How Much Will Insurance Cost Under Obamacare?

May 28, 2013 Update: California’s just-released prices for ACA coverage are close to my 2012 estimates, with an unsubsidized bronze plan (for a 25 year-old) available for $142/month in Los Angeles.

Health insurance premiums for minimum coverage will likely be around $150/month for 27 year-olds under the ACA, since the ACA includes relatively high-deductible plans under the Bronze plan option.

Now that the dust has settled on the Supreme Court ruling, let’s attempt to answer a simpler question – how much will health insurance cost under the ACA (Obamacare)? Individuals purchasing health insurance via the new health insurance exchanges will be able to select from four plan levels: bronze, silver, gold, and platinum. The law dictates that plans falling into these categories must have 60%, 70%, 80%, and 90% “actuarial value”, respectively. The concept of “actuarial value” dictates that the plan must cover the specified percentage of health care costs for enrolled individuals. Individuals enrolled in a bronze plan can expect their insurance to cover 60% of their health costs, for instance [1].

The Kaiser Family Foundation commissioned a study to determine the structure of plans that might meet the 60% actuarial value standard for the Bronze plan.  The study found that the following individual health care plans might qualify (all plans have a cap of around $6350):

  • A plan with a $6350 deductible and 0% coinsurance
  • A $4350 deductible with 20% coinsurance
  • A $2750 deductible with 30% coinsurance

How much would plans like these cost in 2014? We will focus on adults aged 27 in this example, since young adults more frequently go without insurance, and since young adults can now stay on their parents’ plans until 26. We can shop online for similar plans and get some results for comparison [2]:

  • $67.26 for a $2750 deductible / 30% coinsurance plan in Atlanta for a 27 year-old male
  • $98.21 for a $2750 deductible / 30% coinsurance plan in Atlanta for a 27 year-old female [3]
  • $129 for a $2750 deductible / 30% coinsurance plan in Silicon Valley for 27 year-old men and women
  • $73.22 and $95.07 for a $2500 deductible / 20% coinsurance plan in Chicagoland for a 27 year-old man and woman, respectively
  • $95 for a $2750 deductible / 20% coinsurance plan in Houston, TX for a 27 year-old man
  • $132 for a $2500 deductible / 10% coinsurance plan in Houston, TX for a 27 year-old woman
  • $70.75 and $90.46 for $2500 deductible / 20% coinsurance plan in Hartford, CT for a 27 year-old man and woman, respectively

Here are two market quotes for 63-year old females in relatively expensive markets:

  • $302 for $1200 deductible / 10% coinsurance HMO plan in New York, NY for a 63-year old woman
  • $516 for $3500 deductible / 10% coinsurance PPO plan in Santa Clara, CA for a 63-year old woman

The ACA stipulates that the most expensive policies for older individuals can be no more than 3 times the price of policies for younger adults. The data above show that a 27-year old can get a plan similar to the exchange bronze plan for around $100 per month today, but this is less than 1/3 the cost for older Americans. Using 1/3 of the cost of the plans for older women as a price floor, we get an estimate of $150 per month as the lower limit for plan prices [4].

This estimate is lower than the commonly-cited CBO estimate of $4500 per individual for bronze plans via the ACA exchanges. The CBO estimate is for 2016, and so it builds in two additional years of premium inflation (roughly 15%). The CBO number is also an average across all age groups – since young adults’ plans can cost 1/3 as much as the oldest (non Medicare-age) Americans, 27 year-olds’ plans will be much cheaper than the average. While the ACA should have allowed for more high deductible plans, it’s good to know that the bronze plans do provide for some affordable coverage options within the new health insurance exchanges.

[1] The 60% bronze plan threshold and other thresholds are applied to each plan considering the average expenditures for plan members. Given the deductible and copay structure of a particular plan, it’s possible that the plan spends a higher (or lower) percentage on a particular individual’s care. For instance, if you don’t use your plan at all in a given year, then your plan spent 0% on your care. At the other extreme, if you are diagnosed with cancer, and incur $100k in costs in a year, even a bronze plan would cover  perhaps 90% of that amount.

[2] All plans were found on ehealthinsurance.com on 8/2/2012.

[3] The wide discrepancy between plan prices for men and women will be eliminated by the ACA. For these purposes, averaging men and women’s prices enables us to get closer to a representative price under the ACA.

[4] Since health insurance is more expensive for women, and more expensive for older Americans, we used a 63 year-old woman as the prototype for an expensive risk in the existing private health insurance market. At age 65 virtually all Americans gain entry into Medicare (or Medicaid for seniors), and so 63 is the oldest age for which insurance quotes can reliably be obtained (some insurers won’t write short-dated policies, and no insurer writes non-Medicare policies for 65+ Americans). The average price from the two expensive quotes thus obtained was $409. After adding in 10% in premium inflation between now and January 2014, we get a premium estimate right around $450 per month. By law, one-third of this is the minimum that the exchanges can charge for any adult – and this equals $150 per month.

