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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Big shocker there…

OmahaConservative on December 27, 2013 at 10:04 AM

well he at least slowed the rise of the oceans so there’s that…

DanMan on December 27, 2013 at 10:06 AM

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

roflmmfao

donabernathy on December 27, 2013 at 10:06 AM

It won’t be a surprise to those who have been paying attention for the past years.

Those who thought they were getting free healthcare provided by the rest of us..they need a good shock.

HumpBot Salvation on December 27, 2013 at 10:06 AM

When even the Name of a piece of legislation is a lie…..

Mord on December 27, 2013 at 10:10 AM

Even the name of the law is a lie. “Affordable…”

sadatoni on December 27, 2013 at 10:15 AM

We hang the petty thieves and appoint the great ones to public office. ~Aesop

roflmmfao

donabernathy on December 27, 2013 at 10:18 AM

ObamaCare, the gift that will keep on giving all year long.

GarandFan on December 27, 2013 at 10:19 AM

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

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.

Won’t happen, if 0 can avoid it by further delays. Hopefully the employers and insurance companies will not bow to the pressure from The Won to bail him out and delay cancellations.

iurockhead on December 27, 2013 at 10:21 AM

not like many of us were not talking about this 2 years ago.
screw it, the electorate (as a whole) deserves the bleeding this will cause.

dmacleo on December 27, 2013 at 10:22 AM

That’s weird, I thought Obamacare mandated six “free” doctors visits annually. And what about the “free” birth control and the “free” prescriptions. Is this miscommunications due to the fill in the blank bill or were these outright lies to the American people. It would appear that these plans would do nothing to the medical induced bankruptcies that The Won was so “worried” about.

Cindy Munford on December 27, 2013 at 10:24 AM

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.

Won’t happen, if 0 can avoid it by further delays. Hopefully the employers and insurance companies will not bow to the pressure from The Won to bail him out and delay cancellations.

iurockhead on December 27, 2013 at 10:21 AM

Said delays will be through Tuesday, 11/4/2014 only – once Wednesday, 11/5/2014 hits, let the kicking begin.

Steve Eggleston on December 27, 2013 at 10:26 AM

That’s weird, I thought Obamacare mandated six “free” doctors visits annually. And what about the “free” birth control and the “free” prescriptions. Is this miscommunications due to the fill in the blank bill or were these outright lies to the American people. It would appear that these plans would do nothing to the medical induced bankruptcies that The Won was so “worried” about.

Cindy Munford on December 27, 2013 at 10:24 AM

One of those is still there. I’ll let Sandra Fluke tell you which one.

Steve Eggleston on December 27, 2013 at 10:28 AM

This is news? I figured from the start that a $15K deductible meant just that. You pay up to $15K out of pocket before the insurance company coughed up any money. What am I missing?

NavyMustang on December 27, 2013 at 10:34 AM

Steve Eggleston on December 27, 2013 at 10:28 AM

I’m about to be guilty of several ists here……..the people who want to me pay for their children desire to sit on their ass all day at home instead of their birth control will not avail themselves of this perk.

Cindy Munford on December 27, 2013 at 10:37 AM

I really believe that “boutique” medical care is going to take off. I will be fascinated to see how the free market works with it.

Once people see that they are going to have to pay for the honor of having medical insurance which doesn’t pay them, they will go to the boutique doctors in droves.

Of course, the government will step in and screw it up. They can’t allow something like that to succeed, dontcha know.

NavyMustang on December 27, 2013 at 10:38 AM

The idiot 51% and the damage they’ve done… I’ve got grown men on my team who can quote the stats on all the key NFL players, but don’t know anything about the ACA, the NSA, the IRS, Benghazi, ETC.

But they knew enough to vote for Obama, ’cause he’s cool or something.

CaptFlood on December 27, 2013 at 10:38 AM

I just want to thank the media for doing its job so well on ObamaCare, and I hope to see many of them spending their golden years living in the comfort they have earned through their faithful service to their fellow citizens: huddled in a major appliance crate under a bridge, cold, hungry and alone. And sick.

drunyan8315 on December 27, 2013 at 10:39 AM

Damn gun thumpers

rik on December 27, 2013 at 10:44 AM

I feel nothing for the idiots that voted twice for O & now own a “wonderful” bronze plan. My only wish is to be a fly on the wall of each & everyone of them when reality smacks them.

Conservative4Ever on December 27, 2013 at 10:44 AM

Health Savings Accounts would be a great alternative to this for some people. If a young single adult put $200 per month and say the government contributed 30% to that, he/she would have roughly $3100 to use for medical bills, and you wouldn’t lose it because it would keep rolling over. If he/she put in $100 per month, he/she would have around $1500 by year end. Alas, it would be good for many individuals, but it would probably not be enough to pay for everyone else’s premiums.

lea on December 27, 2013 at 10:44 AM

I saw one set of numbers that when you factor in the deductible, the difference between the Bronze and Gold plans was about $100 a year.

J_Crater on December 27, 2013 at 10:44 AM

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.

No way that will happen. Obama will delay it until after the midterms.

Wigglesworth on December 27, 2013 at 10:45 AM

Wow, who could have seen this coming?

