Affordable Care Act hasn't made health care affordable, study finds

Collapse
X
 
  • Time
  • Show
Clear All
new posts
  • Lady Marva
    Senior Member
    • Wednesday, June 17, 2015
    • 13321

    #1

    Affordable Care Act hasn't made health care affordable, study finds

    Thanks for nothing but more money out of my paycheck, Obama.

    http://www.msn.com/en-us/money/marke...b4R7&ocid=iehp
    Despite it’s name, the primary goal of the Affordable Care Act was to expand health care coverage to millions of Americans who had been uninsured. And while it’s done that — 15 million non-elderly adults have gained coverage — making that insurance “affordable” remains a significant challenge.

    Government subsidies for enrollees with incomes below 400 percent of the federal poverty level were designed to help with that, but rising premiums and high deductibles mean that getting health care coverage and treatment remains a financial burden for many Americans. A new study from the Urban Institute shows just how high the toll can be.


    The study found that the median single enrollee earning between $35,310 and $47,080, or a family of four earning between $72,750 and $97,000, will spend almost 15 percent of their income next year on Obamacare insurance premiums and out-of-pocket costs in 2016, even with federal government subsidies. The percentages increase for those with worsening health and those over age 45. And 10 percent of people in the income range the Urban Institute researchers looked at, between 200 percent and 500 percent of the federal poverty level, will spend more than 21 percent of their income on health care costs.

    Although there’s no objective standard for how much people should spend on health care, “a lot of people make the judgment that it’s unaffordable and that makes a real impact,” says Matthew Buetggens, a senior research associate at the Urban Institute and co-author of the study. A Kaiser Family Foundation survey found that cost is the main reason the uninsured give for why they lack coverage.

    Those costs could become a threat to the Obamacare program overall. “The affordability of marketplace premiums and out-of-pocket limits need to be further addressed to reduce the risk that enrollment and reductions in the number of uninsured will be well below the law’s objectives,” the report reads.

    The health care law created penalties for not signing up, and those fees rose this year and will climb again next year. But once the penalties flatten, if the cost of health care continues growing, more people will face financial pressure to drop out of the exchange, Buetggens says: “It’s going to be a gradual decrease in enrollment, but it’s definitely real.”

    Some progress has been made toward making Obamacare actually affordable, though. The Urban Institute report finds that 17.3 percent of non-elderly adults said they had problems paying their medical bills in 2015, down from 22 percent in 2013.

    Of course, steeper health care costs aren’t just limited to those covered by Obamacare — people with employer-based plans are also going to see larger premiums and out-of-pocket costs next year.
    According to an analysis from the employee benefits consultancy Aon Hewitt, the combined premium and out-of-pocket costs for employees are going to be more than $5,000 for the first time next year. For workers who make $50,000 or less annually, that means health care costs will account for about 10 percent of their income. But in general, those with employer-based plans, especially for plans offered by large employers, the premiums and out-of-pocket costs are lower than for those with Obamacare.
  • Tom Servo
    Area Man
    • Tuesday, October 1, 2013
    • 5898

    #2
    Everyone act surprised. Even a relative of mine who crowed about how much cheaper her health coverage became after ACA went into effect (nutshell: her employer dropped health insurance for all employees but gave everyone a raise that was bigger than the first year cost to buy on the marketplace) is starting to feel the burn as her premium almost doubles for 2016. It's simply illogical to think that this is getting something for nothing. The so-called "savings" have to come from somewhere.

    Having said that, all private insurance goes up every year, or almost every year, anyway. It's how the system works. Saying that they are shouldering the burden isn't really fair, their costs go up either way.

    When it comes to healthcare, we traded a beat up Chevy for a beat up Ford all while still making Cadillac car payments we can't afford. When you're too poor to afford a luxury car payment, you have to cut back, but no one seems to have the guts to legislate the kind of cuts we need. Or better yet, save your payments and take the bus - but few seem to be on the single-payer bandwagon.

    At this point, a moderately successful government controlled venture would still be better than the mandated free market horse squeeze we have now.
    “Any sufficiently advanced capitalism is indistinguishable from rent seeking.” ~ =j

    Comment

    • Lady Marva
      Senior Member
      • Wednesday, June 17, 2015
      • 13321

      #3
      Originally posted by Tom Servo View Post
      (nutshell: her employer dropped health insurance for all employees but gave everyone a raise that was bigger than the first year cost to buy on the marketplace)
      No surprise at that either. Agree, all that "free" stuff has to be paid for by somebody. Which is making premiums and deductibles upping.
      And that whole mantra "People won't get as sick because they're getting preventative care".......... uh huh. not happening with high deductibles and co-pays.

