Obamacare

Obamacare Leaves Many With Fewer Choices and Higher Prices

Insurers are bolting from the health law's exchanges, and premiums are rising dramatically.

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credit—KEVIN DIETSCH/UPI/Newscom

Remember when Obamacare's health insurance exchanges were supposed to work like buying a TV on Amazon?

In September 2013, just a few days before the exchanges created under the Affordable Care Act were set to go live, President Obama gave a speech in Largo, Maryland, describing what using those exchanges would be like:

"It's a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak—same way you shop for a TV on Amazon," he said. "You just go on and you start looking, and here are all the options. It's buying insurance on the private market, but because now you're part of a big group plan—everybody in Maryland is all logging in and taking a look at the prices—you've got new choices. Now you've got new competition, because insurers want your business. And that means you will have cheaper prices."

The next month, the exchanges went online, sort of. For the first two months or so, the federal exchange system, which covers a majority of states, was essentially unusable.

Today, the exchanges function properly in a technical sense, at least on the front end that consumers deal with. But for many people they are still not providing the inexpensive, competition-rich experience that Obama promised.

When open enrollment, the period of time during which people are allowed to sign up for exchange-based coverage or switch plans under the law, begins later this year, about a third of the country will have just one option, according to a report from health policy consultancy Avalere Health. More than half of the country will have just two choices. In Pinal county in Arizona, there will be no insurance options available on the exchange at all. Close to 10,000 people in the county purchased coverage through exchange last year. "Depending on where consumers live, their choice of insurance plans may decrease for 2017," Avalere Senior Vice President Elizabeth Carpenter said in a statement.

The exchanges are not fostering competition as promised. While the experience varies by county, it is clear that in many cases, insurers do not want to be in the exchange business.

Major insurers such as Aetna, Humana, and UnitedHealth have all reduced their participation in the health law's exchanges. In Texas, reports indicate that more insurers may be on their way out.

Premiums for health coverage purchased under the exchanges, meanwhile, are set to rise in many places throughout the country, in some cases dramatically. In Tennessee, for example, two big insures, Cigna and Humana, recently filed revised premium increase with the state. In both cases, they were revised upwards by double digits, with Cigna proposing an average of increase of 46 percent, up from 23 percent, and Humana requesting a 44 percent increase, up from 29 percent. BlueCross BlueShield, which did not revise its June request, had already put in for a 62 percent increase.

Obamacare's system of insurance exchanges was often described by its supporters as a kind of private market. But the system does not constitute a private marketplace in any meaningful sense. The exchanges are operated by states and the federal government, and although they facilitate the sale of private health insurance plans, the features of those plans, and the terms of sale, are heavily regulated, making it difficult for insurers to compete by differentiating their products. These are government-designed plans being sold through a government-run store. And while insurers may still sell policies off exchange, for the most part those policies must conform to the same regulations as plans sold through the system.

This design leaves insurers with few options regarding how to conduct their business, reducing the question into a binary choice of whether to participate or not. In many cases, we now see, they are choosing the latter.

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  1. Insurers are bolting from the health law’s exchanges, and premiums are rising dramatically.

    My God. Somebody should tell the President!

    1. If only Comrade Stalin knew of these things!

      1. Evidently his daily copies of Pravda are getting lost in the mail.

      2. This is literally speculators and wreckers ruining it. What are the responsible organs waiting for?!

        1. Bach’s Fugue in G Minor?

    2. MARKET FAILURE!!!1111!!!

  2. 8%!!!!!! GREATEST FREE MARKUT REFORM EVAH! PHAKE SKANDULL!!! NOBODIE CAREZ!!!!

    /derp

    1. The latest excuse I’m seeing for this from Obamacare supporters is that “11 million more people are now covered.” Well, that’s great, but if no one else can afford to pay their insurance, who gives a shit if all these new Medicaid recipients are getting their cheddar?

      And this is for a pseudo-market solution like Obamacare; why the hell should I trust these same people to competently run a government-run healthcare program?

