

She is terrified about the economy. I told her I am in the same place. She notices people buying less, opting for more generic products, and making hard choices about what to leave in the cart or put back on the shelf. Although she would not say the word “Obamacare”, she alluded to it. The cashier said the thing she was led to believe would help her will end up hurting her. And my heart goes out to her.

We will all feel the pain, one way or another.

Philly on December 27, 2013 at 4:41 PM

Bmore. Best page Turner in the business. He also turns wood.

SparkPlug on December 27, 2013 at 4:55 PM

ObamaCare fails on every level. But the website has pretty colors.

SparkPlug on December 27, 2013 at 4:55 PM

Philly on December 27, 2013 at 4:41 PM

This is what I think could push the economy into a nose dive. A couple of years ago when gas prices were rising, the talking heads complained about commuters having to pay an extra $50 to $100 per month for fuel. They talked about the extreme hardship being put on the citizenry.

A $100 per month is a drop in the medical insurance bucket.

Not many people have the dough for premiums, much less visits. There will be no more expendable income and retailers (and the rest of the economy) will tank.

Pazman on December 27, 2013 at 5:03 PM

Is RWM gone or just taking a break?

22044 on December 27, 2013 at 1:27 PM

RWM has been gone? Still a member in good standing.

Ed Morrissey on December 27, 2013 at 1:33 PM

In case anyone missed this in the Top 50 of 2013 thread, Ed posted this…

OmahaConservative on December 27, 2013 at 5:08 PM

I just went shopping at my local Walmart Superstore, and the very nice cashier and I shared holiday greetings and talked about the new year to come.

She is terrified about the economy. I told her I am in the same place. She notices people buying less, opting for more generic products, and making hard choices about what to leave in the cart or put back on the shelf. Although she would not say the word “Obamacare”, she alluded to it. The cashier said the thing she was led to believe would help her will end up hurting her. And my heart goes out to her.

We will all feel the pain, one way or another.

Philly on December 27, 2013 at 4:41 PM

Excellent post.

The outcry against Democrat/Choomcare that we start hearing in January is going to cause mass deafness because of its decibel level…

Anti-Control on December 27, 2013 at 5:12 PM

This is what I think could push the economy into a nose dive. A couple of years ago when gas prices were rising, the talking heads complained about commuters having to pay an extra $50 to $100 per month for fuel. They talked about the extreme hardship being put on the citizenry.

A $100 per month is a drop in the medical insurance bucket.

Not many people have the dough for premiums, much less visits. There will be no more expendable income and retailers (and the rest of the economy) will tank.

Pazman on December 27, 2013 at 5:03 PM

Undeniably true.

Leftards like libfreeliveenslavedordie and verbaloser have their heads up the Preezy’s butt, and fail to understand & see this coming – they will be in for quite a shock come next month!

Anti-Control on December 27, 2013 at 5:20 PM

One bright spot in all this might be that having to pay cash for medical care, that amounts to thousands of dollars, could be the start of a greater consumer awareness of the price of health care with heightened appreciation for the value received for the price ratio.

Right now the employer market would likely swamp the effects of the high deductibles in the individual market but if/when employers start to dump employees onto the individual market the effects of a more cash oriented health care system might start to manifest itself.

This is not to say that the rather drastic change in how the health care market works is going to be pleasant, but it could be a start.

Russ808 on December 27, 2013 at 6:04 PM

This is why I got a gold plan.

besser tot als rot on December 27, 2013 at 6:04 PM

Too lazy to page back but I guess this is troll free?

CWchangedhisNicagain on December 27, 2013 at 6:09 PM

Too lazy to page back but I guess this is troll free?

CWchangedhisNicagain on December 27, 2013 at 6:09 PM

Hi:

Robertson’s Win:

In a statement from the network, executives said that while “Phil’s comments … reflect his personal views based on his own beliefs, and his own personal journey, he and his family regret the coarse language he used and the misinterpetation of his core beliefs based only on the article.”
“After discussions with the Robertson family, as well as consulting with numerous advocacy groups, A&E has decided to resume filming ‘Duck Dynasty’ later this spring with the entire Robertson family.”

http://www.latimes.com/entertainment/tv/showtracker/la-et-st-duck-dynasty-phil-robertson-to-return-to-show-20131227,0,7212096.story#ixzz2oifvZWA8

kcewa on December 27, 2013 at 6:14 PM

And Obama’s Rolling 9/11 against American’s health care continues.

VorDaj on December 27, 2013 at 6:15 PM

Kweca… hello…ain’t that awesome? I heard Medved talking about that on the way home tonight.

CWchangedhisNicagain on December 27, 2013 at 6:19 PM

CWchangedhisNicagain on December 27, 2013 at 6:19 PM

Were you banned once and then came back, ‘bud?
Glad to see ya’ again…

OmahaConservative on December 27, 2013 at 6:35 PM

Pazman on December 27, 2013 at 5:03 PM

I am planning my investment strategy for the year. It’s very easy: Take profits and run. I won’t be out completely, but I will not have as much in equities or bonds this year. I will not be spending much, either. I started scaling back in 2009 and I will be even more frugal this year.

