Obama Administration Confirms Double-digit Premium Hikes

[Grey Lemercier]

Source: Associated Press

WASHINGTON (AP) -- Premiums will go up sharply next year under President Barack Obama's health care law, and many consumers will be down to just one insurer, the administration confirmed Monday. That will stoke another "Obamacare" controversy days before a presidential election.

Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25 percent across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. Some states will see much bigger jumps, others less.

Moreover, about 1 in 5 consumers will only have plans from a single insurer to pick from, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their roles.

"Consumers will be faced this year with not only big premium increases but also with a declining number of insurers participating, and that will lead to a tumultuous open enrollment period," said Larry Levitt, who tracks the health care law for the nonpartisan Kaiser Family Foundation.

snip

Read more: http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PREMIUMS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2016-10-24-17-03-27

---

Single payer is the only answer for this. Assuming we take back the Senate (I am looking at 51 to 53 Dems, depending on PA and NC) and gain 15 to 20 or so in the House (not control, unfortunately) there is a 2 year window to get this done. 2018 will probably be a Senate election problem for us, so the chances after that will be grim.

We will have 10 or 11 hard races, all defending seats, many in red or pink states, all in an off year, all in a 3rd consecutive term of Dem POTUS's.


FL Bill Nelson
IN Joe Donnelly
MI Debbie Stabenow (safest of these 11)
MO Claire McCaskill
MT Jon Tester
ND Heidi Heitkamp
NJ Bob Menendez (mainly due to his criminal case, if it is not resolved and he runs still)
PA Bob Casey
VA Tim Kaine (will be another Dem, due to VP)
WI Tammy Baldwin
WV Joe Manchin

then these

NM Martin Heinrich (safe unless Susanna Martinez, who is termed out, runs)
OH Sherrod Brown (safe unless termed out Kasich runs for Senate)

The main Rethug seat we can realistically flip is

NV Dean Heller

Maybe Flake in AZ

[geek tragedy]

1. subsidies will pick up the difference nt

[snpsmom]

2. Subsidies help

but not everyone qualifies. Single payer has to happen.

[manicdem]

3. How are the subsidies funded?

I'm currently on an obamacare subsidy, and wondered how those subsidies were paid for. With the large rate increases would this reduce the amount of subsidies in the future?

[Travis_0004]

21. We borrow money

There are some new taxes, and penalties if you don't have health insurance, but from 2016-2025, we will borrow 1.2 trillion to pay for obamacare. (per CBO)

[Yo_Mama]

50. If enough people get them, yes. There is a provision in the law linking

total subsidy increases to GDP increase in the future - beginning 2019.

Right now no limitation is supposed to be in effect because so few people (less than half the projected) are getting subsidies.

[strategery blunder]

10. No they won't.

Last year my premium went up, but because my income stayed the same, my subsidy stayed the same.

My premium went from about $70 out of pocket/$280 total to $103 out of pocket/$313 total.

What looked like on paper about a 10% increase was actually almost a 50% out of pocket increase. I make about 160% FPL so I have limited capacity to absorb this.

Yes I recognize that Republicans have underfunded the law but Obamacare is going to need an overhaul soon or those on lower incomes who still make too much for Medicaid (or live in states that refused the Medicaid expansion) are going to start dropping coverage like flies in the next few years.

I have probably about another 1-3 years before the cost of health insurance once again exceeds the cost of paying for my (generic) medication and the doctor visits necessary to maintain the prescription, plus the tax penalty. At that point, the choice will be between keeping health insurance or making rent.

[geek tragedy]

13. the Medicaid gap is a big problem.

Too bad Ick Scott isn't on the ballot now.

The law needs to be improved greatly.

[strategery blunder]

23. Subsidies seem to be almost (if not completely) exclusively income-linked.

If income stays the same but premiums go up, the increase falls entirely on the insured. It easily magnifies an increase that might look reasonable to a regulator to something that completely busts the individual budget, especially when the regulators only consider the total premium rather than the unsubsidized part of the premium. (They will end up with a diluted sense of what effect the increase will actually have on the individual policy holder, as described by the example in my earlier post.) That is a much wider problem than the Medicaid gap imo.

