Obamacare sticker shock!
By Raymond Thomas Pronk
A spoof of the Obamacare website HealthCare.gov home page from the Daily Show.
While gasoline prices may be going down, premiums, deductibles and co-payments for health insurance plans are skyrocketing.
Beginning Jan.1 all individual and group employer-provided health insurance must comply with the provisions of the Patient Protection and Affordable Care Act, commonly referred to as Obamacare.
More than 156 million Americans have their health insurance plans provided by their employers and another 25 million purchase their health insurance in the individual market, according to the Congressional Budget Office.
More than 60 million people age 65 and older and those younger with disabilities qualify for Medicare, a social insurance program that pays on average less than 50 percent of their health care costs. The balance of their health care costs must be paid for by the individual or the individual’s supplemental insurance.
More than 60 million Americans who are poor qualify for Medicaid, a government insurance program jointly funded by federal and state governments for individuals of all ages whose income and resources are insufficient to pay for health care. Obamacare expanded Medicaid coverage to those earning less than 138 percent of the federal poverty line (about $15,000 for an individual and $32,500 for a family of four). Twenty-four states have opted out of the Medicaid expansion, including Texas.
Those who do not qualify for Medicaid because their earned income is higher than the federal poverty line may qualify for subsidies or credits paid for by taxpayers if they purchase a plan from one of the insurance companies offering them on the new health insurance exchanges.
Most individuals and small-group employers and their employees cannot keep their existing health insurance plans because of Obamacare. They are shocked by the high premiums, deductibles and co-payments of the new plans offered by insurance companies to replace their existing health insurance plans.
Credit: Texas Public Policy Foundation
One reason the premiums and deductibles for non-grandfathered (not in existence on March 23, 2010) individual and small-group employer (employers with 50 or fewer employees) health care insurance plans are significantly increasing is Obamacare requires the insurance companies to offer a minimum core package of items and services referred to as Essential Health Benefits (EHB). The only plans not required to have EHB are fully insured large group plans, self-funded administrative services only plans and grandfathered plans.
These essential health benefits fall into 10 categories: ambulatory patient services, emergency services, hospitalization, laboratory services, maternity and newborn care, mental health services and addiction treatment, rehabilitative services and devices, pediatric services, prescription drugs, preventive and wellness services and chronic disease treatment. These EHBs must be included for plans offered both outside and inside the Health Insurance Marketplace such as those plans you find on the website HealthCare.gov.
A second reason the premiums, deductibles and co-payments for non-grandfathered health insurance plans are increasing is that individuals with pre-existing conditions cannot be denied coverage and the plans cannot have a maximum lifetime limit for medical expenses.
Millions of Americans, because of their age, gender, lifestyle, marital status and religion, do not need maternity care and newborn care, mental health services and addiction treatment, pediatric services, abortions and contraceptives. These Americans were satisfied with and could afford their existing health insurance plans and wanted to keep them.
Americans believed Obama when he repeatedly said, “If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”
While in theory they could keep their plans under the Section 1251 “grandfather” provision of the Affordable Care Act, the regulations from the Obama administration interpreted this provision so strictly as to prevent most plans from being grandfathered.
Now the American people are learning from various news reports that the Obama administration officials knew in July 2010, when it was published on page 34,522 of the Federal Register, that “The Departments’ mid-range estimate is that 66 percent of small-employer plans and 45 percent of large-employer plans will relinquish their grandfather status by the end of 2013.” This represents about 93 million Americans facing cancellation of their existing plans because of Obamacare.
A sure way for a president to lose the trust of the American people is to misinform them about something they must pay for, such as the premiums, deductibles and co-payments for their health insurance plans.
Obama broke his promise to the American people and as a result his presidential job approval poll numbers have plummeted from an all-time high of 68 percent in Jan. 22-24, 2009 to a recent low of 39 percent on Nov. 5, according to Gallup.
Instead of making health insurance more affordable, Obamacare has made it more expensive for more than 181 million Americans who are now in sticker shock.
Raymond Thomas Pronk presents the Pronk Pops Show on KDUX web radio from 4-5 p.m. Monday thru Thursday and from 3-5 p.m. Friday and authors the companion blog http://www.pronkpops.wordpress.com.
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