    2. He was right about the last part.

  3. Don’t worry: Hillary says she will open it up to illegal aliens. That will help the balance sheets, right…?

    1. Those illegals will behave in their rational self intrest as the legals.

      The sick will sign up and the healthy will avoid it if possible.

      1. That’s because they’re racist!

  4. Man Obama is just gonna feel awful about how terribly this law has shaken out when he’s sitting in his Chicago mansion writing his memoirs and watching the View.

    1. Obama is more of an LA guy, I think. We’ll see where he settles after he leaves the White House, but I bet its not Chicago.

      1. Places you can golf year-round?

      2. I thought he was staying in DC?

        1. I’ll be surprised if he does. Why settle for “Hollywood for Ugly People” when he can go to the real Hollywood and hang with the Beautiful People?

          1. His wife probably wants a career in politics.

            http://www.marketwatch.com/sto…..2016-05-25

            Only being leased though.

        2. Oh, interesting. I don’t recall a former president settling in DC during my lifetime. I thought it was an unwritten rule.

          The article claims they are staying in DC so the youngest daughter can finish school there. Perhaps they are planning to relocate afterwards, which would explain the rental.

      3. He finally returns to Kenya.

  5. Anecdotal:

    Our finance people tell us they really haven’t seen an increase in people with commercial insurance, and in particular they don’t see much that they recognize as exchange insurance.

    Other hospitals that we talk to say pretty much the same thing. To the extent ObamaCare has helped us, its been Medicaid expansion.

    ObamaCare has hurt us because policies almost universally have much higher deductibles and copays, which aren’t necessarily getting paid. We’ve written off several million dollars worth of deductibles this year. We’re still ahead, a little, on Medicaid expansion, I think.

    1. Since the passage of that law my employer switched to the high deductible plans. Unfortunately they cost just as much as the old insurance, but don’t cover jack shit. So as a result I have racked up about $3K a year in medical bills since the passage of that law (I have a special needs kid). With no end in sight. Sucks ass.

      1. I know an oncologist who was a huge Obama and ObamaCare supporter. Until he started having to tell patients that he couldn’t begin ridding their bodies of cancer until they paid him what was left of their deductible (frequently $5K+).

        1. Sucks for me because I pay my debts. Even if it takes a while, I’m just stupid like that.

          1. You’re a Lanister?

            1. Never seen that show.

      2. I feel for ya sarcasmic – I’ve got a special needs kid too – so far my company has only raised the cost just a few percentage points over the past 3-4 years. It hasn’t been a big bite – yet.

        I do notice when I go to the local Med Center that I seem to get preferential treatment because I do carry insurance that does pay out. Maybe it’s just my white privilege.

        1. My insurance premiums are almost 20% of my income. And they’re going up by another $80/month next year. Sucks ass.

          1. At this rate by 2018 my insurance will cost more than my mortgage. And that doesn’t count the $3K a year that it doesn’t cover. I really don’t know what I’m going to do. Get a second job maybe, just for medical bills.

    2. I suppose this is the downside of the libertarian preference for catastrophic insurance. The way people, especially the poor and lower-middle-class, live, pretty much any unexpected expense is catastrophic.

      1. Health “insurance” is the only kind of insurance that isn’t sold as catastrophic coverage. That’s because of its special tax status. When you get it as a benefit it’s not taxable so ever since WWII when that was instituted as a way for companies to get better people when they were still stuck under a wage freeze, more and more was covered by “insurance” to where it covered every day stuff that, pre-special tax status, would have been expected to be paid out of pocket.

        Of course, when something isn’t paid for directly by the consumer, more and more of it gets used and costs go up. Outrageous court settlements make it even worse. Ten zillion tests to confirm what the doctor knew in a five minute exam. Antibiotics prescribed for a virus (which antibiotics do nothing for) because it makes people feel better to be taking a pill for something. Going to the doctor (or even worse, the ER) for a bee sting or a minor sprain.