Chris of Rights on December 27, 2013 at 10:45 AM

I’m about to be guilty of several ists here……..the people who want to me pay for their children desire to sit on their ass all day at home instead of their birth control will not avail themselves of this perk.

Cindy Munford on December 27, 2013 at 10:37 AM

In my case, it’s blood, turnip, and unfruitful squeezing.

Steve Eggleston on December 27, 2013 at 10:46 AM

Health Savings Accounts would be a great alternative to this for some people. If a young single adult put $200 per month and say the government contributed 30% to that, he/she would have roughly $3100 to use for medical bills, and you wouldn’t lose it because it would keep rolling over. If he/she put in $100 per month, he/she would have around $1500 by year end. Alas, it would be good for many individuals, but it would probably not be enough to pay for everyone else’s premiums.

lea on December 27, 2013 at 10:44 AM

Which is why HSAs are essentially going away after this year.

Steve Eggleston on December 27, 2013 at 10:47 AM

Steve Eggleston on December 27, 2013 at 10:46 AM

So now we must ask…..will there be enough disenchanted to rectify this? The people who get siphoned to Medicaid are pretty much in the same boat they have always been in, their vote for the Left is safe. But what about the formally insured that now live with the financial burden of higher premiums and less care? Can our astute media convince them that this is all for the better? This is got to have some kind of impact on the economy, there will be some big ticket items that people will have to forgo with this added expense.

Cindy Munford on December 27, 2013 at 10:52 AM

lea on December 27, 2013 at 10:44 AM

My daughters job had health savings accounts and Obama’s decision to postpone the employer mandate gave them the ability to opt out of contributing this year to firm up their bottom line. It will be interesting to see what happens because she really liked her plan.

Cindy Munford on December 27, 2013 at 10:54 AM

Even without the elimination of HSA’s there was a large gap for some families.

The HSA max is $6500 or so. The deductible on our family bronze plan is $12k+. That’s 5K+ of fully taxed income to pay for this crap.

Of course, it’s all good. The government workers, unions and corporate cronies all have “seperate but equal” healthcare. They’ll be fine.

acyl72 on December 27, 2013 at 10:55 AM

I really believe that “boutique” medical care is going to take off. …

Of course, the government will step in and screw it up. They can’t allow something like that to succeed, dontcha know.

NavyMustang on December 27, 2013 at 10:38 AM

Remember “Hillary Care”? Part of her comprehensive plan to overhaul the health insurance industry was to prohibit cash payments to doctors.

You don’t suppose we might see that resurface in the near future….

Ace ODale on December 27, 2013 at 10:56 AM

Damn…. isn’t it common courtesy to at least get a reach around when ya bend over…

roflmmfao

donabernathy on December 27, 2013 at 10:56 AM

Yup. I’ve been saying this for months.

Imagine if you can, the young mother… maybe without a dad around to help out, who’s got two screaming toddlers with likely ear infections, and a six year old who’s supposed to be in school. She’s already aggravated for having been up all night dealing with the 2 and 4 year old kids as she packs them on the bus for the ride to her PC physician. She signs in, kids alternatively fighting with each other and crying from the ear aches, and waits the 45 minutes before being called to the check-in counter to render payment.

And she’s broke.

“Tonight at 6. Mother of three arrested at County Medical Professional Center today after allegedly attacking the receptionist at the Children’s Medical Care office on the third floor. We’ll have more information on the fate of the children as the mother awaits bail.”

BKeyser on December 27, 2013 at 10:56 AM

One of my libbie friends, who’d found a rather decent plan for herself & hubby, made SURE to brag about it on FB, awhile back.
Wellllllll …. she’s been having to back-track, announcing her dismay that they’ve had to take out a bank loan to meet her $5000 before she can see her oncologist, which has been scheduled for March.
Of course, she blames the insurance company (they didn’t tell me THAT part !), because, well, she’s a lib !

Not one peep from pambi, I’ll tell ya.

pambi on December 27, 2013 at 11:06 AM

… right before the midterms

Obama will be using “executive authority” to modify the law and delay the employer mandate until after the mid-terms.

TulsAmerican on December 27, 2013 at 11:09 AM

not like many of us were not talking about this 2 years ago.
screw it, the electorate (as a whole) deserves the bleeding this will cause.

dmacleo on December 27, 2013 at 10:22 AM

Those darn Tea Partiers, dumb hicks that Rove and the Chamber of Commerce want to eliminate.
What do we know?

At this point I’d rather elect a true blue lib than a pinkish RINO that has the support of Crossroads!

SayNo2-O on December 27, 2013 at 11:10 AM

The posted article in the NYT with Ron Johnson saying it’s done and the times saying the law is cemented gave me a chill. The republicans have capitulated. Now healthcare is a right.The law may be adjusted but it will never go away because of spineless repubs,cowards just like Holder said, and afraid to fight because they might offend someone.

tim c on December 27, 2013 at 11:12 AM

I just hope the general population in REALLY UPSET about this in NO-vember on voting day…

Khun Joe on December 27, 2013 at 11:13 AM

I have been posting about this for the past few months. This is going to be the breaking point for obamascare. People on Bronze plans actually have deductibles up to $12,000, $5700 and change is just the average. When these Bronze policy holders show up for their cardiac bypass surgery and are told they need to pay the $12,000 deductible, plus copay up front, it’s not going to be pretty. Doctors and hospitals will not extend credit to these people because with the low obamascare fees it will not be anywhere near cost effective.

