Pirate's Cove

Many, including myself, have noted that the NY Times seems to publish articles that often do not conform to the Official Democrat Line on Saturdays. Here’s another, which made the front page

Unable to Meet the Deductible or the Doctor

Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring.

But her new plan has a $6,000 annual deductible, meaning that Ms. Wanderlich, who works part time at a landscaping company outside Chicago, has to pay for most of her medical services up to that amount. She is skipping this year’s brain scan and hoping for the best.

“To spend thousands of dollars just making sure it hasn’t grown?” said Ms. Wanderlich, 61. “I don’t have that money.”

About 7.3 million Americans are enrolled in private coverage through the Affordable Care Act marketplaces, and more than 80 percent qualified for federal subsidies to help with the cost of their monthly premiums. But many are still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families — the trade-off, insurers say, for keeping premiums for the marketplace plans relatively low. The result is that some people — no firm data exists on how many — say they hesitate to use their new insurance because of the high out-of-pocket costs.

The original idea from Democrats was to find a way to make health insurance available for the 30-45 million Americans (the number included quite a few legal visitors and illegal aliens). It was a good idea. From that point, it grew into the monstrosity it is. What’s the point of having health insurance if you cannot afford to actually use it when needed?

While high-deductible plans cover most of the costs of severe illnesses and lengthy hospital stays, protecting against catastrophic debt, those plans may compel people to forgo routine care that could prevent bigger, longer-term health issues, according to experts and research.

“They will cause some people to not get care they should get,” Katherine Hempstead, who directs research on health insurance coverage at the Robert Wood Johnson Foundation, said of high-deductible marketplace plans. “Unfortunately, the people who are attracted to the lower premiums tend to be the ones who are going to have the most trouble coming up with all the cost-sharing if in fact they want to use their health insurance.”

You don’t say.

…A survey by the Kaiser Family Foundation found that the average deductible for individual coverage in employer-sponsored plans was $1,217 this year.

In comparison, the average deductible for a bronze plan on the exchange — the least expensive coverage — was $5,081 for an individual and $10,386 for a family, according to HealthPocket, a consulting firm. Silver plans, which were the most popular option this year, had average deductibles of $2,907 for an individual and $6,078 for a family.

Information that was known not long after they started selling Ocare plans almost a year ago. Good to see the Times is timely in their information dumps.

The article really doesn’t address the limited networks beyond a sentence of two, unlike the headline suggests. Of course, limited networks do not matter all that much when people cannot afford the deductibles. If there was one idea that Democrats could have taken from Republicans….since they claim they took a bunch….was national insurance pools, which would have helped significantly reduce those deductibles.

But we’re also running into the problem now that so many of the people enrolling in Ocare are sicker and older than was expected, so it will be interesting to see if the deductibles rise for 2015. Which might be the reason Team Obama won’t release the costs till after the midterms.

Crossed at Right Wing News.