        My last doctor visit was to a new doctor and had to move a few prescriptions that I’ve been taking for over a decade, some for as long as 30 years. He ordered a $1000 tox screen test. For what? I have no idea. He didn’t even tell me he was ordering it.

  6. Pish Posh! I’ve heard no complaints in the New York Times, clearly the program is working as well as it can what with the Obstructionist GOP congress trying to nickel and dime consumers…. anyway, president hillary is going to add the promised Public Option, so all this whining is just jealousy that the Party of the Future is WINNING.

  7. So in other words, it’s working exactly as intended.

    To fail and pave the way for single-payer.

    1. We’ll have Venezuelan-style health care long before we have Venezuelan-style groceries.

      Should be fun. If some of us survive.

      May the odds be ever in your favor, compatriots!

  8. Excellent. Everything is going as planned.

    1. I really think this whole thesis that the ACA was “planned” to fail…. (as Gojira also says above)….

      ….is attributing malice (and a complex conspiracy) to things that “hubris and incompetence” actually explain far better.

      People like Jon Gruber weren’t tasked to design a federal system that was doomed to explode. They actually knew what they potential ‘Death Spiral’ risks were in its formation, but they just thought they could either bulldoze through them, or blame them on the other party.

      All of their plans were sort of screwed by the epic-fail of implementation. Because there was no one to blame except themselves. and then they got slaughtered in the mid-terms over it. And the idea that TEAM BLUE could bully-pulpit the ACA into popularity was abandoned.

      shorter = i don’t see any evidence anyone wanted this to be a stepping stone to a public option. The people who continue to think that nationalized HC is a great idea remains (in my guess) a minority, and the entrenched interests who pay for lots of Team Blue pols aren’t actually crazy about it either.

      The SEIU want more spending of any type. public option, or super-subsidized, it doesn’t matter. what they don’t want is something to blow up and give the GOP an opportunity to pull their claws out of an industry that is one of their last strongholds.

      just my $0.02

      1. I’m just making a Star Wars reference.

        I think Obama wanted to be able to say he was the one to finally pass health care legislation. Hopefully it worked, but if not, well that’s other people’s problems.

        1. I think Obama wanted to be able to say he was the one to finally pass health care legislation

          Yes, exactly. I think the prime concern about whether it ultimately succeeded or failed was actually a secondary issue. It was ‘moving the ball forward’. – towards nationalized healthcare? who cares. just as long as Team Blue gets a W in their column in the short term.

          keystone was sort of the same sort of thing. it had nothing to do with merits, and everything to do with handing key constituents “a win”.

          1. It was ‘moving the ball forward’. – towards nationalized healthcare? who cares. just as long as Team Blue gets a W in their column in the short term.

            Bingo. High-time preference politics at its finest. “We have to pass it to find out what’s in it.” Who cares about how it will actually work, just sign the damn thing and give us our photo-op. The GOP didn’t help matters by refusing to put an actual free-market reform on the table, just so they could claim to wanting to fix the problem.

          2. it had nothing to do with merits, and everything to do with handing key constituents “a win”.

            Also known as “democratic politics.” Practically nobody cares what’s happening or why, only that their side wins. They make up excuses after the fact as to why they support a given initiative and will hand-wave away any evidence to the contrary no matter how strong.

      2. Yeah, pretty much this. I do think they saw it as a stepping stone, but only because they thought it would work and then people would be more amenable to a public option or single payer.

        1. I disagree. There wasn’t any complex conspiracy necessary to see that ACA was a looming train-wreck and that the solution that the proletariat would clamor for would be nationalized single-payer health-care.

          There’s only two easily foreseeable steps. No 3-D Obama Checkers involved.

          1. There wasn’t any complex conspiracy necessary to see that ACA was a looming train-wreck

            Nope.

            There were similar ideas floated by republicans in the past, and “Romneycare” was a model for state-involvement which Lobbyists favored and kept pitching to pols.

            The idea that it was born to die is just wrong.