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61 Comments »

  1. Black Eagle said

    I have not been to any doctors since 40 years, attending to my own health care by natural healing methods of various sorts, which are inexpensive and work very well. Now I face paying hundreds per month I do not have, at age 63, for MD-Hospital services I would never use. The cures for heart-disease, cancer and all the rest are already known, outside of the medical schools at least, but suppressed by the FDA and AMA. ACA will give you pleny of free heart surgery, toxic cancer drugs and goulish abuses, many “preventative” mastectomies and so on, like the Spanish Inquisition. Burn you alive to “cure” you. Americans you got the health disaster you well deserve, by your own narrow minds and rigid authoritarian leaders. Obama’s schemes will make everything worse, suppressing what’s good, and worsening what’s already bad enough.

    • Anne said

      If you know the cure for cancer, please share it – although I read much of the alternative medicine literature, I have yet to hear of anything that works for all people every time – I know people who have bet their lives, some on chemo and some on natural healing approaches, and most died.

      • I don’t know what the original poster was meaning about a cure for cancer, but I’ll share what I know. There is a doctor in Houston, Dr. Stanislaw Burzynski, who has a high rate of curing patients with a terminal diagnosis, even children with brain stem cancers. He uses amino acids and proteins, rather than toxic drugs. It’s amazing to watch. I watched it on Netflix.

        http://www.burzynskimovie.com/

      • Benji said

        Look around, Black Eagle isn’t wrong. Holistic medicine actually is very beneficial for terminal patients. You might wonder why it isn’t more popular? Because pharma companies haven’t figured out how to make money off of it.

      • vickie frost said

        Anne take a look at the Gerson website and watch some of the movies on that site. The reason a lot of natural cures don’t work for people is because they try it after they have been beat up by chemo and have two weeks left to live. You must study these things. Do it as if your life depended on it!

      • Dan said

        What worked for us, my wife, with several health problems including cancer is the Dr. Budwig protocol. It takes some effort but well worth it in the long run. So what did it do for us, cancer is gone, heart mitral valve stenosis, from severe to almost normal (1.5cm/2 to 3.5cm/2). Liver, fighting a problem created by a medical procedure for over eighteen years, now normal. We learned our lesson, take care of yourself. The best part is the cost, only food and a few herbs, and some time well spent.

    • April H. said

      “Anne”, does something work “every time” all the time? That is a ridiculous statement and only implies that you are dismissing the comment by “Black Eagle” before educating yourself or opening up your mind to any contrary thought. Do yourself a favor and look up and research B17, Gerson Therapy, “A World Without Cancer”, Essiac Tea, etc……. and the list goes on and on and on and on…… You could save your own life or the life of someone you care about – but only when you turn off the TV, think outside the box and read something other than propaganda from the FDA or the ACA. There are natural cures for the diseases that conventional medicine will gladly disfigure and burn your body, inside and out, in the name of treatment.

      Just remember, TREATING cancer is TRILLION DOLLAR a year industry. Yes, it is an “industry” and that is TRILLION, with a “T”. There’s no profit in CURING cancer or other diseases, ONLY in TREATING them.

      EVERYONE NEEDS TO WAKE UP AND EDUCATE THEMSELVES!!!

    • Nucky Thompson said

      dont pay it theres no way they can collect from you legally

      • Lyla Cavanaugh said

        Yes. I agree. The medical situation needs to change BEFORE we support it with our hard gotten tax dollars. Young people cannot afford 10 grand per yr. and 10 per cent copay. That is rediculous. Make your voices heard.

      • Jill Jones said

        if you file an income tax return, the IRS will take the penalty out of your tax return, and if you aren’t owed a return, the IRS will say you owe that tax and bill you for it…(the Supreme Court in its worst moment called it a tax so the IRS can collect it)…and the ACA part of the IRS is now being run by the same woman who targeted conservative groups who applied for non-profit status…welcome to government run amok

    • A. Blackwell said

      News Flash: “Holistic” medicine, “Natural” remedies, and homeopathic “medicines” are a billion dollar industry too. One that cannot prove any effect through scientific research for most of their “remedies”.

      http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/laetrile

      B17 was pulled from the market because it causes CYANIDE TOXICITY and had absolutely zero evidence of antitumor activity. Yes, that evil FDA is really out to get you by hoping to prevent you from getting a useless medication that can kill you. That link is from the nonprofit American Cancer Association who does more research on preventing and curing cancer than anyone. Please stop trying confusing people with your conspiracy theories. I work in healthcare and I can guarantee you that the medical communities is not trying to kill you for money.

      Signed,

      The Enemy, an evil, money grubbing pharmacist with a medical degree and years of experience helping people with cancer

      • Phyllis said

        When your income comes from traditional medicine it is not easy to see clearly. In my experience medication and traditional health care has not helped anyone that I know with ongoing illnesses. Only the symptoms are masked and nothing is helped concerning the cause.

    • SandyS said

      Firstly, Black Eagle, you are eligible for Medicare in two years should you need it. In the meantime, you don’t pay “hundreds of dollars per month” for your health care if you do not want it. You will pay a small fee of around $265 per year until you turn 65. This is your contribution to other folks who do need traditional health care. A small price to pay for your fellow citizens who are not fortunate to be able to afford doctors or hospitals. At some point BE, you may need one too. And all of us under the age of 60 will be paying for your medical care. Best wishes for a long and healthy life.

