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Monday, January 17, 2022
HomePolicyObamaCare Sticker Shock From Out-Of-Pocket Costs Now Reality

ObamaCare Sticker Shock From Out-Of-Pocket Costs Now Reality

obamacare sticker shock

Until now, it has been near impossible for consumers to fully experience ObamaCare sticker shock using the federal health care exchange. However, with the addition of the new “window shopping” option, Americans are now coming to realize the full extent to which out-of-pocket expenses, along with generally higher premiums, will increase the cost of their health care under the new Democratic law.

For individuals, who have already seen their insurance cancelled when ObamaCare destroyed that entire market, annual deductibles are often over $5,000. As many critics and proponents of marriage have long-claimed, the out-of-pocket expense is worse for married couples under the president’s new law. Couples generally see annual deductibles that are over $10,000.

The president and Democrats have been touting for years that insurance premiums under ObamaCare will go down, but in the rare case that premiums are lower, the tool insurers use to reduce that monthly cost is charging consumers higher deductibles.

The New York Times reported, in “El Paso, Tex., for example, for a husband and wife both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium less than $300 a month, but the annual deductible is more than $12,000. For a 45-year-old couple seeking insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month has a deductible of $10,000.”

Another example given by the Times came from Santa Cruz, Calif., “where the exchange is run by the state, Robert Aaron, a self-employed 56-year-old engineer, said he was looking for a low-cost plan. The best one he could find had a premium of $488 a month.” The annual deductible, however, will cost Aaron $5,000, which he correctly observed, “sounds really high.”

Mark A. York, who is a 60-year-old freelance writer in Hailey, Idaho, said that he began shopping the federal online exchange after he became one of millions who received a letter saying that his current insurance policy would be canceled because it did not meet the Essential Health Benefit Standards mandated by ObamaCare. In the exchange he found policies with premiums similar to what he is now paying, approximately $440 a month, but “the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.”

The individual, private insurance market was destroyed when less than 2 percent of the plans complied with the ridiculous Essential Health Benefit Standards, which mandates that insurers offer the same exact coverage for all policies. But when the delay, which the president unilaterally granted to employers without constitutional authority expires, the same will happen to the employer-sponsored insurance market.

According to the Kaiser Foundation, the average deductible for an employer-sponsored insurance plan pre-ObamaCare cost consumers $1,135.00.

Plans in the marketplace are separated into four categories — bronze, silver, gold and platinum — which breaks down based on the various coverage standards, or the “share of costs” paid by insurance for an average enrollee. According to the New York Times, the administration’s experts expect “most people shopping in the exchanges are expected to choose bronze or silver plans, which provide less generous coverage than most employer-sponsored plans.”

While those plans supposedly “provide less generous coverage than most employer-sponsored plans,” consumers on the exchange will face high deductibles and high co-payments for medical services and prescription drugs even before they reach the cap on out-of-pocket costs, which is $6,350 for an individual and $12,700 for a family.

When we dig into the regulations, deemed Esstential Health Benefit Standards, and prices associated with ObamaCare, we better help others understand how our PPD study showed that 145 million Americans will lose their current health plan.

Out of the 189 million Americans with private health insurance coverage, 170.9 million American are covered with employer-sponsored insurance, including workers and their dependents. A study by Jon R. Gabel with the University of Chicago, found that 65 percent of employees (which doesn’t count their dependents) in group health plans had higher-value coverage that would be classified as gold or platinum under ObamaCare regulations. Yet, in order to cover the cost of Medicaid expansion and partially subsidized insurance, those Americans must pay higher out-of-pocket expenses.

For many women, as well, it will not pay to have insurance when they get pregnant. The hospital cost associated with having a baby is literally less than their “shared out-of-pocket cost” that many women will also find “that it defeats the purpose of having insurance,” just as York says.

Written by
Data Journalism Editor

Rich, the People's Pundit, is the Data Journalism Editor at PPD and Director of the PPD Election Projection Model. He is also the Director of Big Data Poll, and author of "Our Virtuous Republic: The Forgotten Clause in the American Social Contract."

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