      3. There’s a handful of vids or reports of Dems saying that replacing it with single-payer was the plan all along.

        For what that’s worth.

  9. Hillary will fix it. Though I am shilling for Jill now, I still love Hillary and she can do no wrong in my eyes. (I used to be a devout Trumpkin – but then I realized that you people are idiots and don’t deserve such a great leader. So, I am voting Johnson/Weld lest they call me ‘pathetic’ for wasting my time on here.)

    1. You should take 8% less cocaine before posting.

      1. AddictionMyth seems like more of a jenkem guy.

      2. I kind of like this sock. Smelling its own farts as it congratulates itself on what it thinks is unnoticed trolling. 8% more than the original one, anyways.

        1. Have you read its “blog”?

          1. Check your sanity privilege, cis-realistic shitlord!

          2. You guys don’t deal with it as much as I do. Always posts at odd times. Thinking its blog may be a google translation from its original Yakut.

      3. It couldn’t figure out how to reduce the amount by 8%

    2. This is just a guess, but I’m pretty sure nobody cares about your death spiral.

      1. I care, but then again I am that rare libertarian who genuinely cares about other people.

    3. Out of some perverse sense of wonder, I clicked on the handle and took a trip to the addictionmyth website. I’m not quite sure what to make of it all…

      1. It’s a cry for help, and I am ready to help him.

        1. +1 tale told by an idiot, full of sound and fury, signifying nothing

      2. Weigel is a manic depressive who depends heavily on medication to keep from bumping himself off.

        His lunacy he engages in on here is almost certainly a result of going too long without his meds. Personally, I wish he would just finally succumb to the ultimate urge.

  10. The first year of ObamaCare I attempted 106 times to log on and set up an account on the pathetic website without success. I eventually bought PPO insurance directly from BC/BS on its website. This year I discovered that the one can only get the ObamaCare tax credit if the insurance is purchased on the pathetic ObamaCare website. F*ck you very much, Obama.

    Last year BC/BS canceled all their PPO plans. So, for 2016, I opted for an EPO from Aetna. It’s much more difficult to navigate an EPO than a PPO, and wife had to fire her ob/gyn for the past 26 years. The increase in cost from 2014 to 2015 was 26%, from $1000/mo to $1263/mo. The new policy has a $12,900 deductible. F*ck you very much, Pelosi.

    Aetna announced last week that they’re quitting Texas, so I’ll shop again in December. But I don’t think I’m going to be buying because rates are projected to increase another 60% for 2016. That’s $2000/mo., about $36,000 out of pocket before insurance covers a dime, and it is just not worth it. So I’ll probably be going uninsured for the first time in 40 years thanks to ObamaCare.

    Before ObamaCare, I had PPO insurance for around $600/month and a $10,000 deductible.

    Sounds like something one would encounter in banana republic, no? But at least my 60-year-old wife can get free contraceptives and I can get gender reassignment covered if I want.

    1. CTC, are you also CatotheElder? Just wondering if that was a Dante reference to Cato the Younger or something else.

    2. That’s right. Think positive!

      You are getting far more coverage now than you ever had!

    3. 1263/mo.

      Holy shit- that’s approximately my mortgage payment.

  11. Really looking forward to the single-payer fight during Hillary’s first term. Maybe Roberts can help her with that when it gets to the Court.

    1. Prediction: single payer will get passed, and will just be starting to ramp up in this country when every other country on earth starts backing away from it.

      1. Too optimistic, Citizen.

        Single payer will get implemented by DHS as a regulation (or possibly “guidance”) and will be paid for without burdening Congress with things like “bills” and “appropriations”.

        Congress will go along enthusiastically, as it won’t be responsible for any of it.

  12. Suderman, you finally read The Iron Laws and took them to heart, didn’t you?

    To wit:

    You get more of what you reward and less of what you punish.

    Major insurers such as Aetna, Humana, and UnitedHealth have all reduced their participation in the health law’s exchanges. In Texas, reports indicate that more insurers may be on their way out.

    Money and power will always find each other.