  2. H. Reardon said

    This thing is going to be a disaster as people realize what they are going to have to pay and premiums keep going up every year. Then to deal with rising costs rationing is going to kick in with the review board guidelines.

    Instead, a high-deductible Health Savings Account approach should have been emphasized, with legislation requiring health care providers to charge everyone the same, as well as requiring up-front pricing for treatment plans and procedures. The FDA drug and device approval process should have been drastically streamlined.

    Health care costs have gone up because it is a completely screwed-up service market in economic terms. If the computer business were regulated the same way by the government, we’d all still be using IBM 286 computers with DOS, and they’d cost $3000.

    You voted for it. Now your going to really get it.

  3. Ron Nemetz said

    There are a few flaws in your initial analysis that you presented.

    First the plan options that you found on ehealthinsurance are preferred pricing. It is not very common for people over 40 years old to get that preferred price, there are typically rate ups for weight/height, medication usage and so forth and so on.

    Second, you haven’t accounted for the fact that these new metallic plans will have to include mandated benefits that are not on the individual market, such as maternity benefits.

    Third, current insurance company pricing is based on underwritten products, so insurance companies currently are able to bar adverse risk.

    All of those factors change starting in Jan 2014, even the Kaiser calculator shows their estimate of plan prices starting that year. I would project that a 27 year old will cost between $250 and $300 per month of an un-subsidized premium and someone at age 60 with the 3 to 1 ratio costing between $750 and $900 per month.

    • Ron, great comment. Bear in mind that there are some offsetting factors that lower premiums vs your analysis. First, insurers (relative to current eHealthInsurance numbers) will have to pay out a higher percentage of premiums for medical benefits. This change has already started to take effect, and has in some cases (that I know of personally) resulted in a significant drop in insurance premiums in the private market. Previously some carriers were paying out as little as 60% toward claims. I’m not judging that part of the law for economic efficiency (it’s a convoluted beast as a whole), but that piece will reduce premiums somewhat.

      Secondly, in my sample of rates I included states that already require insurers to provide significant benefits, in some cases beyond Obamacare requirements (think CA and NY, with their extraordinary requirements). And of course, while adverse risks will enter the market, so will many of the young invincibles who are currently uninsured. This is precisely the point of the law.

      It’s a great question as to exactly where rates will fall. I attempted to make an estimate here, with the point being that the bronze plans will allow for some reasonable rates at the low end. The devil’s in the details of course, and we won’t know all of that for several months more at least. Personally, I do wish that the exchanges included high deductible plans up to the 10k deductible mark at least, and there’s still some chance of that happening if the state exchanges are granted waivers to do so – we’ll see.

    • linda said

      I can not pay that. I only spend 400 a month on food how in the world can I pay that. And if it is against my religion to use health care how can they force me?

      • judy Lazarus said

        Just out of curiosity, what if you are in a car accident and need hundreds of thousands of dollar worth of care? Should I pay for it? How about cancer? Heart attack? Falling down the stairs? Get the point!!!

      • JoeSnow said

        Judy, you’re not paying for it now so what makes you think you’ll be paying for it after January 1? That is a myth that taxpayers foot the bill when someone doesn’t pay a doctor or hospital. When someone walks away from a medical bill, the doctor or hospital sells the bill to a collection agency at a discounted rate and the collection agency attempts to collect the full amount. The doctor or hospital does NOT submit the bill to the government for payment. If you’re so worried about paying someone else’s catastrophic medical bills, the thing you ought to be worried about is the implementation of single payer, which is where all this is leading. If single payer is implemented then you WILL be paying for other people’s catastrophic medical bills because everyone’s medical expenses will come from a single pool of money collected from everyone’s paychecks every week.

  4. Roger said

    No where do I see people calculating the cost of health care under the current system when complaining about the cost of Obamacare. I know many people who have no healthcare and who go to clinics that are goverment supported ( with your tax dollars). Free clinics are not free – someone pays for them – and it’s usually the tax payer through state and federal grants. Others go to emergency rooms for regular health care and hospitals for major medical needs and they have no means or intentions to pay those large bills so the cost of their uninsured services are passed on to insured which makes the insured rates higher. We are paying much more for our medical care than other developed countries because we have a for profit system. And no where does anyone point out that people who go without care end up costing more to take care of when they do need medical care. Give it time folks… it will need tweeking and adjusting but in the long run it will make us and our nation a better …

    • bricklayer said

      Since when should medical care be not for profit ? This is still AMERICA. I am sick and tired of all of you liberals comparing this country with all of these other BACKWARDS over taxed countries. This will go down as the most expensive piece of legislation ever to be passed in this country. People can control their costs through taking better care of themselves, higher deductibles and co pays. As always was the case in this country, people that can not afford it will have access to treatment. This just makes that pool bigger for the rest of us that are responsible with our own lives and don’t look for hand outs from the new food stamp, free stuff administration. If you are irresponsible this system should be right up your alley. For the portion of the population that have always paid our way, this unaffordable health care legislation will do nothing but drive costs up and up and up………………………………………………………………………………….