      Comment

      • Gingersnap
        Resident stylistic consultant
        • Tuesday, October 1, 2013
        • 24058

        #4
        Government healthcare is what it is. In Scandinavia there is an extensive healthcare network and it's great! It's great for what it is: trauma, childbirth, and some preventative health care.

        It's not great for chronic illnesses, unusual health problems, problems related to old age, or aggressive treatment of cancers or normal cancer screenings that you would get in the States. But that system was never designed to mimic U.S. style treatment.

        It was designed to provide solutions to the most prevalent problems of the 1930s - 1970s: trauma, childhood nutrition, pre and post natal care, vaccinations, etc. There's nothing wrong with that. However, even those countries have had to bow to popular demand and allow supplemental health insurance for all the people who want to get a heart stent or a knee replacement or better treatment for lupus or lymphoma in some kind of relevant time frame.

        Maybe Americans are okay with V.A. style health care. Your broken leg gets fixed that day but your cervical cancer might have to wait a while. Your prenatal care is both free and intense but your prostrate problem is both slower and has fewer options. Your childhood screening tests are frequent but your post-50 tests, not so much.
        "Alexa, slaughter the fatted calf."

        Comment

        • Celeste Chalfonte
          apostate
          • Saturday, October 5, 2013
          • 27897

          #5
          I don't understand these stories. My insurance is an employment benefit, but I've bought HRH an individual policy since we moved here. Keep in mind that she DOES have a chronic medical condition (2, in fact), and since I support her, we've never applied for a subsidy. The first year, it was just under $200/month. The premium dropped by about $12/month when ACA went into effect. Kaiser switched her over to an ACA plan that was comparable in benefits to what she had pre-ACA, except some co-pays were about $5 higher; no big deal, since it just about evened out (Kaiser fills all Rx for 3 month at a time, with only one co-pay). Starting in January, it's going up about $9/month. I'm not seeing a dramatic difference.

          I assume our group program has to be ACA-compliant. I certainly haven't seen any problem with the coverage. My 2-level back surgery cost me less than $500 out of pocket.
          "Since the historic ruling, the Lovings have become icons for equality. Mildred released a statement on the 40th anniversary of the ruling in 2007: 'I am proud that Richard’s and my name is on a court case that can help reinforce the love, the commitment, the fairness, and the family that so many people, Black or white, young or old, gay or straight, seek in life. I support the freedom to marry for all. That’s what Loving, and loving, are all about.'." - Mildred Loving (Loving v. Virginia)

          Comment

          • Gingersnap
            Resident stylistic consultant
            • Tuesday, October 1, 2013
            • 24058

            #6
            I am also with Kaiser and have been for a million years (not for any mental health stuff, though). I think big HMOs are less price sensitive to the AHCA because they already manage patient costs.

            While I can get a same-day appointment with a PA if I'm barfing or pus-ridden, I can't just get a minor surgery appointment even though I have a history of sebaceous cysts which are scary-looking and now prone to wild infections. I have to see my doc and then see a skin guy and then maybe get the appointment.

            Same deal with my crazy Hashimoto's disease. My doc knows that my problem is wacky and needs pretty frequent monitoring (not once a year) but I can only get to have an endocrinologist look at my tests (not see me or anything) once a year. So she gamely guesses about my situation until I crash which I do about every 18 months.

            Don't get me wrong - if I was in a tragic car crash and needed state-of-the-art spleen intervention, Kaiser would be great!
            "Alexa, slaughter the fatted calf."

            Comment

            • Celeste Chalfonte
              apostate
              • Saturday, October 5, 2013
              • 27897

              #7
              Originally posted by Gingersnap View Post
              I am also with Kaiser and have been for a million years (not for any mental health stuff, though). I think big HMOs are less price sensitive to the AHCA because they already manage patient costs.

              While I can get a same-day appointment with a PA if I'm barfing or pus-ridden, I can't just get a minor surgery appointment even though I have a history of sebaceous cysts which are scary-looking and now prone to wild infections. I have to see my doc and then see a skin guy and then maybe get the appointment.

              Same deal with my crazy Hashimoto's disease. My doc knows that my problem is wacky and needs pretty frequent monitoring (not once a year) but I can only get to have an endocrinologist look at my tests (not see me or anything) once a year. So she gamely guesses about my situation until I crash which I do about every 18 months.

