runs something like this:
“Our premiums for health insurance are being raised by my husband’s employer, and it’s directly caused by Obamacare!”
Doesn’t make sense to me. My employer (same state) isn’t changing my coverage at all. the employer isn’t being forced to cover more people (with the exception of kids ages 22-26, I guess).
Is there something I’m missing? She asserts this confidently, but is frequently wrong about things politically (from my POV) and, of course, wants to blame Bams for everything.
Fight my ignorance (or hers)?
Certainly in the last few years for my insurance, the yearly “we’re raising your rates” letter says “because of expenses associated with the Affordable Care Act”. I suspect most such letters do now, and that may be what your friend is going on.
Of course, in years prior to Obamacare, there were similar increases due to “market conditions” or “the increasing cost of care”. I suspect that the correlation between what the insurance companies say is causing the increase, and what is actually causing the increase, is quite low.
ACA requires qualifying plans to offer certain coverages. If the previous plan was sub-par, and now has added enough to qualify as a valid ACA plan, the premiums may increase to cover the new benefits.
This. There are minimums associated with ACA - must cover the following, co-pay cannot exceed $X (percent of income) etc. If your relative had cheap(er) health care because it didn’t cover enough, or didn’t pay enough, then of course it’s not really “affordable” health care; just that they complain about the higher premiums today because they never yet had to complain about how much a medical procedure cost them on top of their health care. If they’d badly needed a stay in the hospital, then they’d be singing a different tune with the improved coverage…
Or it’s possible that the employer is taking advantage of politics to dump more of the cost on the employees or the insurance company sees a way to make a quick buck and jack up the cost while blaming it on someone else.
I guess it depends - did they get a letter also explaining what more coverage they had for the new price?
No, not so far as I know. She’s since responded with other generic complaints about Obamacare (not sure of her source, probably Fox but maybe something more valid), such as “if companies haven’t been offering care they’ll face penalties, which will get passed on.” I pointed out to her that her husband’s company was apparently already offering coverage, so not relevant to her. A follows B follows C logic is not her strong suit.
Well, yeah, companies that offer any health care at all in the last 50 years have incorporated those benefits into their pricing structure.
Companies that didn’t offer health care, everyone else was paying for the emergency room care that thier employees got when they had to resort to emergency rooms. If a hospital treats someone who has no money and no coverage (as they are required to do) and medicare/caid does not pay for it, then all the rest of their customers - the ones with coverage - pay for it. Which raises their premiums. Which gets reflected in their employers’ costs.
So basically, until now, you the consumer have been paying the generous companies to subsidize the un-generous companies’ employees’ emergency coverage.
My insurance rates thru my company have increased 65% over the last ten years; that’s an average of 6.5% for the non-math readers. This year the percentage increase was less than 0.5%; the lowest it’s been since I started working there. Yet my fellow employees still insist on crying about the increase; stating that they were told that health care would be free under Obamacare. You are never going to convince true believers, even with facts that show up in their paycheck. Some people just live to complain.
My experience is the same as yours Amigo. This year is the first in about 5 that we have had no significant changes to our contributions or coverages. I think many large insurers actually began restructuring right after the ACA passed (and quite a few of the requirements have been in place for at least a year or two at this point).
One also needs to consider that for an employer it’s always preferable to say “employee contributions are going up because of Obamacare” than to say “employee contributions are going up to cut costs”.
For the last two years I have gotten letters from my insurance company letting me know that they were issuing refunds to my employer (a small business), because they had not paid a large enough percentage of their premiums as claims. They must pay out 85% as I understand it.
I suspect Mrs. Cad may be in the same boat. Her insurance through work was basically paying $100 for having them not cover anything. She actually dropped the insurance because why pay $1200/yr AND your medical expenses on top of that.
The factual answer to the OP’s question of course is it is impossible to know if your relative’s personal health insurance premiums went up because of the ACA or not. It is entirely possible they did.
It’s not even necessarily the case that her old health insurance was “bad” and coverage would have been lacking if she got sick, either. For example part of the ACA is that qualifying plans must cover preventive care. For men this is basically (IIRC) an annual physical and I believe certain screenings once you are over a certain age. For women it is a physical & gyn exam (which are often delivered in one go), and I believe mammograms etc.
Your relative may have had great coverage that maybe only had a small copay for such services (the health insurance I had at one point it was like $25 a few years ago for visits like that), with great coverage for hospitalizations and etc. But the ACA would require the plan to change, so that instead of collecting a small copay for those visits, no copay would be charged. That would raise the costs of providing the coverage, and would raise premiums. This would be a small increase, though.
Health premiums have been going up for years due to increases in healthcare costs, the difference in copays collected under a pre-ACA plan and a post-ACA plan for most employer provided health benefits wouldn’t represent a big portion of the increase in cost (but it would represent some.) The biggest increases would be employers who offered very skimpy plans (with low annual and lifetime maximum payouts, for example), they would not be compliant at all with the ACA and the replacement plans that would be compliant would indeed be substantially more expensive for the employer to provide so you’d expect a corresponding decent jump in premiums.
I know that the one at my mom’s work (and, thus, for public schools in Arkansas) didn’t go up because of ACA, but they keep on trying to imply it did. It says, in as opaque terms as possible, that they are reducing the amount of coverage they offer, while also increasing cost significantly. They further state that they are doing so because the ACA “gold standard coverage” minimum allows them to do so. They state that this is “to be more in line with the ACA,” but their treating a minimum as a maximum is not the ACA’s fault.
And, since they don’t say that the ACA has driven up their predicted costs, when that would actually be a good reason for all of this, it seems clear that this is not the case. It shouldn’t be, as it was pretty good insurance anyways. I’m pretty sure it’s just part of Arkansas’s obsession with budget cutting. (Remember, we have one of those balanced budget amendments that says we can’t have a surplus.)
Well, that and a way to try and get the ACA repealed. That’s the only reason I can come up with for so many insurance companies putting out large changes (or overemphasizing small changes) and specifically naming the ACA as the cause. It would not surprise me at all if this was the reason your relative believes what she does. Although her news watching habits (or those of her friends) may also be to blame.
Well, if the ACA says "affordable"means 8% of income - logically, any insurance plan that does not yet charge 8% will be motivated to bump premiums up to 8%. What was a ceiling logically becomes a floor too.
(Are health plans allowed to charge “percent of income” or are they required to publish the same rate for all members?)