    • JoeSnow said

      Are you really THAT stupid? Do you think that students would choose to spend all the time and money going to medical school if there wasn’t a big payoff waiting for them at the other end? Hell, NO! they would find some other profession that pays better. Do you think that pharmaceutical firms would invest millions of dollars every year into developing to develop new drugs, treatments, and therapies if the government wasn’t going to allow them to profit from their ingenuity? The same goes for medical device firms. Do you think insurance carriers would continue to sell health insurance if there was no profit in it? They would leave the health insurance field entirely and then where would you be? The profit motive drives advancement. If you take the profit out of the medical field, then medicine in this country will stagnate like it has in other countries where the government places limits on how much can be charged for medical goods and services. You’ll be stuck with outdated drugs and treatments that have lower success rates and more side effects than newly developed cures. And forget about anyone developing treatments for diseases there are no cures for yet. People will just continue to die from those diseases because nobody will be willing to develop a cure for them because there is nothing in it to compensate for their time and investment.

    • Madmango37 said

      I think the issue we’re missing here is the ridiculous costs of the services. I have insurance (which I severely overpay for due to being short and fat, no health problems, I just don’t fit the 5’5″ chart the doctors have for who is a health risk and who isn’t), so I took my insurance and put it to use when I split open the webbing between two of my fingers. 1100 dollars was billed to my insurance company for a x-ray and ONE STITCH. I was in and out of urgent care in 20 min, Set a rate, or I’ll start charging $95 for a watch battery at my repair store to make up for my health insurance costs. Everyone bitches about costs of gas, watch battery replacement, underwear, etc… but doesn’t complain one bit about doctors charging 3X as much, knowing the insurance company isn’t going to pay them the full amount anyways

      • Theresa said

        I agree with you. In 2009 I broke my ankle. There were three costs. About 3000 for the surgeon. 900 for the anesthesiologist and $15,000 for the hospital. I was in the hospital for three hours. The hospital only supplied the room. My doctor supplied everything else. I was self insured. I paid the doctor etc. but I have been paying $200 per month to the hospital. There is no way what the hospital did was worth $15000 dollars. I am in good health otherwise. I do not go to doctors normally. I had not been to a doctor in nearly 10 years when I had my pre op exam. I have to admit I was a little scared but all was fine. I am grateful I can walk as the surgery was extensive. I was 55 then and I just turned 60 this year. I checked insurance rates for me and the least expensive was just under $200 per month with a $15,000 ded. Do the math. I am better off not getting insurance. One last thing, the 10 years previous was when I had my gall bladder out in 2008. I did have insurance then. Total cost for surgery and a 2 1/2 day stay in hospital was about $3000 dollars. What happened to the medical costs in that 10 years? My income surely did not go up to match the increase in medical costs. There are definitly problems with medical costs and if the government wants to meddle why not check on the Medical costs charged. My doctor was worth every penny……but $15000 for 3 hours is a crime. I definitly paid the money to make up the difference for what the hospital had to accept as payment by Medicare, Medicaid and other insurances for similar procedures. I am lower income now by my own decision. I do not want someone else to pay my way. So for right now I will pay the penalty.

  5. Judith said

    I agree, I lived in Europe in the late 70′s and the health care worked fine, thank you very much, and it was equitable for all.

    • Yeah, and it has changed drastically since then. That is the point!

    • JoeSnow said

      How old were you when you lived there? Government run medicine SEEMS to work fine as long as you are young, reasonably healthy, and don’t need a lot of care. That changes when you get older and are claiming more in government benefits than you are paying in taxes. The government is not going to spend millions of dollars to cure an 89 year old of cancer when they are not contributing anything to society. They will let them die not only to save on their medical care but also so they don’t have to pay their old age pension and other benefits they may be collecting. I don’t want anyone with that much of an incentive to just let me die being in charge of making my healthcare decisions for me, and you shouldn’t either.

      • dave said

        Over there? You are under gov healthcare in the US if your over 65. Most every senior I know like the service. Weird sometimes the evil government can provide good sevice?

