Obamacare Shopping Is More Important Than Ever

Shopping? Sopping for healthcare? Is that like shopping for toilette paper? How about choosing worse from worser.

So, we have to switch plans to keep costs down, but my doctor is not on the cheaper plan. Another promise broken.

Wow, sick of the whiners complaining about switching every year. A lot of people could not get insurance at any cost prior to ACA. That's number one, and it's important because without insurance, eventually, the sick person goes bankrupt. and we all pay anyway.

The problem is that the only real competition between health insurers is how they can each get a basic premium then provide as little actual coverage as possible. They all basically provide just catastrophic coverage. That's not so bad but at least let's be honest and call it that.

Midicare for all. Single payer.

COMPETITION WORKS How interesting that the Government, using market forces to control pricing of Obamacare, is working very well, indeed. The law is so reviled that it has become the GOP battle cry, as it seems that there are weekly motions i Congress to repeal it completely.

A plan based on one by a former Republican governor, Mitt Romney, using the dynamics of a free market by defining the factors by which the government can attract purchasers to its plans, can win over private insurers.

No wonder, because GOP free market ideology has become a set of buzz words and high pitched dog whistle signals intended for the select few in the 1%.

What a bracing experience to witness a government program being conducted as a reality game, while the private insurers are stranded on Gilligan's Island, watching I Love Lucy.

Yes! And I'm one of the old white guys who abominates the stuff and nonsense spread around by the GOP.

Earth to DC: Nobody wants to shop for health care. We just want to be able to go to our doctor. Then, if that doctor says we should go to another doctor, we want to be able to do that, too. And if we need medicine, then we want to be able to buy it.

Why would the NYT present the most expensive and confusing bill of sale in the history of the world (excluding wars), as anything other than what it is? It's big, complex and expensive. It costs near as much in time as it does in money, just to figure out that you can't figure it out. When I think I've bought one thing, I come to find the website isn't up to date, and that specialist I need is now off plan and will cost extra.

Americans, sick and healthy, covered or not, are still paying more and more money for less and less health care. Why the myopic focus on who's buying what, when nobody really buys it at all?

As Jane notes below, you can also shop off-exchange plans. But, be aware that if the on-exchange plans are costly in your market and feature narrow networks and high deductibles, so too will the off-exchange plans. If you can find an insurer that is not offering insurance on your state or federal marketplace you might luck out and get a better plan. Or, you can explore professional associations that in some states may still offer small group coverage. (They were barred from doing so in NY.)

Otherwise, given the law put everyone in the individual market in the same risk pool, understandably fearing adverse selection, that healthy and/or unsubsidized people would shun the marketplaces and shop elsewhere, and required insurers to offer the same plans on or off exchange, you're stuck. What you see on healthcare.gov or state marketplace is pretty much what you get.

It's interesting that health policy experts always quote the "average price for a 40 year old non-smoker". I think they know if they referenced the "average price for a 61 year old non-smoker" people would be shocked.

The cost for healthcare without subsidies is a huge stress which seems guaranteed to become worse. How any middle-class family can afford college, a mortgage and health care is beyond me. If only we had the courage, as a nation, to follow the lead of our kinder neighbor to the north!

People should keep in mind that they can shop and compare both on and off exchange (Obamacare) plans. You are not locked into just Obamacare plans. Healthcaregov doesn't have all available plans, so shop around other sites, speak with a licensed agent. I would caution anyone searching the web for quotes to be very careful. If a website asks you to disclose if you have a pre-existing condition, simply to receive quotes, you should leave that site. A website that doesn't ask for personal data, and has phone options as well, is https://HealthNetwork.com

They're a legitimate price comparison website that doesn't collect information or try to sell you anything.

The the massive Federal Empolyees Heath Insurance Exchange is also having outrageous cost increases and huge copayment and deductible and catestopic limits increases for 2016. This is of course related to the Congress removed themselves from FEHB and put themselves on a special small business exchange in the DC market place. This special market place just for members of congress and their aides, gets the employer contribution of the Fed employees plan and they get to claim they are on Obamacare. Who wants to guess that they have a wife network and small increases.

Regular Fed employees once again are the pawns in the made up budget crisis ( we waste more money on wars ) get only 1%. While premiums for insurance alone over 7.5%. But copays on BCBS going up $20 to 25, 25 to 30, 30 to 35, $250-350. With catestropics going from $6k to 11k . This is on top of massive premium hikes!

Federal Retirees and Social Securiy beneficiaries both get 0 increase yet premiums go up 7.5% plus copays go up 20-25%.

This has not been my experience.

For many years I purchased a very high deductible "catastrophic coverage" policy. At the time I instituted that policy I was paying nearly $25,000 per year in prmiums for my wife and family. I found a $30,000 deductible plan for $700/YEAR in premium costs and set aside the roughly $24,000 difference. each year.

It worked fabulously well for myself and family as our year to year out of pocket expenses rarely exceeded $6,000.

With the ACA that catastrophic plan was discontinued because the deductible was not consistnat with the legislation.

