I don't post to this blog often, but decided to give my 2 cents about health care-health insurance. As a state employee, I still have good insurance - an HMO (now known as EPO) through CareFirst BC/BS. My employer pays most of the premium, though I do contribute a portion of that premium. I have no deductible and my copays are low. If I complete wellness activities, some copays are waived. A "Cadillac"plan - probably as good as it gets in today's market. So far, I have only seen modest premium increases since the ACA has been in effect. Good insurance - good care. I am fortunate & I am grateful.
I have mixed reactions to the results of Obamacare so far. I have a unique perspective because I deal with people every day who have truly been helped by two specific features. 1. coverage for children up to age 26 on their parents' plan, and 2. Expanded Medicaid. For the unemployed & those with no income, Obamacare has been a blessing. They pay no premium, and have little or no out of pocket costs. I have helped many of these folks get Medicaid & stressed the importance of taking care of their health before catastrophic need.
It is the individual and family "exchange" coverage for the "working poor" that I question. I have looked at the "metal" plans, premiums, deductibles & out of pocket costs. This is lousy coverage with a high cost to the individual & family. If they are eligible for a subsidy, this only goes toward the premium, not the out of pocket costs. The deductibles & copays are not affordable - especially for the working poor. So they have an insurance card, but in reality they still cannot afford health care.
Most people I know (self-employed or employer did not provide coverage) said they did not qualify for any kind of subsidy. It is absolutely NOT affordable, & the costs keep rising. These are the folks who either pay the fine or claim hardship. Either way, they have no insurance & don't get any until catastrophic need occurs.
Then there are the vast majority of people who have or had coverage through their employer. They used to have decent insurance coverage, with reasonable premiums - many had HMOs. The HMO, which was supposed to keep costs down is now the most costly type of insurance. Most employers no longer offer the HMO as an option. One of the fallouts from Obamacare is that many of these folks now pay higher premiums for less coverage. The out of pocket costs are skyrocketing for this group. They have insurance, but avoid going to the doctor when they get sick because they can't afford it.
So yes, the system is still broken and in need of an overhaul. I have not read the AHCA documents, but have listened to the rhetoric & hype from both sides. Whatever they do, I believe that keeping coverage by parents until age 26 & some form of expanded Medicaid needs to continue. I like the idea of tax credits as opposed to subsidies - put the $ back into the hands of the individual - taxpayer - instead of the insurance company.
I have mixed reactions to the results of Obamacare so far. I have a unique perspective because I deal with people every day who have truly been helped by two specific features. 1. coverage for children up to age 26 on their parents' plan, and 2. Expanded Medicaid. For the unemployed & those with no income, Obamacare has been a blessing. They pay no premium, and have little or no out of pocket costs. I have helped many of these folks get Medicaid & stressed the importance of taking care of their health before catastrophic need.
It is the individual and family "exchange" coverage for the "working poor" that I question. I have looked at the "metal" plans, premiums, deductibles & out of pocket costs. This is lousy coverage with a high cost to the individual & family. If they are eligible for a subsidy, this only goes toward the premium, not the out of pocket costs. The deductibles & copays are not affordable - especially for the working poor. So they have an insurance card, but in reality they still cannot afford health care.
Most people I know (self-employed or employer did not provide coverage) said they did not qualify for any kind of subsidy. It is absolutely NOT affordable, & the costs keep rising. These are the folks who either pay the fine or claim hardship. Either way, they have no insurance & don't get any until catastrophic need occurs.
Then there are the vast majority of people who have or had coverage through their employer. They used to have decent insurance coverage, with reasonable premiums - many had HMOs. The HMO, which was supposed to keep costs down is now the most costly type of insurance. Most employers no longer offer the HMO as an option. One of the fallouts from Obamacare is that many of these folks now pay higher premiums for less coverage. The out of pocket costs are skyrocketing for this group. They have insurance, but avoid going to the doctor when they get sick because they can't afford it.
So yes, the system is still broken and in need of an overhaul. I have not read the AHCA documents, but have listened to the rhetoric & hype from both sides. Whatever they do, I believe that keeping coverage by parents until age 26 & some form of expanded Medicaid needs to continue. I like the idea of tax credits as opposed to subsidies - put the $ back into the hands of the individual - taxpayer - instead of the insurance company.
No comments:
Post a Comment