              Don't get me wrong - if I was in a tragic car crash and needed state-of-the-art spleen intervention, Kaiser would be great!
              Kaiser is highly variable by region and even by facility. There's nothing in your Kaiser coverage provisions that keeps you from seeing your endicrinologist when you need to. You need to get Member Services involved if you're being told that.

              This is what I do for a living.
              "Since the historic ruling, the Lovings have become icons for equality. Mildred released a statement on the 40th anniversary of the ruling in 2007: 'I am proud that Richard’s and my name is on a court case that can help reinforce the love, the commitment, the fairness, and the family that so many people, Black or white, young or old, gay or straight, seek in life. I support the freedom to marry for all. That’s what Loving, and loving, are all about.'." - Mildred Loving (Loving v. Virginia)

              Comment

              • scott
                Go-to Guru
                • Tuesday, October 1, 2013
                • 15799

                #8
                Originally posted by Celeste Chalfonte View Post
                I don't understand these stories. My insurance is an employment benefit, but I've bought HRH an individual policy since we moved here. Keep in mind that she DOES have a chronic medical condition (2, in fact), and since I support her, we've never applied for a subsidy. The first year, it was just under $200/month. The premium dropped by about $12/month when ACA went into effect. Kaiser switched her over to an ACA plan that was comparable in benefits to what she had pre-ACA, except some co-pays were about $5 higher; no big deal, since it just about evened out (Kaiser fills all Rx for 3 month at a time, with only one co-pay). Starting in January, it's going up about $9/month. I'm not seeing a dramatic difference.

                I assume our group program has to be ACA-compliant. I certainly haven't seen any problem with the coverage. My 2-level back surgery cost me less than $500 out of pocket.
                She's 20. When she's 40 that'll be triple. Your plan is generous and currently not being affected much. It will.

                "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."
                -John Locke

                "It's all been melded together into one giant, authoritarian, leftist scream."
                -Newman

                "Grievance groups are playing King of the Hill."
                -Newman

                Comment

                • Gingersnap
                  Resident stylistic consultant
                  • Tuesday, October 1, 2013
                  • 24058

                  #9
                  Originally posted by Celeste Chalfonte View Post
                  Kaiser is highly variable by region and even by facility. There's nothing in your Kaiser coverage provisions that keeps you from seeing your endicrinologist when you need to. You need to get Member Services involved if you're being told that.

                  This is what I do for a living.
                  Oh, yeah - I can see him after my doc does whatever screening tests are needed to get into the door. Problem is my problem is 20+ years old (all with Kaiser) so my thing is not a "thing" with any urgency. She is not very concerned so she lets go until I have a crisis. Then it's 2 months until things sort out.

                  We've done this dance many times now.

                  But what can I do? Nothing since I have voluntarily agreed to this. I'm not complaining so much as explaining how HMOs work for chronic stuff. You will not get the same level of interest or treatment as you might get with a different situation.

                  On the other hand, they will be all over that spleen explosion.
                  "Alexa, slaughter the fatted calf."

                  Comment

                  • Lady Marva
                    Senior Member
                    • Wednesday, June 17, 2015
                    • 13321

                    #10
                    Originally posted by Gingersnap View Post
                    Oh, yeah - I can see him after my doc does whatever screening tests are needed to get into the door. Problem is my problem is 20+ years old (all with Kaiser) so my thing is not a "thing" with any urgency. She is not very concerned so she lets go until I have a crisis. Then it's 2 months until things sort out.

                    We've done this dance many times now.

                    But what can I do? Nothing since I have voluntarily agreed to this. I'm not complaining so much as explaining how HMOs work for chronic stuff. You will not get the same level of interest or treatment as you might get with a different situation.

                    On the other hand, they will be all over that spleen explosion.
                    Thanks for the information. Glad my insurance is not an HMO.

                    Comment

                    • Celeste Chalfonte
                      apostate
                      • Saturday, October 5, 2013
                      • 27897

                      #11
                      Originally posted by Gingersnap View Post
                      Oh, yeah - I can see him after my doc does whatever screening tests are needed to get into the door. Problem is my problem is 20+ years old (all with Kaiser) so my thing is not a "thing" with any urgency. She is not very concerned so she lets go until I have a crisis. Then it's 2 months until things sort out.

                      We've done this dance many times now.

                      But what can I do? Nothing since I have voluntarily agreed to this. I'm not complaining so much as explaining how HMOs work for chronic stuff. You will not get the same level of interest or treatment as you might get with a different situation.