Affordable my a$$

NOMOBO on December 27, 2013 at 11:17 AM

With ObamaCare comes ObamaRecession….

albill on December 27, 2013 at 11:19 AM

Unexpectedly!

David Blue on December 27, 2013 at 11:22 AM

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.

Clubs for medical conditions where individuals with said condition or conditions, crafted to get care that is necessary for that condition and working with physicians and pharmaceutical companies for group pricing with set payout would allow said clubs to actually address those conditions far better than ‘comprehensive coverage’.

Yet because the asinine idea of ‘health insurance’ has gotten sold to us as being the same as ‘health care’, you can’t get this sort of thing started because of the pre-existing system which attempts to give you everything, from both genders and all racial and ethnic backgrounds… in a Nation that is a melting pot and has diverse risk types by region, ethnicity and even by neighborhood.

I would gladly sign up for a couple of health clubs to allow me to cover the minimal necessary visits expected for my conditions, along with associated tests and a discount for the rarer major medical costs that can be associated with the conditions, and then some sort of catastrophic care that understands I have club care and that it doesn’t need to cover those areas.

Heck I would take an investment system of paying into a club formulation for future care years out by investing at a set rate that gets me some minimal benefits and allows me to forward pay for some of the larger costs expected with my disorders. That could be cross-club exchange portable like a bond that reaches maturity for cashing it in.

Any of this is scads better than what we currently have and what we have had since the end of WWII and wouldn’t require the biggies of ‘cross-State portability’ as the clubs could be set up locally with an exchange system worked out by the clubs for portability for those conditions they cover.

That requires that we first remove all overhead from the federal government on health care and health provisioning across the boards at all levels as each and every bit of legislation trying to make care more ‘affordable’ just cost shifts it with the expense of overhead for doing so added into the mix. That last is not a zero but a percentage of the cost which varies, but has gotten larger over time due to the complexity of the system. No one knows what ANY single visit or drug actually costs because of all the layers of complexity added in by law as a mandate and requirement. No one can say that ‘medical care is too expensive’ for anyone because we have no real sense of what it costs vs the value of it and having to weigh in the personal risks in the cost vs value equation.

‘Health insurance’ is not even a good way to mitigate risk as it is inherently not a bet about if you will even NEED health care that you have with an insurer. That is not insurance. If we want people to manage their own health care in a better way, then they need the freedom of not being penalized for walking away from the insane and bureaucratic system with kickbacks and penalties mandated by law. I have nothing against insurance companies but this is not insurance and they should have NO part in it.

You cannot ‘win’ by legislating good things via government power.

Everyone loses.

It is time to walk away from the game and call it rigged against the people of the United States by its government because IT IS.

Take all that overhead away and leave simple liability and waivers behind. Let individual freedom and liberty deal with the problems of life, let us pay what it actually costs to get health care without ‘help’, and then let the people contribute as much as they wish to medical charities to help their fellow man. That is the system we used to have and the poor were cared for and no one died in the streets, and all understood that the cost of health care was a burden for each of us and that we should help the less well off via charity, and that doctors and hospitals worked out payment plans for those things that did cost a lot.

That was a better system and we could do better with that as a basis and letting our freedom craft better solutions. Let liberty work its magic.

And I fully understand that doing that might just get me dead in short order.

I also understand that I may be a better manager for my own care than any ‘health insurance’ provider can ever do for me, and that I may just have more left over to give to charity and help my fellow man.

That cannot be done within a rigged system that is hostile to me, to you and to our fellow man. The system must go so that we can be free, or die trying.

ajacksonian on December 27, 2013 at 11:23 AM

“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.”

Legalizing twelve to twenty million undocumented Democrats should more than cover that – and that’s just what the GOP wants to do.

David Blue on December 27, 2013 at 11:27 AM

I really believe that “boutique” medical care is going to take off. I will be fascinated to see how the free market works with it.

Once people see that they are going to have to pay for the honor of having medical insurance which doesn’t pay them, they will go to the boutique doctors in droves.

NavyMustang on December 27, 2013 at 10:38 AM

Remember “Hillary Care”? Part of her comprehensive plan to overhaul the health insurance industry was to prohibit cash payments to doctors.

You don’t suppose we might see that resurface in the near future….

Ace ODale on December 27, 2013 at 10:56 AM

Maybe, but I bet “boutique” medical care might eventually look something like this: an obvious black market where doctor’s offices/clinics are in very nondescript buildings, or very well hidden within other buildings, with very careful security set up. Knowledge of the location would likely be hushed word of mouth. Payment for procedures would likely devolve into having an “official” set of books for the government and another for the actual deposits.

Or you and a friend or family member might visit a coffee shop or a library or store and be discreetly introduced to a ::: person ::: who, after speaking with them a few minutes, might know quite a bit about a medical issue you are having and can make quiet arrangements to take care of it.

Whatever happens with Obama/Hillarycare, I have full faith that my fellow American citizens — doctors and patients alike — will find very creative ways to not comply.