      • Theresa said

        When one is 65 and over they get Medicare. If you are poor, Medicaid pays the $110 Medicare takes out of the social security check every month. The person then receives their whole ssi check. Most also get supp insurance like Humana. There is a cost there too. But say you are that poor person that goes into a nursing home. The first 100 days is covered by Medicare after that Medicaid starts in. The difference is the quality of Care one gets changes drastically when medicaid kicks in. This is a true story. The person I was caring for had early onset Alzheimer’s. I took care of him on my own for years. He was about 55 when he was diagnosed. In 2010 I needed help. I had an aide come in for the time I was at work. I was lucky if they showed. By February of 2011 I had no option but to have him placed in a nursing home. He walked in could eat with some assistance and he knew his children and me. By the end of March 2011 he was given no chance to live. The doctor at the hospital said he was overly chemically restrained he was not fed or given enough liquid to survive. He was waisted, malnourished, extremely dehydrated, pnomonia and had a really bad bacterial infection septic. His blood pressure was at the end of survival. I made the decision to make him comfortable and let nature take its course. He was still alive after several days so I made the decision to have a stomach tube put in for feeding. He started to come around after about 7 days in. After about two weeks it was a miracle. He was able to sit in a chair and watch tv. The hospital moved him from intensive care to a step down ward. I thought he would be there a few more days but to my surprise they sent him back to the nursing home. Where they chemically restrained him again. Why, I asked, he did not have any behavior difficulties. I pulled him out of the nursing home sending him back to the hospital so I could have time to find someplace different. The hospital said they could not keep him there had to send him back again to the nursing home. I had them stop the restraining drugs. When he came to again he could not walk, eat on his own had trouble swallowing. But because he was still on Medicare he could have therapy. The staff worked on swallowing, walking, etc. had to get his weight up so Left feeding tube in to get extra calories. ( he is the type of individual that had a fast thyroid and need calories or he loses weight fast. I came in every day after work and stayed with him til he was asleep. I fed him his evening meal as the rules go if he would not open his mouth they would not feed him. I had to treat him like a baby, but to the staff this is demeaning. He still knew me but did not know his children at this time anymore. Also, he had bladder cancer in 2008 and had his badder removed in 2009 at the Va. Hospital. This did not help his Alzheimer’s. He had to have help with the urostomy. I had to keep him very clean to have no infection. After 100 days Medicare stopped and Medicaid started. All therapy stopped. He was now just housed. Last December of 2012 I got a call that he had taken a turn for the worse. His son and I made the decision to stop all meds and feedings as Hospice would not help unless the feeding tube was removed. God bless him it only took less than two days and he died. He was 67. No human being should ever have to go through this. I live with the guilt of putting him in the nursing home because the nursing care people would not show up and I had to work. Let me ask a question….I am a mailman….the mail has to go out everyday if not by me then I better have someone there to take my place. Then tell me why a human being is less important then the mail? Why were they not there for him? You might ask about elder care abuse protection…I did report. Nothing. When I followed up the would not talk to me about the case. I tried to get a lawyer, but would not take my case as he was not a viable person. I was asked if he won what would he do with the money….I said get better care. I have pictures of each stage. The doctors thought I was the crazy one. Oh I forgot, I asked if the powers that be could pay me to take care of him. Response was….you already do it for free. I said I would quit my job only pay me for the 8 hours. There would be a definite pay cut. They said no as he could not sign for hours. What a loss. Medicare paid people that did not show, extremely incompetent, but would not pay me. A man died much to early and suffered at the hands of people who were suppose to help. Pray that you or anyone you know never have to go to a nursing home especially if they have to be on Medicaid. He is with God and Jesus now. No more suffering. Just think what Obamacare will do. This is not an isolated incident. I watched many residences of the nursing home die. No one was there for them either. Some I am sure were natural causes but some were not. I cry inside daily.

  6. Jerrold said

    I don`t care what it costs i just want the best.Not interested in going to the dollar store for my healthcare, I just want the best Doctors according to my own opinion and i want to see them when i want to see them and i don`t believe it some bureaucrats business or anyone elses.Sorry to say when you take profit out of the equation you may not get the best , not many people i know will be motivated to spend hundreds of thousands of dollars and several years out of there life to work at a job that only pays 50 thousand a year.

    • Opinions based on evidence said

      We pay twice as much by any measure for healthcare than any other country, and our outcomes are not as good (i.e we don’t live longer). Those are just the facts.

      Even though we have the most advanced capability. That is because “for profit” healthcare’s primary goal is to make money, rather than care for health. It doesn’t make the system evil, it is just that companies simply do not have morals, and their primary purpose is to make money. They provide as much healthcare as they are required to, and at what cost they can get away with.

      I work with people from all over the world including Europe and Australia, and live VERY near and work with Canadians every day. The systems they are in ALL pay LESS per person for healthcare, and ALL have better outcomes for the participants.

      Yes, yes, I hear that anecdotal stories of somebody said, that somebody said, that an un-named Canadian came here for something, and not everybody on the planet will ever be completely happy with all of healthcare, but I just got back from long stints in Canada and Australia, and I can assure you those system works VERY well, at almost half the cost. They in fact use it as a competitive advantage (healthy workers work more).