                      On the other hand, they will be all over that spleen explosion.
                      Frankly, I would change doctors.

                      I have a case in which the injured worker is a longtime Kaiser member and receives both her regular medical care and her treatment for the work injury at Kaiser. It comes as no surprise that they're still treating her extensively for a 5-year-old work injury; after all, workers' comp bills aren't subject to the terms of the Kaiser contract. However, I don't just get to read her work injury records; I get the whole medical record. And the treatment for her non-industrial diabetes has been very aggressive, despite the fact that the injured worker is a non-compliant slug who can't be bothered to take her medicines regularly or manage her diet. They not only get specialist consultations when she asks for one, they actively try to cajole her into seeing the nutritionist, the eye doctor, the podiatrist, pharmacy consultant, etc, etc.

                      If you're not getting care up to the standard of care (and by your account, let me assure you, you're not), you have recourse. Access to member services and the ombudsman is not controled by your PCP.
                      "Since the historic ruling, the Lovings have become icons for equality. Mildred released a statement on the 40th anniversary of the ruling in 2007: 'I am proud that Richard’s and my name is on a court case that can help reinforce the love, the commitment, the fairness, and the family that so many people, Black or white, young or old, gay or straight, seek in life. I support the freedom to marry for all. That’s what Loving, and loving, are all about.'." - Mildred Loving (Loving v. Virginia)

                      Comment

                      • Tom Servo
                        Area Man
                        • Tuesday, October 1, 2013
                        • 5898

                        #12
                        I'm finding a new gripe about this recent foray of mine into healthcare… somewhere along the line my info got passed on to telemarketers and now I'm getting phone calls and crap in the mail soliciting for additional health-related goodies. Just today I got some unsolicited RX Savings Card and when I searched for the company name online everything pointed to a personal info-stealing scam group.

                        The worst though seems to be the phone calls. I'm not one to answer unknown numbers calling my cell and they don't leave messages, or the messages are blank. Yesterday morning I received no less than NINE calls from three different area codes between 6 am and 2 pm. A few of the numbers came back to shady scammy type companies and the others were tied to companies that appear to up-sell people on added insurance benefits or something like that.

                        Either way it all started after I began searching healthcare options on the Federal exchange and some private company sites, like BCBS and Humana. Dunno if I accidentally put my number in some third party site or what, but whatever I did, I royally screwed up to get this many calls every day.
                        “Any sufficiently advanced capitalism is indistinguishable from rent seeking.” ~ =j

                        Comment

                        • Gingersnap
                          Resident stylistic consultant
                          • Tuesday, October 1, 2013
                          • 24058

                          #13
                          Originally posted by Celeste Chalfonte View Post
                          Frankly, I would change doctors.

                          I have a case in which the injured worker is a longtime Kaiser member and receives both her regular medical care and her treatment for the work injury at Kaiser. It comes as no surprise that they're still treating her extensively for a 5-year-old work injury; after all, workers' comp bills aren't subject to the terms of the Kaiser contract. However, I don't just get to read her work injury records; I get the whole medical record. And the treatment for her non-industrial diabetes has been very aggressive, despite the fact that the injured worker is a non-compliant slug who can't be bothered to take her medicines regularly or manage her diet. They not only get specialist consultations when she asks for one, they actively try to cajole her into seeing the nutritionist, the eye doctor, the podiatrist, pharmacy consultant, etc, etc.

                          If you're not getting care up to the standard of care (and by your account, let me assure you, you're not), you have recourse. Access to member services and the ombudsman is not controled by your PCP.
                          My issue is probably not going to be managed much differently by another Doc since I've had many over the years (Doc retired, Doc left the practice, Doc moved to another facility, etc.). My problem is that normal test results and treatment protocols aren't enough for me. I'm outside the curve (which my endocrinologist knows and communicates) but Kaiser is set-up to manage normal problems (no complaints about that - it's what they do). Their system doesn't work very well for me on this issue.

                          I have no complaints about the kind of care they are set-up to do. You just have to be much more educated and much more assertive about treatment if you have something weird wrong with you. It's more difficult for the Docs to think outside the box in that system and when they do, they have to justify every move over and over to various administrators. They get tired and so do I.

                          On the other hand, they are superb at fixing stuff that has known fixes and that's the kind of thing I'm more likely to die from (at least in the short-term). It's a trade-off.
                          "Alexa, slaughter the fatted calf."

                          Comment

                          Working...