PatriotGal2257 on December 27, 2013 at 11:27 AM

wait a tic…dear leader signed up on the bronze plan…boy, is he in for a surprise

/

cmsinaz on December 27, 2013 at 11:28 AM

…And if healthcare is a ‘right,’ how can food and shelter not be? You might be fine for years without access to healthcare, but food and shelter are constants.

And to go off-topic, I’d love to hear HA’s take on the proposed new state of ‘Jefferson.’ Some very interesting arguments there (said the man from Massachusetts, who’s spent his life without any actual representation as to his wants and needs…)

CaptFlood on December 27, 2013 at 11:31 AM

“right before the midterms”?
With what we have seen them do already, why would anyone believe that the lawless obama administration would let that occur?

GaltBlvnAtty on December 27, 2013 at 11:35 AM

cmsinaz on December 27, 2013 at 11:28 AM

Hey, OC is looking for you on the Dyson thread. He is worried about your absence of late. Could you pop over there and let him know you are okey dokey

Cindy Munford on December 27, 2013 at 11:35 AM

Maybe, but I bet “boutique” medical care might eventually look something like this: an obvious black market where doctor’s offices/clinics are in very nondescript buildings, or very well hidden within other buildings, with very careful security set up. Knowledge of the location would likely be hushed word of mouth. Payment for procedures would likely devolve into having an “official” set of books for the government and another for the actual deposits.
PatriotGal2257 on December 27, 2013 at 11:27 AM

I like. So instead of whispering, “Joe sent me,” as was done during prohibition to gain access to the Speakeasys, we’d all whisper, “Ted sent me…”

CaptFlood on December 27, 2013 at 11:38 AM

Eight ways to opt-out of ObamaCare:
http://www.breitbart.com/Big-Government/2013/12/25/Top-8-Ways-To-Opt-Out-Of-ObamaCare

Cheetah1956 on December 27, 2013 at 11:40 AM

Thanks Cindy….will do

cmsinaz on December 27, 2013 at 11:40 AM

ajacksonian on December 27, 2013 at 11:23 AM

Very well stated, sir.

This is one of my favorite articles: The “Impossible” Health Care Solution: Go Back to Cash

PatriotGal2257 on December 27, 2013 at 11:43 AM

So now we must ask…..will there be enough disenchanted to rectify this? The people who get siphoned to Medicaid are pretty much in the same boat they have always been in, their vote for the Left is safe. But what about the formally insured that now live with the financial burden of higher premiums and less care? Can our astute media convince them that this is all for the better? This is got to have some kind of impact on the economy, there will be some big ticket items that people will have to forgo with this added expense.

Cindy Munford on December 27, 2013 at 10:52 AM

I would like to hope so, but never underestimate the power of being able to con people by offering “50% off” on something priced at three times its worth, which is what PlaceboCare is for the lower-middle class.

Steve Eggleston on December 27, 2013 at 11:43 AM

I’ve said for quite a while now that this is a giant tax hike and that you will be paying for 100% of your healthcare. Sure everyone allegedly will have health insurance but everyone will still be paying 100% of their healthcare costs. How many people spend 12k a year on healthcare? I’m sure there are some but I would bet it’s a minority. I don’t think I’ve spent more than 1k in the last 3 years and that is for a family of four. With BOcare, which I will be straddled with in 2015 because my employer will be dropping health insurance, I will never ever hit the deductible so I will be paying through the nose for insurance and paying 100% of any healthcare. On the bright side my post menopause wife will get free birth control. Then again it may only be free after the deductible is paid off.

BOcare is the biggest rip-off and screw job ever seen in this country and the MSM and left is orgasmic over it.

Dr. Frank Enstine on December 27, 2013 at 11:44 AM

CaptFlood on December 27, 2013 at 11:38 AM

Heh … :)

PatriotGal2257 on December 27, 2013 at 11:44 AM

Experts are worrying that some new enrollees will be discouraged from seeing doctors if they have to pay the full charge

Isn’t that the reason Obozo came up with this piece of crap in the first place…people weren’t going to the DR regularly and missing annual check-ups, making health-care more expensive. He just made it more expensive, and didn’t solve a thing. Genius!

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.

So, they will have to pay upwards of $10000 before they get any “coverage”. That’s even more for a family, where the deductible is $12000. What in the hell are they paying for then? What is they monthly payment buying? It doesn’t seem like it is buying a damn thing.

I don’t think anyone could have screwed anything up more thoroughly than they have with this. My hat’s off to you Democraps. Job well done! This was your goal all along.

Patriot Vet on December 27, 2013 at 11:44 AM

So now we must ask…..will there be enough disenchanted to rectify this? The people who get siphoned to Medicaid are pretty much in the same boat they have always been in, their vote for the Left is safe. But what about the formally insured that now live with the financial burden of higher premiums and less care? Can our astute media convince them that this is all for the better? This is got to have some kind of impact on the economy, there will be some big ticket items that people will have to forgo with this added expense.

Cindy Munford on December 27, 2013 at 10:52 AM

When people complain about deductibles they weren’t prepared for, the leftists will blame the insurance companies.

When people complain about being thrown off their employer based plans, the leftists will blame the employer.

It doesn’t matter that it was the leftists that created this situation, they have the media to sell whatever message they want to sell.

