Wednesday, October 2, 2013

The "Affordable" Healthcare Act.....

Well, the healthcare marketplace thingy is open. And now the lies are beginning to be exposed. Or confirmed. Or re-lied. Or covered up and sugarcoated.

Taxes, fees, and more lies.

Remember back in September 2009 when Mr. Obama said that requiring health insurance (individual mandate) is NOT a tax increase? (http://www.cnn.com/2009/POLITICS/09/20/obama.health.care/)
"For us to say you have to take responsibility to get health insurance is absolutely not a tax increase," Obama said in response to persistent questioning, later adding: "Nobody considers that a tax increase."


Cool. Wait.....

Remember back in June 2012 when the Supreme court said that as a fee or fine (penalty) the individual mandate would be unconstitutional, however it is Constitutional as a tax? (http://www.cnn.com/2012/06/28/politics/supreme-court-health-ruling/index.html)
"It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance," Chief Justice John Roberts wrote in the majority opinion. "Such legislation is within Congress's power to tax." He later added: "The federal government does not have the power to order people to buy health insurance. ... The federal government does have the power to impose a tax on those without health insurance."

Now that the healthcare marketplace is available.... guess what? It's not a tax anymore! It's a FEE! A PENATLY! (https://www.healthcare.gov/get-covered-a-1-page-guide-to-the-health-insurance-marketplace/, https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/)

"If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1% of your income (whichever is higher). The fee increases every year."
So, lets take a look at these "affordable" healthcare plans. By the way, for all you folks who voted for Obama and cheering on the "free health insurance" you thought you were going to get... There's no such thing as free.

What's it gonna cost?

According to the Obamacare site, "The plans are presented in 5 categories: Bronze, Silver, Gold, Platinum, and Catastrophic" (https://www.healthcare.gov/health-plan-information/)

One caveat here. I am not going to be able to give final prices without filling out an application, and I sure as heck am not going to be filling out an application, so these prices may vary. I'm going to show the prices as listed for my state and county (Shelby County in Alabama), and my situation (Family with both parents) As the site says, family size and income affect the final price:
"IMPORTANT NOTE: The prices here don’t reflect the lower costs an applicant may qualify for based on household size and income. Many people who apply will qualify for reduced costs through tax credits that are automatically applied to monthly premiums. These credits will significantly lower the prices shown for a majority of those applying. Final price quotes are available only after someone has completed a Marketplace application."


In my area there are 2 companies listed for healthcare insurance providers. Humana Insurance Company and Blue Cross and Blue Shield of Alabama. Both are offering PPO type plans. These figures are per month and are straight from the https://www.healthcare.gov/how-do-i-choose-marketplace-insurance/ website as of the writing of this post. By the way, this is just the monthly premium, not the copays, coinsurance and deductibles.

Humana Catastrophic: $473.50
Humana Bronze: $622.96
Humana Silver: $706.50
Humana Gold: $805.82
Humana Platinum: $908.50

BCBSAL Blue Protect Catastrophic: $497.94
BCBSAL Blue Saver Bronze: $575.72
BCBSAL Blue Value Silver: $713.56
BCBSAL Blue Saver Silver: $756.90
BCBSAL Blue Value Gold: $923.62
BCBSAL Blue Choice Platinum: $1111.46

Welcome to the world of "Free" healthcare. You can estimate your costs with the Kaiser Family Foundation health insurance costs and savings calculator. (https://www.healthcare.gov/how-can-i-get-an-estimate-of-costs-and-savings-on-marketplace-health-insurance/)

I plugged in my numbers and it says I would pay, for me and my family (taking in account the $1,691 annual tax subsidy they say I would get):

Catastrophic: "With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ($12,700 in 2014)."
Bronze: $791.66
Silver: "The plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest"
Gold: Not listed
Platinum: Not listed

Based on the website , all plans cover "10 essential health benefits"  which include the following:
  • ambulatory patient services
  • emergency services
  • hospitalization
  • maternity and newborn care
  • mental health and substance use disorder services, including behavioral health treatment
  • prescription drugs
  • rehabilitative and habilitative services and devices
  • laboratory services
  • preventive and wellness services and chronic disease management
  • pediatric services, including oral and vision care.

This page shows an example of the difference between plans. Basically the more of a premium you pay, the lower percentage you pay when you actually use healthcare. So, if you have to see a doctor and get medicine, you'll pay a percentage of that cost on top of what you are already paying for the monthly premium. Here's how it shakes out for that:

  • Bronze plan: 40%
  • Silver plan: 30%
  • Gold plan:  20%
  • Platinum plan: 10%

  • So if I'm on a Bronze plan and take my child to the dermatologist for severe acne, and they prescribe Accutane, I can expect to pay my monthly premium of $791.66 PLUS 40% of  doctors charges and medicine costs. Lets just say the doctor is pretty cheap and only charges $100 for the office visit. My part of that is $40. Accutane is a pretty expensive drug and my 40% of about $420 (actual cost when we had to get it for one of my kids) comes to $168. So I've just paid $208 for a doctor visit and 1 month supply of medicine under Obamacare.

    Under my current plan, I pay $439 monthly premium ($352.66 less than Obamacare Bronze), I pay a $30 office visit copay ($10 less than Obamacare Bronze) and $30 for a premium level medication ($130 less than Obamacare). Therefore, under the Affordable Healthcare Act, for one month's premium, 1 doctor office visit, and 1 month supply of medication, I will pay $500.66 MORE than I do now.

    I currently pay $439/month in healthcare insurance. This is expected to rise by as much as 30% next year (if our employer still offers it!) thanks to Obamacare. Affordable? For those of you that voted for Obama and our current set of Democratic congress, when will you pull your heads out of your collective socialist asses?

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