    These are government-designed plans being sold through a government-run store.

    If everything is a priority, nothing is a priority.

    This design leaves insurers with few options regarding how to conduct their business, reducing the question into a binary choice of whether to participate or not. In many cases, we now see, they are choosing the latter

    The less you know about something, the easier it looks.

    The next month, the exchanges went online, sort of. For the first two months or so, the federal exchange system, which covers a majority of states, was essentially unusable.

    You aren’t free unless you are free to be wrong.

    ..Cigna and Humana, recently filed revised premium increase with the state. In both cases, they were revised upwards by double digits, with Cigna proposing an average of increase of 46 percent, up from 23 percent, and Humana requesting a 44 percent increase, up from 29 percent. BlueCross BlueShield, which did not revise its June request, had already put in for a 62 percent increase.

    (cont)

    1. You get more of what you reward and less of what you punish.

      This is especially true when it comes to these risk corridors, which are perhaps the stupidest part of the whole thing.

      You’ll give us money if we record a loss but take money from us if we record a profit?

      Gee, I wonder if you’ll be more likely to see profits or losses. Hmm….

  13. (cont)

    Me today, you tomorrow.

    The exchanges are operated by states and the federal government, and although they facilitate the sale of private health insurance plans, the features of those plans, and the terms of sale, are heavily regulated, making it difficult for insurers to compete by differentiating their products.

    Foreseeable consequences are not unintended.

    Then…

    Remember when Obamacare’s health insurance exchanges were supposed to work like buying a TV on Amazon?

    Now…

    Today, the exchanges function properly in a technical sense, at least on the front end that consumers deal with. But for many people they are still not providing the inexpensive, competition-rich experience that Obama promised.

    Meaning comes from context.

    Obamacare’s system of insurance exchanges was often described by its supporters as a kind of private market. But the system does not constitute a private marketplace in any meaningful sense.

    1. Didn’t realize there was a new one. I’ll have to update my list.

      1. The Compleat [sic] Iron Laws, as compiled by RC Dean, Counselor and philosopher extraordinaire.

    2. Corollary to rule #5

      It is always Today

      You are never getting yours.

      1. You get support from where you get it

        amirite guys? Amirite?

  14. Looks like Suderman is just getting Megan to do his work today….

  15. A feature, not a bug, on the pathway to the progressive ultimate goal: single payer / governmentally controlled and run healthcare. Good job Barry!

  16. It amuses me that one of the arguments for Obamacare was that while there were low-cost insurance plans on the market, they were terrible because they had high deductibles. And now official Obamacare plans turn out to cost a lot, and have high deductibles.

  17. The Obamacare supporters throw out a bunch of BS in response to these stories about massive premium increases.

    Some claim that the rates had already been going up that fast beforehand (total bullshit).

    Some claim the pre-existing policies were “substandard” (total bullshit).

    Some claim that the subsidies bring people’s costs down but that does nothing for those who make too much money to qualify for them. Those folks get the double whammy of paying full cost for individual policies and paying taxes to further subsidize those who don’t.

    Some get all sanctimonious and question how dare you not want to help pay for people with pre-existing conditions.

    Basically their attitude is that is perfectly acceptable to sacrifice those higher income folks who need to buy individual polices.

  18. Suderman keeps hammering this issue, when a nobel prize winning economist has characterized this as an minor crack in the road. How many nobel prizes does Suderman have?

    1. What did the economist win a Nobel prize for?

      There isn’t a Nobel prize for economics.

      There is prize established by a Swedish bank in the name of Nobel.

  19. Fewer options? Bernie approves.

  20. Yes, the costs went up and the care went down. I mean, come on people! The gubment called it the “Affordable Care Act” right? So you should have know it would not be affordable and that you would receive less care, right? I KNOW I am not the only one seeing the pattern here…. (War on Poverty, War on Drugs, War on Terror, we have less of any of those?)

  21. That’s really cool. I would be interested in seeing more graphs of different information you pull from these logs.

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