In both cases, the leftists will whip up a mob against 2 of the things they hate most. Insurance companies and employers. And it’ll work. It works every time it’s tried.

There is simply no downside for the leftists on this. If it didn’t mean the destruction of this country, you’d almost have to applaud them.

In other words, the media won’t try to convince anyone that any of this is in their best interests. They’ll simply convince everyone that if anything goes well it was the leftists who provided it, and if it goes badly it was the evil rich who took it away. And it’ll work. Again.

runawayyyy on December 27, 2013 at 11:48 AM

PatriotGal2257 on December 27, 2013 at 11:43 AM

Thank you, Ma’am.

The ‘system’ needs to go with the LiB philosophy.

Better off without the ‘system’ that we have foisted on us so we can start over and do better on our own. I trust my fellow citizens more than my government in this and many other areas.

ajacksonian on December 27, 2013 at 11:48 AM

I was on the ‘individual market,’ and, needless to say, my plan got cancelled, so I’ve been thinking a lot about this, and commenters on HA have really had a lot of smart input. What I’m thinking about doing at this point is just going without insurance, paying the penalty/tax, and putting the $450 per month that I would spend on Obamacare (double what my old plan cost) into a savings account instead, where at least it could earn interest, and keeping my fingers crossed. Thankfully, I’m relatively young and healthy and a single guy. (I can’t imagine what this ordeal must be like for people with families or more serious health concerns.)

That would be roughly $5400 a year right there (roughly what the deductible would be), and I would have it rather than throwing it away on junk health insurance.

WhatSlushfund on December 27, 2013 at 11:52 AM

runawayyyy on December 27, 2013 at 11:48 AM

I think you are correct. Although some people have had a good relationship with their insurance companies, they might be a little harder to convince but I am not sure there are enough of them.

Cindy Munford on December 27, 2013 at 11:53 AM

There is something missing in this entire debate. From my personal experience, I placed my son in the individual market due to the fact that the amount we need to pay for him on our company plan was about $500 per month. We got him a Kaiser policy. His policy wasn’t cancelled, they merely sent us a “negative consent” letter that stated his policy was changing and we now had to pay more than double. So… he’s not one of the “cancelled” policies that are being counted. Our premiums just doubled.

Alibali on December 27, 2013 at 11:58 AM

ajacksonian on December 27, 2013 at 11:48 AM

Yes. Agree with you completely. It will be very interesting to watch, for sure.

PatriotGal2257 on December 27, 2013 at 12:01 PM

“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.”

Technically, it’s already delayed until after the midterms because it starts in 2015. But, since insurance plans set premiums around May for the following year, the premium notices are going to start coming in well before the midterm elections, and they are going to be ugly. Obama would have to delay the small business part of Obamacare until at least 2016 to prevent that from happening and that would be a politically difficult thing to get away with.

eyedoc on December 27, 2013 at 12:04 PM

In both cases, the leftists will whip up a mob against 2 of the things they hate most. Insurance companies and employers. And it’ll work. It works every time it’s tried.

In other words, the media won’t try to convince anyone that any of this is in their best interests. They’ll simply convince everyone that if anything goes well it was the leftists who provided it, and if it goes badly it was the evil rich who took it away. And it’ll work. Again.

runawayyyy on December 27, 2013 at 11:48 AM

One of my coworkers was yakking about this very thing not too long ago, after Obama was badmouthing (again) the insurance companies for cancelling individual policies. IIRC, Obama was calling those plans “junk” and “substandard” and the government’s plans were oh-so-fabulous compared to them.

This boneheaded coworker of mine has the same insurance carrier that I do, obviously. They’ve been in our area for decades and I know I’ve been more than satisfied over the years with the level of care I’ve received. I can’t wait to see his reaction when we all get dumped out of our employer-sponsored plans next year and have to go on whatever Pennsylvania has cobbled together in terms of a state exchange — right now, there isn’t one. And I can’t wait to tell him how intellectually dishonest he is for badmouthing both our employer — who is giving him a paycheck — and the insurance carrier — who has provided him and his family with quality health care. It’s going to be very hard for me to conceal my total contempt.

PatriotGal2257 on December 27, 2013 at 12:14 PM

I’ve been wondering who wrote the ACA. See link below. Insurance companies are NOT the good guys here. And neither is big pharma. And the Obama administration were willing and able to do their dirty work.

http://commongroundamerica.net/Who_Wrote_the_PPACA.html

Alibali on December 27, 2013 at 12:22 PM

Some plans won’t pay for doctor visits before you meet your annual deductible, which could be thousands of dollars.

Some plans?! Surely they mean, “No plans.” That’s what deductible means.

There may be a few carefully controlled exceptions allowed so they can claim to give free doctor visits, but fundamentally, any deductible means the insurance company pays nothing until you’ve met the deductible.

There Goes the Neighborhood on December 27, 2013 at 12:23 PM

What else could one expect from Obama, Reid, Pelosi and their gaggle of slimy charlatans.

rplat on December 27, 2013 at 12:24 PM

I really believe that “boutique” medical care is going to take off. I will be fascinated to see how the free market works with it.

Once people see that they are going to have to pay for the honor of having medical insurance which doesn’t pay them, they will go to the boutique doctors in droves.

