Out Of Sight. Out Of Mind. Out Of Money.

You may be forgiven if you haven’t been focused on the looming health insurance crises. Most of us are on information overload.  With the daily revelations of inappropriate business deals and the on again / off again nature of the summit with North Korea, who has time to contemplate the administration’s ongoing war with Obamacare (Patient Protection and Affordable Care Act)?  That’s our job.

Over 150 million Americans get their health insurance at work. The premiums are paid by their employers.  The employees’ portion, if any, is deducted from their paychecks.  Most of our clients on individual coverage (non-group) have the premiums deducted automatically from their credit cards or checking accounts.  The premiums are a huge issue in November, when the clients see next year’s price, and January, when that first higher amount comes out of the account.  Otherwise, the cost of insurance is just another part of that great American mystery, “I work hard, but I can’t seem to save any money!”

There are, of course, lots of Americans challenged by the recent changes in health insurance, our method of accessing and paying for health care.

It is fair to say that President Trump and the Republican-controlled Congress, having failed at repealing Obamacare, have quietly settled on sabotage.  The strategy might work.

The first salvo was President Trump threatening last spring to eliminate the funding for the Cost Sharing Reduction. The risk of losing millions of dollars chased insurers like Anthem Blue Cross out of the market.  He can play politics with the health care of millions of Americans, but the insurers who must answer to shareholders cannot.  Those insurers that remained in the market were forced to substantially increase their premiums.   Anthem’s decision to leave as well as the pricing moves by those that stayed were confirmed when Trump eliminated the funding in October.

Premiums are about to take another unnecessary jump. The Congressional Budget Office is projecting a 10% annual increase due to the most recent tax bill that eliminated the penalty for failing to carry compliant health insurance beginning 2019.   Killing the Individual Mandate will cost us 10% per year!  Without the (negative) incentive to retain coverage, many healthy Americans will drop their major medical policies and either go bare or purchase short term policies.  You can’t fund a health care system with just the sick and the responsible.  Premiums will rise exponentially. The CBO estimates that this alone will cause 4 million more Americans under age 65 to join the ranks of the uninsured in 2019.

The increase in premiums has been forcing more Americans to choose less comprehensive policies. Our top selling contracts may cover preventive care at 100% without copays or deductibles, but your child’s strep throat, with office visits, testing, and Rx, may cost you $100 or more.  It is not unusual for someone to have a $5,000 or $6,500 deductible.  That amount seems incidental if you have a major claim over $100,000.  But lots of people have smaller claims, under $10,000, and find that they are paying the entire bill.

The average American has about $1,000 in savings.  Where will that person find $4,000 or $5,000 the next time he/she slips on the ice or trips on an uneven sidewalk?

The limitations, restrictions, and network reductions of our new health plans are ignored or forgotten until you get sick or injured. And then it is too late.  And then no amount of stories about Korean missiles will get your mind off your bills.



Picture – Surprise! – David L Cunix

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