I purchased a new and "better" plan with a $6,000 deductible that came with a yearly premium of ONLY $8,000 for my family. Fortunately I didn't have many out of pocket costs last year. But they all fell within the deductible so my healthcare costs last year were considerably higher

That plan was discontinued this year and the only plan I can now find with the maximum allowed deductible of $6,000 will cost about $12,000/year in premiums.

Obamacare is bureaucratic, inefficient, flawed and the worst health plan than any of our peer countries.

Having said that, it is still much better than what the republicans want to do, ie bring us back to their de facto criminal plan or be rich or not have a bad life event.

Let's move closer to any of our peer countries and not regress back to the de facto criminal republican plan.

My Obamacare experience:
I was paying $174 a month for a high quality no lifetime limit BCBS policy
1st year of Obamacare premium increases to $450 & deductible does up to $5500.
2nd year of Obamacare premium increases to $468 network shrinks to local & a prescription I take is dropped from coverage costing me an additional $175 a month.
3rd year of Obamacare (2016) premium increases to $652 deductible goes up to $6850.
That's almost $15,000 per year before insurance kicks in.
The yearly check up isn't even free because I need a prescription refilled & they charge separately for that!

Be aware of the "two fer" effect, as if you choose Cigna, you get a new pharmacy benefit manager named United Healthcare. That's right, you get to support the bottom line profits and stock buybacks of not one, but two S&P companies now.

http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess...

This might also explain why Cigna may want out of this 10 year contract with the PBM, Catamaran, a wholly owned subsidiary of United Healthcare as Cigna folks could be converted to Anthem to get out of having a United Healthcare company be their pharmacy benefit manager. Get's more gray every year, right?

" ...for people with complex needs and established relationships with doctors, the switching can be more difficult."

Important as this is, the difficulty of switching goes further. I do not see how it is possible to assess your overall cost savings when you try to calculate how much you will spend in deductibles and co-pays. And then there is the challenge of determining your limitations as far as seeking expert specialists, tests and procedures should you need them for serious illnesses. From my examination of various insurance plans as well as Medicare Advantage plans, my conclusion is that you will probably spend the first year learning about the "fine print" of any insurance plan. The question is to what extent insurers use the fog of complicated plans to lure in new customers. The ultimate problem, it seems to me is that getting good, affordable healthcare is more challenging than even this article presents it.

As a freelancer, I've been dealing with finding individual health insurance since 1994. As someone who developed a couple of pre-existing conditions, I became uninsurable in 2002. Obamacare, while not cheap, had so much better coverage than that subsidized by the state, that I was thrilled to have it, despite the website difficulties that, in my case, took almost two years to fix. But this year, my last before Medicare, not only have the rates gone up about 20%, but many plans from the last two years are no longer available – and the benefits and doctor and hospital networks offered have been severely downgraded. Whether Bronze, Silver, or Gold, about half the plans in my area only start paying benefits after the deductible is paid. And that can be up to $6850! The way insurers calculate paying off the deductible pretty much guarantees that you'll never get through it, even with minor surgery, so one may still have to pay thousands of dollars for treatment in addition to a large premium. Provider networks: forget the major medical centers. Forget being able to continue seeing doctors that I've worked with for 20 years. Forget being able to avoid going through "step therapy" yet again because the formulary doesn't support medications that I've taken for years and I'm forced to have to fail, once again, on their "preferred" meds, even with doctor support. And I mostly take generics. It's "rape and pillage" health care. SINGLE PAYER FOR EVERYONE!

Several readers commenting have highlighted the inherent failure of the ACA to deliver on its promise of "affordable healthcare for all Americans." In essence we created a new inherently unfair system, changing who won and who lost in the access to health care game, with affordable coverage for subsidized 9 million (plus Medicaid expansion) and increasingly unaffordable coverage for the millions more who are unsubsidized.

Like others, I pre-shopped health insurance plans in the marketplace for my age group. For even the poorest, narrow network, "x" marked bronze HMO the monthly premium was over $500 (silver plans were $600 and more) and the deductible was $6800. (I mention the "x" because I was asked last year by providers if my Humana POS had an "x" because that was out of network.)

Pre-ACA I had Humana One insurance at $335 premium with $3500 deductible and all preventative care covered at no cost, 6 doctor visits for co-pay, etc., etc. I'm hoping to get permission for a catastrophic plan despite my age.

A past supporter of the ACA, I now recognize that however many people we covered - 8 or 9 million on the marketplaces and, depending on the estimate, maybe 7 or 8 million more through Medicaid, the law has failed in its basic promise of affordability. Whether people shop or not, without that subsidy - and it's mostly middle income people who are paying full price - the insurance is neither affordable or high quality.

We desperately need a different approach.

Private Health Carrier-Companies' Plans (the Swiss-type model?) are governed by private profit dynamics; hence all those Health Insurance Companies can *switch whatever plans they want each year* and "may sometimes (!)"
*offer you a more expensive one than you might pick from their offerings* s. Mix of Private (and multiple!) Companies is what "Republican GOP" and a few "Blue Dog Democrats" insisted as a compromise to get health insurance reform. Single-payer? No; We're stuck shopping for Insurance!