      • Sandra Malone said

        To Opinions: No, the Insurers are not evil. The healthcare system here is not Universal. We don’t pay $8 per gallon for gas and our taxes don’t add up to 50% of our earnings unless we are incredibly rich. You forget the cost of healthcare here. In countries you spoke of, doctors don’t make a million dollars a year, and the gov’t doesn’t own them. Hospitals charge an arm and a leg because the gov’t doesn’t set costs. They have an entirely different system in those countries. Feel better. The new Obamacare will set you free. LOL! If your Employer isn’t covering you or is charging you more than 9.5% of your income for coverage, you can go to the Individual Exchange and possibly even get a subsidy, very possibly, unless you make over 400% of the Federal Poverty Level. Dr’s and hospitals can charge what they want here, and the Insurers MUST pay the claims. The whole problem is monumental. The young people who are healthy don’t buy insurance. Only those in Groups or Individuals with serious and expensive health problems seem to be insured, which will continue forever the problem of not enough premium to pay claims. Obamacare will completely crash and burn if the healthy young people do not sign up and just pay the penalty for not buying insurance. This thing is an upside down pyramid and will collapse under it’s own weight. Even people at 400% of the Federal Poverty Level will be subsidized by the taxpayers, and that means the weight falls on the middle class. This is a debacle. I agree with you that in spite of the money we throw at healthcare, the outcomes are not as good as some other countries. Our infant mortality rate is abominable in comparison. As long as hospitals can charge $3000 for an MRI, insurance rates will continue upward. Dr’s charge $100 for a primary care visit. However, now as of 1/1/2014, Insurers MUST SPEND 80% OF ALL PREMIUM ON CLAIMS. That’s a start, but now how many dr’s and hospitals can survive with the upcoming amounts they will get for services. Every good dr I know plans to retire, or take NO INSURANCE WHATSOEVER THROUGH THE EXCHANGES. They already don’t take Medicaid. Nightmare!!!!!!!!!!!!!!

      • JoeSnow said

        You are 100% wrong about our outcomes not being as good. We have the best healthcare in the world which is why foreigners come here from around the world to get treatment they can’t get in their own country. We have BETTER outcomes, not worse. Healthcare costs more here because we have better treatments than what they get in other countries. In other countries, they won’t pay for the best treatments because they cost too much. Remember the old adage, “You get what you pay for”. Do you really want that applied to your healthcare?

    • Scotty J said

      The pursuit of profit is also the driving factor behind diminishing services. The reason it costs ten times as much to buy something that severely lacks in the quality department. Look at the housing markets resurrection. Homes today lack the quality control they had ten years ago. General contractors profits are at an all time high on a percentage basis while sub contractor profits continue to decline and as a survival technique sub contractors cut corners and use cheaper products in order to operate businesses that attempt to produce the same profit margins. Greed is only good for those who already hold the wealth.

  7. Tausha said

    I can’t afford health insurance before or after obama care. I make too much to qualify for govenment help. I’m screwed either way. It’s just not right.

    • Joe Wiram said

      Reminds me of the late 80′s , my first house, The wife an I paid 10% interest, new home.. exactly like the one across the street.. Both brand new,but my neighbor paid 8%, because he was a single income home.. SO, if you bust your butt, both spouses work, you are penalized for your effort… That’s when I knew things were unfair. Same issue now, the wife an I are retired, but NO HELP with medicare premiums, why, we made too much money in our lives an worked to hard..and were too responsible.

      • Sandra Malone said

        Joe, Each of you, you, and your wife will have Medicare. Why shouldn’t EACH of you pay for your Part B of Medicare. If you are at a certain level of income you will get free Part B, and assistance with drugs and premium. Obviously, you two combined make enough to pay your own. Why should other taxpayers pay for you????

      • Sandra Malone said

        Joe, I was thinking that perhaps you have a misunderstanding about Medicare. You pay nothing for Part A of Medicare, but you do pay for Part B, which is mostly outpatient. You aren’t being penalized in any way because you “worked hard and were responsible”. What does that have to do with paying your Part B Premium. Lots of people worked hard, and were responsible, and made very little income and are still trying to live on nothing but, i.e. $800 x 2 per month of Social Security. If you aren’t on Medicaid and don’t QUALIFY for poor people assistance, and/or, have investments, savings, etc., you don’t get that help. It’s for people who NEED IT and can’t survive elsewise. Be happy you have resources, which is why you worked hard. Be happy you aren’t on the dole like so many really poor Medicare Beneficiaries. My Mother worked hard, unskilled, was responsible, and she got $600 per month on Social Security. Back then, 20 yrs ago, she got no help, there were NO DRUGS whatsoever on Medicare, and they still took her Medicare part B payment. Today she has drugs and pays no Part B and no Prescription Premium. She has Medicaid assistance. Why would you wish to be in that boat??? You don’t get taxpayer assistance because you make enough to support yourselves, without taxpayer assistance. Get rid of all savings, investments, and other assets, spend it all, and then you may get assistance. GEEZ!!!!!!!

    • Sandra Malone said

      Tausha, I have no idea how much you make, but it’s very likely you would qualify for a SUBSIDY through the new Exchanges. Starting in October, you can apply for the Individual Exchange plans. If you have Group Insurance, your Employer is paying a nice chunk of your insurance right now. If you need some help with this REPLY to me on or about October 1. You didn’t say if you were single or insuring a family. You will HAVE TO BUY INSURANCE one way or the other, OR, YOU WILL PAY A GOVERNMENT PENALTY. REPLY if I can assist.

  8. jim said

    my gov has said it is not going to cover and your insurance company can say no to you and get a way with have fun there is going to be a lot of people with out insurance

    • Sandra Malone said

      Jim, your comment is barely readable. However, EVERY AMERICAN must buy coverage either through the Exchanges, or have coverage through their Employer. You can’t be turned down. A lot depends on your income. The Exchanges have subsidies for low and even median income people. It’s all a debacle, but you can get good coverage.

      • JoeSnow said

        What point is it to have healthcare if you can’t afford to pay rent or buy food?