Unfortunately ACA was very weak as far as cost containment is concerned. If the law had done more to hold medical inflation down to the rate of inflation in the general economy, the problems that I, along with millions of others, am experiencing with ACA cost increases would be much less severe. Unfortunately this was predicted by the unheeded single-payer advocates who were shut out of the public hearings that legislative processes are in theory supposed to have. Too many compromises were made chasing Republican votes that never materialized, leaving the final law critically weakened.

[geek tragedy]

25. I thought post-subsidy cost was pegged

as a % of income. No?

There were never the votes for single payer. Not even a majority of Democrats would have voted for it.

[strategery blunder]

33. That's not what happened when I received my ACA notice last year.

In a single year the OoP premium went from about 5% of my income to 7% of income. And that's gross, not net, though I pay far more in payroll taxes than actual income tax. That is before anything like deductibles (which I am guaranteed to meet due to DEA regulations mandating I see a doctor to renew my prescription multiple times per year, though it be medically unnecessary--my doctor and I both agree on that point--because someone somewhere might theoretically abuse said prescription). Once those mandatory deductibles are considered, my medical expenses easily surpass the 8% of income that was bandied about as the theoretical maximum that health expenses should be when the ACA was under debate.

My income did not change last year, therefore my subsidy remained the same even as the cost went up. I was left bearing the entirety of the increase.

If the increases in my state (WA) turn out to be nearly as bad as what media is reporting in other states for the next year, the OoP premium alone will easily surpass 8% of my income and might even reach 10%. I expect I can hold out for another year, but probably not much longer if the next Congress is content to let ACA fail.

[Leontius]

44. No they won't for many people.

[Yo_Mama]

49. For most, they won't pick up all the difference, for about 20%, none.

Not everyone receives a tax credit. And for many of those who do, the tax credit won't change much, but the underlying copays, etc, will.

There are a lot of people who used to have insurance who don't any more in my area. They just flat-out can't afford to get healthcare and pay the premiums. They now save and pay on their own.

[Yo_Mama]

51. The reason why the lack of competition hurts so badly is the subsidies.

Once a market is one or two insurers, they can raise rates for all policies. Subsidies are figured on a percentage of your income and the second-lowest silver plan available in your county. And that silver plan might be one that you simply cannot accept - perhaps it is a narrow network that won't cover much of anything of your actual health care needs (for example, I know physicians with patients with narrow network plans that can't find a SINGLE endocrinologist covered). Also if you travel, narrow network plans leave you basically uninsured.

[TexasBushwhacker]

4. They're just asking for a public option

Maybe we'll finally get it. Then, of course, single payer.

[ehrnst]

5. And gas prices "go up" when a hurricane evacuation is announced....

So we should blame the people who ordered the evacuation for the high gas prices....

[procon]

6. Does this prove that a for-profit healthcare system will never be cost efficient?

It has never made any sense to me that healthcare was supposed to care for the medical needs of patients AND make a good profit for those who controlled the system itself. Its a con game. The conflict of interest is so illogical that the whole scheme is nothing more than a criminal enterprise where the victims have no options for redress.

[Igel]

30. Everything's supposed to make a profit.

Look at your own life. You have minimum needs. You need food, clothing, shelter, and transportation. That's the cost of your labor.

You were educated, probably partly at your own expense.

There's maintenance. That's investment in infrastructure. Things like health care.

You sell your labor and skills and need to cover maintenance.

Everything above that is profit.

My labor costs far less than my employer pays. My infrastructure maintenance isn't that large these days. And my investment in education is entirely paid off. I could survive on near minimum wage. Even with amortizing education over 35 years--the average useful lifetime, with the occasional upgrade--most people don't need most of what they have.

We like profit in our lives. Working class families near the bottom of their cohort have little profit. Those on welfare are receiving government subsidies for their output.

It's a bleak perspective, but one that's fairly accurate. Profit is what you get after you've paid off your investment and paid for labor and materials. Most of us demand a minimum profit, so we should understand greedy employers who demand a minimum profit.