Studies have shown that Medicare Part D drug insurance plans use low teaser premium rates to get people, then they jack up rates later. So you save money by switching plans every year. Same seems to be happening with these market-based health insurance plans. If you stick with the same plan you get screwed.

But people don't want to shop for new insurance every year! And if you're sick or have chronic health issues, it's very stressful and hard! Is ANYBODY listening?! This is insane!

And the Republicans talk about turning Medicare into a voucher plan! Yes, let's have old frail folks, including those with dementia, heart failure, cancer, etc. shop for a new Medicare policy every year.

Having window shopped for silver plans in my area, the two cheapest silver plans (and remember, it is the second lowest cost silver plan than the subsidies are based upon) has no physicians within 40 miles of my house, just a single nurse practitioner. This is despite the fact that there are three hospitals within that same radius. Not complaining, just stating a fact. I will be staying with my same insurer in 2016.

If we are going to keep Obamacare, the penalties for not carrying coverage should be much higher. They need to be higher than the cost of the insurance coverage to ensure that people actually purchase the coverage rather than pay the penalty. The penalty should be the annual unsubsidized premium of the cheapest bronze policy in my opinion. That would improve the risk pools by ensuring more healthier and younger people enroll.

Medicare-For-All is the only possibility for controlling our runaway health care costs. Healthcare is an enormous weight on our economy as it acts as a tax.

The rise in costs is beyond insane. Honestly, we are the dumbest of industrialized countries paying far more for health care than it is worth. Let us all become smarter and soon.

People want to find a doctor they like and not have to look for another doctor because some insurance company won't offer compensation to the doctor at a community rate. We need community rates of compensation by insurers for physicians, just like we have community pricing of policies. Surely the medical community can come up with a few basic determinants for establishing compensation levels, such as experience and costs. That will enable people not to be constantly flim-flammed by their insurance company cutting physician compensation, and causing the doctor to have to stop taking that insurance.

How does shopping around for a new insurance plan every year or so make people any healthier or give them better medical treatment??

I have a friend who is retired and disabled and should be getting 100% free coverage on Obamacare, but because he lives in Virginia (one of 22 states that refuse to expand Medicaid) he is facing higher premiums that he can't afford. Shopping for a better deal will be stressful and difficult for him. Many of the problems people face with Obamacare premiums are rooted in the deliberate failure of 22 states to expand Medicaid for their most vulnerable citizens. We need a public option that would allow Medicaid dollars to fund expanded coverage for people doomed to live in backward states.

Shopping for insurance is no small thing; it’s as complicated as buying a house in terms of the many decisions involved. $400–600 may be a significant amount of money but not enough to make changing carriers worth it.

Forced competition between insurers on a pretty level playing field is the approach we have, and all we are going to have for some time, in the private insurance market. We are not going to have a government controlled, single payer plan such as in Britain. Nor, are we going to have a public-private health plan as heavily regulated by government as in Germany or Canada. So, we need to make competition work.
And it has been working in the private market. In 2015, enrollees who shopped experienced on average only a 1% increase in premiums. For 2016, as the article states, a shopper can find a plan costing on average $610 less per month. So, shopping works. And this year the federal exchange will make it easier to find out if particular doctors are in network and whether ones' drugs are covered by each plan.
Many employers in the group market change insurers or change plans offered by the same insurer each year. So, employees also have to adapt to changes in plans. Employers, who are paying 65%-80% or more of the costs, are forcing competition upon insurers. Obamacare has made that easier for them, as well as in the individual market, by requiring coverage of the same essential benefits, by enforcing the same requirements about lifetime limits, pre-existing conditions, administrative costs, profits, etc. and by making transparent the percent to be paid out-of-pocket (with excesses rebated to enrollees).
So, shop and save. It's a better use of time than complaining

Received my Blue Cross 2016 premium yesterday. It increased 26%. I, like many millions more than this article suggests, receive no subsidy. It seems to me that privately insured Americans who do not qualify for subsidies are bearing a disportionate share of funding the subsidies. Contrary to popular opinion, most of us unsubsidized, privately insured folks are not wealthy and never will be. When Obamacare passed, as a single male I was paying $256 a month with a simple $2500 deductible. In 2016, I will be paying $556 with a $6000 deductible. I'm sure Obamacare has benefited some, but it is forcing millions to to accept lower quality, more expensive policies.

If you want a messed up system, turn it over to the for-profit sector.

Single. Payer. Please.

"Early information about premiums suggests that the total prices of plans in many states are going up by a lot, though the structure of government subsidies will insulate most customers from the changes." This is a complex "shell game". The significant direct price increases are borne by just a few so
the real cost of insurance has little relevance to policymakers. Those who purchased their own insurance pre-Obamacare are left behind in the Obama giveaway are being tossed under the bus again and again. Massive expansion in the scope of coverage, increased deductibles, fewer and fewer doctors who will accept individual coverage and huge jumps in premium. But heck...few people actually pay the real premium, right?

The networks and the deductibles are why Obamacare does not make sense. Naturally, different plans have different prices.

In countries with working private-insurance systems, such as Germany and Switzerland, there are no networks. Each plan covers all treatments at all doctors with fixed co-pays, so they compete on price alone.