NavyMustang on December 27, 2013 at 10:38 AM

Remember “Hillary Care”? Part of her comprehensive plan to overhaul the health insurance industry was to prohibit cash payments to doctors.

You don’t suppose we might see that resurface in the near future….

Ace ODale on December 27, 2013 at 10:56 AM

Maybe, but I bet “boutique” medical care might eventually look something like this: an obvious black market where doctor’s offices/clinics are in very nondescript buildings, or very well hidden within other buildings, with very careful security set up. Knowledge of the location would likely be hushed word of mouth. Payment for procedures would likely devolve into having an “official” set of books for the government and another for the actual deposits.

Or you and a friend or family member might visit a coffee shop or a library or store and be discreetly introduced to a ::: person ::: who, after speaking with them a few minutes, might know quite a bit about a medical issue you are having and can make quiet arrangements to take care of it.

I don’t think it will take much effort to get lower prices…I called my local med center, claiming to not have coverage, and that I was interested in negotiating cash for services… Did they have a schedule of fees? Indeed they did, and they further informed that the price would be 40% off the published fee. The kicker… she said that was what had been negotiated by the insurance company… yes company, we have a single provider here in NH. Go figure…40% less, for cash!!!??? Soon we may be back to eggs and swine.

PatHenry on December 27, 2013 at 12:24 PM

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.

Past experience should have taught us that they’ll find some way to push the sticker shock until after the elections.

There Goes the Neighborhood on December 27, 2013 at 12:24 PM

And to go off-topic, I’d love to hear HA’s take on the proposed new state of ‘Jefferson.’

CaptFlood on December 27, 2013 at 11:31 AM

And to go further off-topic, how about talking up the Independent Republic of Texas. If that ever happens I’m worried that the continent would tip over on it’s side.

NOMOBO on December 27, 2013 at 12:31 PM

“Honey, I signed us up for Obamacare – we got bronzed.”

oldroy on December 27, 2013 at 12:34 PM

Another headline somewhere else yesterday said that the Bronze plan may be viewed like Medicaid…come to be seen as Medicaid, the only thing is, these Bronze plans cost too much for what really looks a lot like a catastrophic plan with Mrs. Seb’s 10 mandated coverages added in. If you pay all that, need a deductible of $5-6,000K where exactly is your premium going, these plans are NOT cheap no matter what Sebelius says.

What is being paid for with the premium dollars that is sucking up all the money?

As a Senator from Massachusetts, promoting the health care law, John Kerry said there was something like $750 billion spent every year on health care, and it was Being Spent Wrong, and on the Wrong People,that there was enough money in the system already to pay for whatever it was that he thought was the important things.

I presumed this meant that me, getting my nice employer bennies was getting something unfair, and what he wanted was my $27K from my employer, say, for my family plan, in the system with other people getting their’s first before I could use mine for my (insert indulgent health care want here) things I think I would like. But I did not know he meant this would apply to people with the bronze plan too. The goal of the government health care reform is to re prioritize the dollars to pay for the things the government thinks medical dollars should pay for, especially if it means they get to pay less. But expanding Medicaid doesn’t make the government pay less, so they need to tax the plan you are not allowed to use even more…so in the end you pay a lot and get nothing. And don’t think that any Single Payer utopian dream will be any different. Not with this government.

Instead of saying the Bronze plan will start to resemble Medicaid, they should say, that Medicaid needs to have a $5700 deductible before you get any free benefits, and charge them the co pay, because we know that is to discourage you from making frivolous claims…and why should Medicaid recipients not think about that too?

Fleuries on December 27, 2013 at 12:36 PM

Gee, a year ago I had one of those “junk” plans that had a much lower total out of pocket and offered physician and specialist co-pays without referral before the deductibles were met. It was an 80/20 plan. And it cost a lot less than every Bronze plan offered in my service area now.

How dumb I must have been to pay less for a plan that was really good and let me choose whether I wanted to pay for maternity and substance abuse benefits. I must have been blind to forgo paying for services I won’t use, thus lowering my plan cost. Dang those free-market choices. They really led me astray.

Philly on December 27, 2013 at 12:39 PM

Maybe, but I bet “boutique” medical care might eventually look something like this: an obvious black market where doctor’s offices/clinics are in very nondescript buildings, or very well hidden within other buildings, with very careful security set up. Knowledge of the location would likely be hushed word of mouth. Payment for procedures would likely devolve into having an “official” set of books for the government and another for the actual deposits.

There’s no reason for it to be hushed up because there’s nothing wrong with a patient not submitting a claim to their insurance company for services provided and paying cash instead. Except for Medicare. Medicare providers would have to drop out of Medicare in order to see Medicare patients for cash. The penalty for getting caught doing it without having dropped out of Medicare would probably not be worth taking the risk.

eyedoc on December 27, 2013 at 12:51 PM

“It’s worth the trouble. It’s going to be a glorious thing,”

..and it’s ME ME ME ME that twisted arms. threatened members, contorted and shredded the Constitution all because we.we..we just want to help you little people…

Have a nice day,

Nancy

BigSven on December 27, 2013 at 12:58 PM

Which means the choice will be to waste $500 a month on useless insurance or or use a portion of that money to pay the doctor direct. There will be a drop off of paid premiums once the logical choice is made.

