October 28, 2017

Obamacare: What happened to the "affordable" part of the Affordable Care Act?


Definition:  af·ford·a·ble (əˈfôrdəb(ə)l)
adjective:  inexpensive; reasonably priced.

2018 open enrollment for health insurance under the Affordable Care Act (commonly referred to as "Obamacare") begins on November 1.  If you have health insurance through Obamacare, have you priced your premium cost for 2018?

Get ready for some major sticker shock.  Nationally, Obamacare Gold Plan premiums for 2018 are rising by 16% on average, compared to 2017 premiums.  Lower cost/higher deductible Bronze Plans are increasing by an average of 18%. 

In some states, the premium increase is much higher. Georgia tops the list, with a jaw dropping rate increase of 57% for some plans.   Florida is not far behind at 45%.  In California, the average Obamacare  premium increase is about 12.5%.
Which begs the question:  Is health insurance coverage provided by the Affordable Care Act (“Obamacare”) truly affordable?
I live in California and have a grandfathered high deductible Blue Shield PPO Family Plan that covers both me and my husband.   I recently learned there will be no premium increase in 2018.  My Blue Shield plan has maximum out of pocket costs of $5,200 per person/$10,400 per family.  My monthly premium is $797 ($9564 annually).

A similar Obamacare Plan has total annual costs 43% higher than my grandfathered Blue Shield plan.

That's hardly "affordable".

For comparison purposes, I checked the most similar Blue Shield plan (Bronze 60 PPO) offered for 2018 through Covered California, California’s Obamacare exchange.   The Obamacare plan has 26% higher maximum out of pocket costs than my grandfathered plan:  $6,550 per person/$13,100 per family.  The Obamacare plan also has a 61% higher premium of $1281 per month ($15,372 annually).

Worst case scenario, if we meet our family deductible in 2018, the  total health care cost of our grandfather plan ($9564 annual premium + $10,400 out of pocket) is $19,964.  However, the same worst case scenario total health care cost for the Obamacare plan is $28,472 ($15,372 annual premium + $13,100 out of pocket).  The Obamacare plan’s total cost is $8508 more  – 43% higher - than my grandfathered plan.  That cost difference is simply head shaking.  I do not qualify for a tax subsidy.

I remember when politicians disparaged the grandfathered health insurance plans as being "crappy".  Well, I can tell you one thing:  a lot of people out there would like to have my "crappy" Blue Shield grandfathered health insurnace plan today!

This comparison begs the question:  Is Obamacare truly "affordable" as the name "Affordable Care Act" promises ?  I certainly think not.

Mary Rae Fouts

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