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The hard truth of Obamacare

Photo Editor

Published: Tuesday, September 24, 2013

Updated: Thursday, December 12, 2013 21:12

The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, has been in headlines since it was signed in March 2010.  With the Jan. 1 deadline quickly approaching, some cold, hard facts are being realized by Nebraska Blue Cross Blue Shield customers.

According to Steve Jordan of the Omaha World-Herald, I was one of 45,000 Nebraska Blue Cross Blue Shield customers who received a letter last week notifying me that my current healthcare plan will no longer be available as of Jan. 1. This letter explains that previous plans are being changed to bronze, silver or gold plans in order to comply with the ACA. One has automatically been selected for me and no action is needed if I agree with that coverage.

This new bronze level plan has additional coverage, but it comes with a price.  The cost differences in the plans are shocking. Monthly premiums jumped from just under $140 to $277.59. The deductible has increased by 225 percent to $4,500. The single out-of-pocket limit hiked up to $6,350, the maximum allowed by the ACA.  It also drops the number of primary care office visits to two a year, while increasing the co-pay to $60.

These costs don’t seem affordable to most college students. Hopefully they can stay under their parents’ plan, but the change in benefits will still hit home after their third office visit in a year. There is coverage available through Health Services that has an annual premium between $1,016 and $1,360.  This plan is designed for accident and illness, but has maximum benefits that are paid out along with co-pay.

There are additional benefits that need to be considered.  It now provides benefits for substance abuse and mental health, as well as free preventative care.  These are understandable; however, it is the next three “additional” benefits that have me scratching my head.  This 29-year-old male columnist with no children now gets coverage for pediatric dental, pediatric vision and maternity.

The ACA made these additional benefits required for all health care coverage.  Unless I have missed a major medical achievement, which is possible, I now have mandatory coverage for benefits I will never use.

In Jordan’s article on Omaha.com, it says that in order to keep the same benefits there is a higher premium or that there is an option to have higher deductibles and out-of-pocket expenses for the same premiums.  However, the letter that I received from BCBS has plans with monthly premiums ranging from $227.74 to $415.90 for single coverage.

These premiums can hardly be considered affordable by a vast majority of the public. Especially considering that over half of the plans have out-of-pocket expenses of the legal maximum of $6,350. According to the letter there are subsidies available to those within certain income levels, but this section is not clear.  It instead directs you to Nebraskablue.com/subsidycheck.

Along with the ACA come the penalties and fees for not being covered. Washington Post’s “Washington Wire” reports that on the 2015 tax returns those who did not have insurance in 2014 there will be a penalty of $95 or 1 percent of their taxable income, whichever is greater.  This penalty will increase to $695 or 2.5% for the 2016 return.

There will be a new option available with The Marketplace, which is government sponsored.  These new plans will be available through healthcare.gov on Oct. 1. According to the website “In the Marketplace, you can compare coverage options based on price, benefits, quality, and other features important to you. You can choose the combination of price and benefits that fits your budget and meets your needs.”

Thankfully, those with pre-existing conditions will no longer be able to be denied coverage. However, in July, the Treasury Department announced that the “play or pay” penalties enforced on employers with more than 50 employees have been delayed until 2015.  This once again leaves those who do not have an option of coverage through an employer with the short end of the stick.

The letter from BCBS states that you must reply by Nov. 1 leaving only one month to consider the available options for this individual mandate.  With all the changes in coverage and rates, will this flagship legislation of the Obama administration really create affordable healthcare for those who were not already covered?  
All things considered, this columnist questions whether the Patient Protection and Affordable Care Act is really the appropriate name. The Insurance Company Protection and Mandatory Purchase of Privatized Coverage Act sounds closer to the mark.  I guess I’ll just have to wait for October to find out.

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