TerryW on December 27, 2013 at 1:00 PM

The last line is the most significant.

Schadenfreude on December 27, 2013 at 1:02 PM

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.

Well, that’s what’s scheduled to happen, and what should happen according to the law… but does anyone think that’s what will happen? We already have the precedent of presidential ‘prerogative’ for selective enforcement.
If the employer mandate is delayed, I predict Republicans will harrumph at hearings and courts will find no one has standing to file suit.

Marcola on December 27, 2013 at 1:11 PM

Alibali on December 27, 2013 at 12:22 PM

You’re right, they aren’t the good guys and they will be bailed out then ultimately gotten rid of. They have to realize this and there are a small percentage of people who are making sure they get theirs and screw the rest of us.

Cindy Munford on December 27, 2013 at 1:11 PM

Grow it, dummies.

Schadenfreude on December 27, 2013 at 1:17 PM

PatHenry on December 27, 2013 at 12:24 PM

Five years ago, my hubby had to be admitted to the hospital for a week, very unexpectedly. At the time, I had us both signed up for an HSA plan four months before, figuring that we were both in pretty good health and could manage what I thought were only going to be occasional doctor’s visits through it.

When he was discharged, I had nowhere near the amount of money in the HSA to pay the hospital bill, so I called them. The customer service clerk immediately asked for my credit card number, but I told her I did not want to put it on any credit card and that I’d like to set up a payment plan. They did, and I paid the amount they stipulated (and doubled up the payments when I could) for the next year or so until it was paid off.

I plan to ask now what the cash fee is going to be for any health care needs we have going forward.

PatriotGal2257 on December 27, 2013 at 1:25 PM

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.

Or 4 visits to the ER at $1,500 a pop minimum. And that’s exactly what they’re going to do.

xblade on December 27, 2013 at 1:29 PM

“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,”

I don’t know ANYONE who could afford this. If you’re young and in perfect health you’d be throwing away money on premiums every month if you go all year without having to see a doctor. It would make more sense to put those premiums in a savings. If you’re middle aged and have some issues you’ll go broke seeing the doctor. Only an insane idiot could call this an affordable act.

scalleywag on December 27, 2013 at 1:30 PM

There’s no reason for it to be hushed up because there’s nothing wrong with a patient not submitting a claim to their insurance company for services provided and paying cash instead. Except for Medicare. Medicare providers would have to drop out of Medicare in order to see Medicare patients for cash. The penalty for getting caught doing it without having dropped out of Medicare would probably not be worth taking the risk.

eyedoc on December 27, 2013 at 12:51 PM

Very true! Thank you for your insight — it’s good to have a doctor here explaining the real-world facts of the matter.

I guess I’ve been reading too many spy novels. :)

PatriotGal2257 on December 27, 2013 at 1:32 PM

ObamaCare, the gift that will keep on giving all year long.

GarandFan on December 27, 2013 at 10:19 AM

Kinda like cancer.

bw222 on December 27, 2013 at 1:33 PM

Most all of us here knew damn well what was coming, so it’s no surprise to us.

But will this “sticker shock” be enough to bring about an open revolt from the ‘working class,’ who were NOT expecting this?

Stay tuned . . . . . . . . .

listens2glenn on December 27, 2013 at 1:55 PM

“Honey, I signed us up for Obamacare – we got bronzed.”

oldroy on December 27, 2013 at 12:34 PM

.
. . . : )

listens2glenn on December 27, 2013 at 1:56 PM

This boneheaded coworker of mine has the same insurance carrier that I do, obviously. They’ve been in our area for decades and I know I’ve been more than satisfied over the years with the level of care I’ve received. I can’t wait to see his reaction when we all get dumped out of our employer-sponsored plans next year and have to go on whatever Pennsylvania has cobbled together in terms of a state exchange — right now, there isn’t one. And I can’t wait to tell him how intellectually dishonest he is for badmouthing both our employer — who is giving him a paycheck — and the insurance carrier — who has provided him and his family with quality health care. It’s going to be very hard for me to conceal my total contempt.

PatriotGal2257 on December 27, 2013 at 12:14 PM

Some of us don’t have to wait. My fortune 500 employer decided to comply with the law as it was written, and as a result I lost my plan a year ago. Along with 30,000 others at least. Surely we aren’t the only ones.

They did offer an ACA-compliant plan, of course, which is pretty much what’s described here. The premiums weren’t significantly higher, but the deductible was enourmous. So I dropped it and we’re all now on my wife’s plan.

In other words, the insurance industry is now getting less than half the money from us that they used to. My copays are a little higher, but until her company decides to comply or dump us I’ll ride it out and give less than I was.

runawayyyy on December 27, 2013 at 1:59 PM

Silver plans are almost no different than the bronze ones. I am in California, and I figured that until you have $9,400 of medical bills, you are better off paying cash than buying a bronze plan. With the silver plan, that’s $9,100–only a few hundred dollars different. Both have the same $6,350 max a year (which still doesn’t count co-pays), so you are almost always better off with the bronze plan–in the end, the premium becomes the main difference.