  9. Mike said

    Great! A bill that no one can tell you for sure how it will be run or how much it will cost! Who comes up with these laws and who are the idiots that vote them through? That’s right! It’s the ones that aren’t subjected to them! Universal healthcare is a great idea, but I believe little thought went into it. Prices based on income I understand. Keeping yourself I healthy understand. The reward for making a good living and making healthy choices? A higher cost! Makes perfect sense.

    • JoeSnow said

      Universal healthcare is a lousy idea and is failing in every country that has it.

      • Pat Evans said

        Kind of hard to say that all the industrialized nations in the world are backwards and All have had universal heatlh care for years and years…I wouldn’t call Australia or Sweden backwards..and many of the other countries like Canada. They all have low crime rates, the population is well educated, most of them are not engaged in endless wars…this country is pathetic. We have so many of our young people maimed from wars that should have never been fought, we are deeply in debt because of those wars, we have idiots killing people everyday because of our gun laws, our children go to bed hungry all over this nation due to poverty, our wages are too low to support a decent standard of living, and our crime rates are the highest among the industrialized nations..this country has moved down the list as a civilized nation…it is very sad.

  10. workingmom said

    Can you shed any light on whether ACA will increase or decrease the cost of health care for people who already have health insurance through their employers? We currently have a family of four and ~$180 every two weeks is taken out of my husband’s paycheck for health insurance. The BCBS plan we have still has a $2000 initial deductible, and then we pay 20% up to $5000, at which point everything is covered.

    If you do the math ($180*26 paychecks = $4680) plus a $5000 deductible = $9680/year!

    Will ACA make those costs go down? We paid ~$8,000 for the birth of our first child and now will max out the $5000 with our second (That’s with what is supposed to be “good” health insurance coverage). It makes me wonder what people with no health insurance pay. Probably close to nothing… So yeah, i hope everyone being required to buy health insurance lowers the cost of the those already paying what feels like too much. I’m afraid the complexity of the new system will make that impossible though.

    • Sandra Malone said

      ACA will probably increase the cost due to the “forced” minimum coverages for everything you can think of, and all preventive costing 0. It sounds like you have Group insurance for yourself and your family. That means the Employer is likely paying a good portion of at least YOUR coverage. So, the premium is much larget than you think for your plan. Also, depending on your INCOME, you may be eligible for a large subsidy “IN THE EXCHANGES”, and even then, ONLY if your Employer Plan leaves you paying more than 9.5% of your INCOME. The taxpayers will also foot the bill for your subsidy. ALL low income (100% to 400% of Federal Poverty Level) will receive subsidies. You have the wrong bad guy. Obama came up with this idea to cover over 3 million people who can’t afford, or don’t choose to carry health insurance. Of course the rates will skyrocket. What you have is now the entire middle class paying for their own insurance plus the subsidies for millions and millions of others who make up to $90,000 with a 4 person family, who will still get a subsidy. This is insane, and it won’t work. You have no idea the other taxes involved. By the way, you may or may not be allowed to add your spouse to your 2014 plan. If your employer says “No”, your spouse can go through the Individual Exchange, but likely will not receive any subsidy. There are thousands of rules and regs. Way too many to go into here. As far as deductibles and co-insurance, hold on to your hat. It will be worse than it is now for you with only 60% paid on the Bronze Plan. Good Luck! If your Employer chooses NOT to offer a plan for 2014, you can go to the Individual Exchange. If the Federal Poverty Level shows you at a certain level of income, you and your family will end up forced into Medicaid. How many Doctors and Specialists do you know who will even ACCEPT Medicaid??? We have 6 here in 2 whole counties, and they sure aren’t the good ones.

  11. Knif said

    Face it, insurance companies and pharmaceutical companies are the devil! When I picture them, I picture the devil himself counting profits and laughing while the lower to middle working class dies. I don’t care who is in office those of us that work but don’t make a ton of money are the ones who always pay. Those who don’t work and those who make 3 figures are the ones who always reap the benefits of what the government does. I’m a middle age woman in a non profit healthcare company and because most of us are over 35 the insurance companies will continue to punish us regardless if we have insurance though the government “co-ops” or through out work (which by the way does all they can to try to keep our costs down while still managing to stay open so we have jobs).

    • Sandra Malone said

      Kniff, there won’t be “co-ops”. There will be EXCHANGES and depending on your level of income, you may get a subsidy. However, you should remember that as you probably have GROUP insurance now, the Employer is helping out A LOT with your premium. Of course the rates will skyrocket. What you will have is now the entire middle class paying for their own insurance plus the subsidies for millions and millions of others who make up to $90,000 with a 4 person family, who will still get a subsidy. You should know that your Employer can choose to no longer offer health insurance at all, which means you would HAVE to go to the Individual Exchanges. If your Employer offers coverage and it costs you no more than 9.5% of your income, you have to take the Employers plan and cannot go to the Exchanges or receive a subsidy. (This depends on where you are on the Federal Poverty Level Chart). The Insurance Companies had nothing to do with this debacle. It’s all on Obama, and it’s socialism in it’s worst form.