There’s a reason why a Wall Street guy advised people to invest in food and ammo for the coming year. He must be one of those redneck tea partiers.

Homeland Security has millions of rounds and so should we.

Philly on December 27, 2013 at 6:38 PM

Robertson’s Win:
In a statement from the network, executives said that while “Phil’s comments … reflect his personal views based on his own beliefs, and his own personal journey, he and his family regret the coarse language he used and the misinterpetation of his core beliefs based only on the article.”
“After discussions with the Robertson family, as well as consulting with numerous advocacy groups, A&E has decided to resume filming ‘Duck Dynasty’ later this spring with the entire Robertson family.”
http://www.latimes.com/entertainment/tv/showtracker/la-et-st-duck-dynasty-phil-robertson-to-return-to-show-20131227,0,7212096.story#ixzz2oifvZWA8

Where is the HotAir post? HotAir certainly isn’t as quick as it used to be. I remember how posts were often updated multiple times. Today posts are rarely updated.

bluegill on December 27, 2013 at 6:54 PM

…no tin plan?

KOOLAID2 on December 27, 2013 at 7:06 PM

This is why I got a gold plan.

besser tot als rot on December 27, 2013 at 6:04 PM

And they’ll come after you next with the Cadillac plan tax.

Kensington on December 27, 2013 at 8:04 PM

Watched Cavuto on fox,interesting segment on ACA, the problem was
1. the percentage some one will have to pay is being misrepresented, they showed premiums of 19k for a couple earning 65k problem is the deductible was 10k so the actual cost to them before it starts paying anything is 29k almost half their income, didn’t say it was before or after taxes.
2. the person from fortune magazine was saying they will have access to health care, well the jury is still out on that one. sometime next year we will find out about that one, problem is will anyone report problems.
3. no mention of the new taxes that kick in in Jan 2014

RonK on December 27, 2013 at 9:01 PM

A family of four only needs to pay $12,000 before coverage begins here in California. Or $6,000 per person, whichever is less.

Those people who quality to have all but $200 per month of their premiums covered should be happy.

They will only have to pay $8,400 for the entire year should they enter the hospital.

/sarc

unclesmrgol on December 27, 2013 at 9:52 PM

PT was right…. there’s one born every minute!

roflmmfao

donabernathy on December 27, 2013 at 10:06 AM

Actually, he’s now wrong because the pace has picked up to 2.4 idiots born per second.

Steve Eggleston on December 27, 2013 at 10:20 AM

To be honest, they’re not born, they’re created.

The public screwls generate 2.4 functional idiots every second and Common Core is designed to kick it into overdrive and double them. By 2020, they expect the 47% to become 90% and the remaining 10% will be the elite overlords appropriately trained at the exclusive École nationale d’administration and it junior affiliates.

AH_C on December 27, 2013 at 11:14 PM

Why has it been so hard for people to figure this out? I’ve been uninsured for 17 years and have no intention of buying a policy from Obama. They are only worth buying if you KNOW you have a very significant health issue, a big one, not anything less than that. I’m not about to waste $11,000 for my wife and me for _rap.

BillCarson on December 27, 2013 at 11:30 PM

A family of four only needs to pay $12,000 before coverage begins here in California. Or $6,000 per person, whichever is less.

Those people who quality to have all but $200 per month of their premiums covered should be happy.

They will only have to pay $8,400 for the entire year should they enter the hospital.

/sarc

unclesmrgol on December 27, 2013 at 9:52 PM

I know this is sarcastic, but the penny has not dropped with many people: those that were one-paycheck-away-from-bankruptcy can neither afford the deductible nor the premium. We’re not talking just about those receiving a subsidy.

virgo on December 28, 2013 at 12:05 AM

The average deductible among the examined bronze plans in Miami is $5,735.

Yeh, we’ll at least they’re insured now. Thanks Obamacare! /

Hill60 on December 28, 2013 at 12:20 AM

The American people, or 51% of them who bothered to vote, wanted this to happen.

Give them what they voted for–give it to them good and hard.

MidniteRambler on December 28, 2013 at 6:18 AM

PT Barnum once said ‘A sucker is born every minute”.

With Obamacare a sucker is born every second.

banzaibob on December 28, 2013 at 8:41 AM

So I wuz right–it is the UnAffordable Less Care Act!

stukinIL4now on December 28, 2013 at 10:53 AM

The “ACA” or “Obamacare” was NEVER about healthcare, people. It was ALWAYS about income redistribution and government control.

LilyBart on December 28, 2013 at 10:58 AM

The “ACA” or “Obamacare” was NEVER about healthcare, people. It was ALWAYS about income redistribution and government control.
LilyBart on December 28, 2013 at 10:58 AM

I think you are rights but I believe that your thoughts could be expanded on.