Of course, medical providers know full well that the consumer is on the hook for all this money, and many are talking about getting the cash up-front, before treatment–and that’s if you can even find an MD who will see you.

HakerA on December 27, 2013 at 2:03 PM

I compared my numbers for every metal level using the lowest plan where the deductible counted toward the out of pocket and where it did not. With the exception of one platinum plan, the bronze plan is the worst overall cost if you max out your health insurance on an annual basis. Granted, these numbers apply to my age, income and family size, but I think the overall pattern of costs likely applies nationwide as deductibles and out of pockets are fixed per plan per state.

You can see where the only winners under this system are not the poor, but those that are the sickest and use the most healthcare.

These of course are only the in-network maximums, as, in my opinion, you are basically without insurance if you have an emergency while traveling out of your network.

Deductible does not count toward annual out of pocket amount
                              Annual Premium      +Deductible and Max Out of Pocket
                              (subsidized)
Bronze                 $2,747.16                 $23,447.16
Silver                   $3,911.52                 $15,911.52
Gold                     $5,972.64                 $16,472.64
Platinum            $7,876.32                 $11,476.32
Platinum            $8,024.40                 $11,024.40
Platinum            $8,762.40                 $14,762.40
Either no deductible or deductible counts toward annual out of pocket amount.
Bronze                 $3,019.68                 $13,619.68
Silver                   $3,911.52                 $11,145.52
Gold                     $5,549.28                 $9,749.28
Platinum            $7,876.32                 $11,476.32
Platinum            $8,024.40                 $11,024.40
Platinum            $8,762.40                 $14,762.40

As a side-note, other than creating my own website and blog is it too much to ask for comments that you can cut and paste tables into? Also, auto-refresh has eaten this post thrice before I could post it. Perhaps wordpress isn’t the best platform for a professional blog of this caliber.

NancyWhisky on December 27, 2013 at 2:50 PM

Some of us don’t have to wait. My fortune 500 employer decided to comply with the law as it was written, and as a result I lost my plan a year ago. Along with 30,000 others at least. Surely we aren’t the only ones.

They did offer an ACA-compliant plan, of course, which is pretty much what’s described here. The premiums weren’t significantly higher, but the deductible was enourmous. So I dropped it and we’re all now on my wife’s plan.

In other words, the insurance industry is now getting less than half the money from us that they used to. My copays are a little higher, but until her company decides to comply or dump us I’ll ride it out and give less than I was.

runawayyyy on December 27, 2013 at 1:59 PM

We all got a letter not too long ago, which said that our employer-sponsored plans were in compliance with the ACA through Jan. 2014. The costs went up a little bit, but not by an outrageous amount. I won’t have the option of going to my hubby’s plan because he’s self-employed and on mine. What’s going to happen after Jan. 2014 is anybody’s guess — mine being that we’re all going to be dumped. Don’t know what we’re going to do yet once that happens, but I’m sure we’ll figure it out when we’ll be presented with “options.”

PatriotGal2257 on December 27, 2013 at 2:58 PM

Gee, a year ago I had one of those “junk” plans that had a much lower total out of pocket and offered physician and specialist co-pays without referral before the deductibles were met. It was an 80/20 plan. And it cost a lot less than every Bronze plan offered in my service area now.

How dumb I must have been to pay less for a plan that was really good and let me choose whether I wanted to pay for maternity and substance abuse benefits. I must have been blind to forgo paying for services I won’t use, thus lowering my plan cost. Dang those free-market choices. They really led me astray.

Philly on December 27, 2013 at 12:39 PM

This is a lamentation that will be heard in many quarters where the occupants voted for Obama. Miserabile dictu.

timberline on December 27, 2013 at 3:08 PM

Good for all you budding statisticians and neolithic marketing annalists out there that after all is said and done are starting to look at this ACA mess objectively and with less emotions. Yes it is a tangled mess that will continue to weave a web of deceit for some time to come. So stand down from it en mass or live with it for ever. It ain’t going away.

Now young’s we need to turn our united efforts to what caused this problem. Our Government? Yes BUT! The Democrats? Yes BUT! The one set of DOTS that connecters. 9-11, ACA, Fast and Furious, WACO TX. Ruby Ridge, Benghazi, and a few dozen others is????

THE LACK OF ACCOUNTABILITY.

No one but no one in this government is ever held accountable for anything they do.

“We The People” are the fault of this. We do not hold there feet to the fire for the mistakes they put on us.

jpcpt03 on December 27, 2013 at 3:37 PM

As I have said on here in the past, people are going to wake up to reality about the 4th of July when they are still paying out of pocket at the Doctor or the Pharmacy. That is when it will hit them that they have been seriously lied to.

Johnnyreb on December 27, 2013 at 3:51 PM

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.

New Headline:

America much healthier

Since the advent of ObamaCare, fewer people are going to the doctors indicating that America is the healthiest country in the world.
“Before Obamacare, the average family visited the doctor an average of 2.7 visits per year, since the inception of ObamaCare it has dropped to less then .8 visits, a 1/3 drop in doctors visits”, stated the worlds highest authorities in health care, “…it’s a miracle that only a Messiah could have created”…

right2bright on December 27, 2013 at 4:06 PM

Schadenfreude

Bmore on December 27, 2013 at 4:22 PM

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