That includes doctors, whose investment is far larger than most of us so the *same* ROI should yield higher incomes. Just like you'd expect higher income from an investment of $500k than $500.

Want health care to not make a profit, dispose of hospitals that aren't government owned and run. Dispose of doctors who have a say in where they go to college--make their education free and demand that they work for #35k/year, but then immediately idemnify them against losses due to medical errors. Make their equipment free. Make them, in other words, state serfs.

[ronnie624]

35. What a bunch of gibberish.

[ProfessorGAC]

43. ^^^This^^^

That whole post was double talking nonsense. The poster admitted he/she is overpaid? I don't believe it for a second. If that were true all the rest of that nonsense about profit being everything is contradicted by that statement.

Total nonsense, or as you said, gibberish.

On Edit: Besides, the problem is for profit health care. It's the superfluous layer of profit taking that occurs as the insurance companies become cash transfer organizations.

[ronnie624]

45. The only thing clear about the post

is the obvious theocratic belief in capitalism as the default for human economics.

An honest examination of the underlying assumptions that mainstream economic theory is founded on however, reveals them as illogical and devoid of moral legitamacy.

[harun]

47. +1, You can't reason someone out of a position they didn't reason themselves in to

That post was a reason free zone .

Governments role in Defense is not for profit. Seems to work there. Doctors would make money same as defense contractors do.

[LanternWaste]

48. Your post is what happens when one fails to take any sociology courses in college...

Your post is what happens when one fails to take any sociology courses in college... or simply fails to remember the lesson plans.

[guillaumeb]

52. The US health care system makes a profit opportunity out of denial of care.

Insurance companies are massively profitable, as are pharmaceutical companies. Those profits come at the expense of US citizens who pay far more for care than people in every other industrialized democracy.

This system was not "inevitable", it was planned to allow corporations to profit from denying care.

So if you believe in profit over people, your ideas make a sort of sense.

[Botany]

7. United Health Care is cutting me off as of Jan. 1

I have had no claims, pay $600 a month, and a big ass deductible too.


The insurance companies are trying to kill the A.C.A.. Single Payer.

These are not "health care companies" but cold blooded bankers.

CEO Pay Watch UnitedHealth Group Inc.
Stephen Hemsley, CEO

Total compensation: $66,125,208 for the year ended Dec. 31, 2014

Salary: $1,300,000

Non-equity incentive pay: $3,949,000

Other compensation: $107,479

Exercised stock options: $45,569,049

Value realized on vesting shares: $15,199,680

New stock options: 83,918

[Throd]

8. I just got a letter projecting my costs to increase $3,600 next year.

[Grey Lemercier]

14. Is that a post-subsidy increase?

Also 1 out of 5 people do not qualify for subsidies (it rises to 35% non-qualification for non-group covered people). Cost sharing ends (and is only good for the Silver plans) if you make over 28K usd gross or so per year, and all subsidies end if you make more than 47K gross per annum. Those numbers are for a single person, btw.

The deductibles for these plans (especially Bronze) look really high. IMHO it is utterly fucked the way the US does their health care. I have always been in a single payer system (mostly the NHS).

[Throd]

16. What subsidy?

[Grey Lemercier]

18. some of the commenters are saying that some of the increases will be offset by increased subsidies

So I was asking if that 3600 usd increase was AFTER subsidy increases.

[catbyte]

29. My premium went up over $150/mo, but my subsidy didn't change.

[austinlw]

9. The next obvious step is a public option low overhead Medicare plan

available to all under 65 to compete with the private plans. Most folks will likely choose it, since the premiums will be much lower. The private insurers will then likely either go out of business, offer secondary insurance plans to cover copays, and/or offer "Cadillac" plans for those who can afford them. Then the next step after that is single payer for all, which we'll likely pay for through payroll taxes instead of paying an insurance premium.

[Hoyt]

15. I support public option, but don't expect premiums to be much lower. Part B premiums increase 22%

for 2017, that's the projection. And, that doesn't included prescription drugs. Fortunately, those on Social Security will have the increase capped by the amount of their COLA, which ain't much.