The current governments priorities are:

1.THE PRESERVATION AND GROWTH OF THE PARTY
2.HEALTHCARE THROUGHT INCOME REDISTRIBUTION
3.BETTERMENT OF THE PEOPLE THROUGH GOVERNMENT CONTROL
4.PRESERVATION OF THE PARTY THROUGH INCOME RESIDTRIBUTION AND GOVERNMENT CONTROL

These are the trunnions of a collective communistic philosophy.

Please all historians out there correct me. The systems that have some what worked through out history:

Had a disparage between the bottom group and the top groups in their societies.
Societies that worked very well were those where the bottom group maintained the believe that they could be in the top group.
The top group had responsibilities to the society and that if they did not maintain those responsibilities they could be in the bottom group.

It is this conveyor belt of society that maintains the balance on wealth distribution NOT the control of government.

jpcpt03 on December 28, 2013 at 12:33 PM

Has anyone ever figured out what the cost to taxpayers would have been if the gov’t just paid the health insurance premiums for people that actually want health insurance but cannot afford it?

JetBlast on December 28, 2013 at 1:08 PM

Has anyone ever figured out what the cost to taxpayers would have been if the gov’t just paid the health insurance premiums for people that actually want health insurance but cannot afford it?
JetBlast on December 28, 2013 at 1:08 PM

Good question. No real answer since no one really knows the cost of ACA nor how many people would be in the Target group or what the cost would be for each individual.

There are a few facts that can be used and a few some what “safe” assumption that can be made. So here goes a best queses.

Total US population = 316,668,567
15% uninsured = 47,500,285
7% not buy choice = 22,166,799
3.5% would = 11,083,399

ACA cost to date are $3-6 Trillion dollars
Average cost of insurance is about $5,800/year, premiums plus deducts.

These are generally amounts that the government has been putting out with the exception of the ACA Costs which are what is generally floating through the blogs and the news.

You can set this up your self on a spread sheet and as the news changes you can see the cost changes.

Any case here goes. Target population of 11,083,399 X annual cost $5,800 = Annual cost $64,283,719,101. That’s $64.2 Billion or about 1%-2% of what the first year ACA costs are.

You can use what ever numbers you like from what ever source you can find and the answer is going to be some variation of the same that ACA is very, very, costly.

lest we forget they have the TOP, TOP people on this and the are not accountable for any of it

jpcpt03 on December 28, 2013 at 4:39 PM

I ran across this Web site “obamacarefacts.com”, owned by and the only site of “walt whitney dog Media Solutions” and run by it’s creative director and vice president at dog Media Solutions of New York City, a Marketing and advertising agency.

My first thoughts were to see if media can actual give unbiased and non-miss leading information for the public to learn from.

The first things that caught my attention was that there was no date on the information. Second thing was that who were these people providing me the information?

In spite of this their first sentence looked good, “Obamacare Facts provides unbiased information on ObamaCare (the Affordable Care Act or ACA), health care reform and the health insurance marketplace.”

Went to “Cost of ObamaCare: Obama Care Cost” went through the first two paragraphs and gave up. The sit was so filled with miss direction and well crafted wordings as to be useless for any fact gathering. If then you can find out that his is put together by an advertising agency for a due profit. Then the only questions that remain is who was the client and do we add this cost to the total cost of ACA.

It is “We The People” that suffer from these attempts to sell the “New Car Oder” and not the values of the program.

jpcpt03 on December 28, 2013 at 7:52 PM

I have not heard or read of any new policy that relieves the hospitals of the requirement to treat anyone regardless of their ability to pay.

This had created generations of people who use the emergency rooms as their doctor office, for free medical care. Having insurance that has a co-pay is not going to change how they seek medical care. They know how to get it for free without a co-pay, though now, assuming they got it free, paid for by tax payers, they will present their junk Obamacare insurance card and continue to game the system as before. Of course they may have an advantage and get a silver plan at taxpayer expense, but if there is a deductible or co-pay, it will be the emergency room. or taxpayer paid clinic they head to.

Now we have a group of people who had insurance that paid part of the cost of seeing the doctor, that now pays nothing until the deductible is paid. Some of those will join the free loaders in the ER, and others will either suffer through and hope it is not something serious with an unfortunate diagnosis on down the road, or they will do as they have always done and accepted the responsibility and added a payment plan to the medical insurance burden.

Bottom line is that more people than before will be unable to afford the cost of seeing a doctor, or may not be able to find a doctor, and will end up in the emergency rooms. Can our hospitals deal with this new burden without raising cost as they do now on those who have insurance that will pay or can pay out of pocket?

insurance companies negotiate how much they pay. The difference is charged to the patient. Those that can pay will now have the additional burden of paying for those who can’t, along with the unaffordable junk policies that are set up to pay nothing for basic care.

Franklyn on December 29, 2013 at 3:07 PM

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