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Saturday, July 11, 2015

The left speaks out against Obamacare

Slate:  ...The bill for the health care expansion is coming due, just as the recipients will be heading to the ballot box to vote in the first primaries for the 2016 election. More than a few are likely to be annoyed. 

Last week Oregon’s insurance commissioner, Laura Cali, announced that the state had approved a 25 percent premium increase for the largest health insurer on the state’s exchanges. The second largest insurer did even better: It received permission to boost its monthly charge to consumers by 33 percent.

Oregon might be the first health insurance exchange equivalent of a penguin getting shoved off an ice floe, but it won’t be alone in the freezing-cold waters for long. For example, BlueCross BlueShield of Tennessee requested an average 36 percent price increase for the plans it offers—after receiving a 19 percent bump last year. And that sounds like a relative bargain compared with Minnesota and New Mexico, where the BlueCross BlueShield family is looking for increases of more than 50 percent. Even if the final numbers are lower than the asks, it seems quite likely these states will approve substantive premium increases.

The problem is simple. As Trudy Lieberman reported this month in Harper’s, the ACA made a decent stab at solving the problem of Americans lacking insurance. Unfortunately, the bargain struck to get the bill to a point where lobbyists for the hospital, insurance, and pharmaceutical industries to sign on, or at least not fight it, did not adequately address the issue of overall medical costs.
And that’s where the consumer comes in. Someone is “it,” the party paying the bill. And that “it” is increasingly you, whether you receive insurance on the exchanges or from an employer.


True, more than 80 percent of those purchasing insurance on the exchanges are eligible for subsidies for their premiums. But that’s not a solution, in either the short-term or the long-term. First, there are still deductibles, and although subsidies covering parts of the deductible and other approved costs are available to those meeting certain income limits who sign up for particular plans on the exchanges, it’s a complicated, difficult-to-understand process.* Second, subsidies don’t mean freebie. The taxpayer pays the money to the insurance industry, leaving less funding for other priorities. Third, of course, it leaves the people who are not eligible for subsidies feeling like chumps, stuck paying the bill for a health insurance expansion that, no matter how necessary, many of them don’t see as offering them enough in return for their own personal increased costs. It’s highly unlikely they will give the reforms a pass simply because premiums were also increasing before the ACA became law. Obamacare, after all, was supposed to put a stop to this sort of thing.

In sum, it’s a problem so pressing that even Ezekiel Emanuel, one of the major players behind Obama’s health care reforms, took to the Wall Street Journal this week to declare, “If Mr. Obama doesn’t act soon to control costs, escalating costs may ultimately threaten the sustainability of his coverage expansion.”
In the meantime, you shouldn’t need a political consultant to tell you why consumers paying hundreds of dollars—or even more than $1,000 a month—for health insurance they are required to buy and often can’t afford to use might well get angry. Once you name something the Affordable Care Act, people oddly expect the product on offer to be affordable. Who’d have thunk it?

(Full story)

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