[Skittles]

11. well isn't that special

who could have possibly seen that coming?

[Plucketeer]

12. When the fuck will >WE< have a say in it?

SCREW the F'ing health rip-off insurance companies and their god-be-damned lobbyists! MEDICARE FOR ALL!

[llmart]

42. I don't mean any disrespect but....

I'm a little tired of the "Medicare for all" meme. Those of us on Medicare (if you're not one of them) still have to pay a substantial amount for decent insurance. If I don't purchase a supplemental plan, I'm taking the risk of having to pay 20% out of pocket if I ever have a major health event. So, even though I don't go to doctors and am very healthy right now at 67 years old, the risk of eventually developing a major condition is greater for seniors. Plus everyone on Medicare pays (currently) $104 a month out of their Social Security check for Plan B.

I don't know yet what my supplemental premium will go up to, but this year it's been $173 a month on top of the $104. So, a Medicare type plan for all isn't what some people think it would be.

As someone downthread said, it's time we had some regulation/price controls on these greedy insurance companies. I am very tempted to take my chances with just the Medicare and no supplement because on a fixed income, that $173 is pretty steep.

[Plucketeer]

46. I'm 71, on Medicare and buying supplemental ins like you are

I'm in decent shape healthwise, but have had a couple of things hit me out of the blue - like a kidney stone a year ago. Medicare COULD be amended to eliminate that "gap" we're paying to cover.

[vadermike]

17. Can

Someone help
Me understand how we fix Obamacare with 51 to 53 senate majority and extra 15 maybe 20 dems in the house ? Maybe HRC can do a another budget reconciliation? But if not Ryan has no incentive to play ball with HRC ? How do we fix it ? It will be one of her first priorities along with the economy and immigration reforms ..

[Grey Lemercier]

19. My argument all along about the ACA was that when the rates and other costs really kicked in, and

when the scum, for-profit bloodsuckers that are the insurance companies and many providers did their multi-years sabotage of pull outs, rate increases and false narratives, that it would wreck so many people's faith for a government, social democratic (aka single payer) system.


It is going to be very easy to convince troglodytic reactionary non-thinkers of this meme >>> "Look! We tried gubmint health care (a lie btw) and Obama Care was a disaster! NOW you want a complete gubmint takeover of the whole things?? GTFO"

It was a set up from the beginning. I REALLY hope I am wrong.


The best way would be for President Clinton to bully pulpit the hell out it, frame single player as the ONLY truly fair and workable system, make sure that most Americans realise that EVERY other advanced nation has it, that it provides truly better and lower cost healthcare. Demonise the fuck out of the bloodsuckers who profit billions at the poor's, the middle class's, and the sick's expense.

She has to make it her biggest priority or it will fail. I hope she does so.

[Throd]

20. What if it is run like the VA?

I absolutely loathe the health insurance companies, but I'm not sure a giant bureaucracy should be assumed to be an improvement.

I am highly skeptical of both.

[Grey Lemercier]

22. Model it after the best EU countries' systems, such as France, Norway, Germany, Sweden, etc

I find it astounding that Americans, taken as a whole, accept of system that costs them (over their lifetimes) a hundred (maybe hundreds) thousand plus USD more PER PERSON, with worse care (or no care due to costs) than almost other advanced nations on the planet.

The same goes for the university system and your 1.3 trillion USD (more than your credit card debt) collective student debt.

To a mostly life-long ex pat like me, it's just mind boggling.

[rebecca_herman]

38. Some of those countries don't have single payer

There are developed countries with universal health care but not single payer. They have a two tier system. France doesn't have single payer, I don't think Germany does either but I may be wrong. Australia also has a two tier system.

Personally, I prefer that to single payer because I'd hate to see what gets funding cuts, what things aren't covered at all for "moral" reasons, the next time Republicans control Congress. I honestly don't trust a single payer system to work well long term in this country.

[Grey Lemercier]

40. yes, I know they all are not single payer systems

The Netherlands for instance with its mandatory and extremely low cost mandated insurance plans. I am sure we can find the right formula and a system that blocks repug scum from throwing a spanner in its works.