    • JoeSnow said

      If it wasn’t for those “evil” health insurance and pharmaceutical companies healthcare in this country would be a lot worse. You should be thanking them and not vilifying them.

  12. JAMES said

    i went to get my yearly check up and made my copay of 35.00 then two weeks which is today got my bill for blood test i owe 199.86 and for my ekg i owe 256.67 and for my chest xray i owe 650.69 that use to be covered last year and years before. isnt 2014 when obamacare kicks in. yes holist treatments work s they do for pets also… and any with pets i just read on line obamacare wil effect those with a dog or cat in vet cost… wow! which they would stick o’care where the sun don’t shine!!!!!!!!!!!!!!!!!!!!!!!!! sorry that i used such awful words but iI..AM..MAD!!!!!

  13. Jamie said

    Before buying a health insurance policy you should shop around and visit state websites to see if you qualify to any special insurance programs based on your income. Many times these state websites will list companies that offer low cost health insurance programs rather than more expensive health insurance plans.

  14. Ron said

    Sadly, we DO NOT have the medical care, overall, in the world. Here is proof: http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems

    We rank #38 worldwide in health! Below Dominica, Costa Rica and Argentina.

  15. arlenekoenig@comcast.net said

    I am 62 years old recenlty became unemployed. I am looking for health insurance the deductibles for the
    ones i have seen are $5,000 and $10,000 with premiums of $300. a month. No one has this kind of money
    to pay these high deductibles and the premiums are two high. I am going to have to do without insurance
    because a i do not make enough money to afford this insurance and pay my bills.

  16. TK said

    I was looking forward to finally being able to purchase health insurance from the school district I will be working for in the fall in Houston and now they have increased the cost by 90%. The cheapest will be 517 for an individual and 1232 for a family with a high deductible and coinsurance. Since I will be an aide and not a teacher the cost is nearly as much as I will earn. My husband earns 43,000 and his employer offered plan is 700 per month for a family and going up so basically all of the plans offered cost more than the 9.5% of salary. I doubt the exchanges will be much better. If the subsidy doesn’t lower the cost to less than 9.5% of salary can we still be penalized for no insurance and can they really enforce it? How many people will fall through all of the loopholes?

  17. marie said

    i have many health problems i would go to clinics ,my husband is disabled and gets medicaid and medicare,i was taking care of my husband who had 3 major surgeries in 3 years and needs 2 more.i found a new job which is hard labor cleaning houses not sure how long i can do this since i have multiple unlooked after health problems of my own however without this job we could loose our apartment.so everyday i now work in pain.if i can continue i will be making 32.000 a year which means my husband looses medicaid which pays 20 percent of medicare and i will not have access to free clinics cause of my new income.how will i afford Obama care plus living expenses and copay’s deductibles for both of us .we both have multiple serious health problems i am 55.he is permanently disabled and sees multiple doctors monthly.we are barely getting by now.i go hungry often and neglect my own health problems.

  18. miles nelson said

    age 63 unemployed and on unemployment benefits of $1296.month no insurance ……pls explain my requirements

  19. Future RN said

    It is beyond me that he got re-elected. Everyone knew what this would mean for our country and yet he was re-elected. The way I see it is that my premiums will triple and I already pay 360/month for a family of four but a $10,000 deductible. We had to choose such a high deductible just to afford any insurance. I’m very concerned about how this is going to impact my family. I have instructors at my school being denied hours due to the fact that they will be required to give benefits if tthey finish the semester . I have a 16 week course and other faculty will come in and take over for the last 3 weeks to avoid this. It’s beyond sad.

  20. Candy still said

    How can I afford insurance when Im on SS but not old enough for Medicare? I would love to see the president live like I have to.. There is something seriously wrong with this country. I thought it was a free country.!!!

  21. Brick Mason said

    My individual policy for me and my wife with Michigan Blue Cross Blue Shield has been DISCONTINUED effective December 31, 2013. The reason for the DISCONTINUED policy is that it did not meet the requirements of the new Unaffordable Care Act. I have had insurance with no breaks for over 40 years with this company. Because of this new piece of crap law requiring insurance companies to include CERTAIN procedures that not everybody needs it has given insurance companies an out to raise rates through the roof. I am self employed and am not eligible for a GOVERNMENT HANDOUT because my income is above 400 times the poverty level ( just barely ) Make sure when you are getting quoted you use your MODIFIED ADJUSTED GROSS INCOME.
    My monthly premium went from about $ 600.00 per month ( for two ) to a like coverage policy of about $ 1200.00.
    This will force people to buy catastrophic insurance and have large out of pocket expenses. After 40+ years of continuous coverage, I am not going to renew this policy and will play Russian Roulette until I am on Medicare. We have always had coverage for people that could not afford treatment through Social Security disability and Medicaid. This is just going to be a BIG expansion of that that will cover a lot of lazy people that just really don’t like to work that much. The TRUE cost of this piece of crap will be revealed in the upcoming years. He truly will be remembered as THE FOOD STAMP PRESIDENT…………………………………………..

  22. Theresa said

    I will be doing the same. I am 60 and in good health although I do need to loose weight. I do nat take any meds. I will wait until 65 too

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