[James48]

24. How we fixit -

The best way to "fix it " now- without enough support for "single payer",
is to

1. let licensed Canadian pharmacies to do business here by mail;
2. Reduce the amount of time that drugs can be under patent from the standard 20 years, to 7 years.
3. Make all drug patent information pubic information not subject to patent after 7 years.
4. Let anyone who has a patent on a drug delivery device *(Epi-pen), lose all patent protection after 7 years as well, AND pass a law that stats that if the price charged is too high, that patent protection is subject to be withdrawn.


Those measures could pass with a simple Dem majority in both houses, and would make a real dent in costs.

[manicdem]

37. Need to balance it out.

Good ideas, however it's very expensive and risky to develop new drugs due to the lengthy testing process and only one drug out of many failures gets approved. It would have to be a balanced approach so that companies still have an incentive to develop new drugs. One way would be to quicken the approval process and reduce some regulations so that drugs are cheaper to develop but still safe to use.

[shenmue]

26. The president does not raise the premiums

[Grey Lemercier]

27. no one claimed he does....... nt

[catbyte]

28. I got my premium notice from Blue Cross/Blue Shield of Michigan--went up from $191 to $358.

And the deductible doubled.

Shit.

[christx30]

31. Mine is going to go up about $30 per paycheck,

just because I'm upgrading to a premium plan, because both my kids need to see neurologists, and my wife has diabetes.

[still_one]

32. If we get control of the Senate, the first priority would be the SC. We barely made it through with

the ACA not only legislatively, but also through the Supreme Court.

The next step would be to increase the income limits for the subsidy qualification, and factor in expenses such as rent/mortgage, and other costs in its determination, and not just Adjusted Gross Income, so more people qualify for the subsidy.

All those things achievable in a reasonable amount of time.

After the above "fall-back" positions are in place, we should then push for Medicare for all, since that system is already in place, but in this political environment I do not see much hope unless we can take back the majority in both houses.

However, if we don't get control of the Senate, everything will be in question, and we will be lucky to get the Supreme Court appointments

[Festivito]

34. CAREFUL! Lots of misleading information surrounds health care.

1. People who say their premium goes up, but, does not tell you that they make ten times what you do.
2. People who paid excessive out-of-pocket, but, do not say that they called to have their premiums adjusted, or see 1.

From Obama's 2009 to 2014 HC% of GDP went from 17.3 to 17.5, a 1.2% increase.

From Bush's 2001 to 2009 HC% of GDP went from 14 to 17.3, a 24% increase. TWENTY TIMES WORSE UNDER THE REPUBLICAN!

http://www.healthsystemtracker.org/interactive/health-spending-explorer/?display=Per%2520Capita%2520%2524&service=All%2520Types%2520of%2520Services

[SunSeeker]

39. Thank you for putting it in perspective. nt

[humbled_opinion]

36. Single payer is the only way..

You have to control the costs by controlling the amount that those that provide the services get paid, the only way to do that is to put it all under government control. Treat the entire system like one big Medicare system that every doctor and hospital must accept or they are barred from practice in the USA.

Pretty simple solution right there. Additionally, the 1 percenters need to pay their fair share end the loopholes that let Trump write off all of his business losses.

[GreydeeThos]

41. The insurance companies are extracting their profits

For profit insurance will never meet the sprit of Obama care. They are showing their true motives by keeping prices at the maximum the market will bear. If the Government steps in with subsidies (which only guarantee company profit), the situation does not get any better because the prices will remain high for the people who can pay.

The solution is clear:

[font size =5]
Medicare for all / single payer

[/font]

[cbdo2007]

53. This will be like them raising the tax from 4% to 7% in a single payer system...

And everyone here will be spouting some other new system is better, lol. The govt are the ones raising the doctor and facility rates every year, so nothing much will be any different.

[Gary S]

54. The single greatest cause of increases was when House Republicans did not fund the "risk corridors"

The single greatest cause of increases was when House Republicans did not fund the "risk corridors" provision of the Affordable Care Act. Here is my discussion of the issue:
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=8700122