Tag Archives: health insurance reform

BCBSNC Affordable Care Plan Rates

Blue Cross Blue Shield of NC released their premium rates for their various Affordable Care Act plans and while the numbers are very general, which makes it impossible to compare directly to your current plan if you have one, and there's also no way of knowing which subsidies you might qualify for until you can plug your income numbers into the formula. Those subsidies will be significant for some people:

Consumers can purchase the same BCBSNC ACA health plans, and access subsidies, from the Exchange or directly from BCBSNC. BCBSNC’s buy online tool facilitates the transaction for those who qualify for a federal subsidy (consumers purchasing their own coverage with income levels between 100 percent and 400 percent of Federal Poverty Level2). The subsidy impact will be significant for some. For example, a person earning 100 percent of FPL could pay $19.15 per month for a Silver plan.

And then there's this tidbit:

ACA health plans generally offer richer benefits than plans many BCBSNC customers choose today, according to the insurer. In addition to requiring richer benefits, the ACA eliminates the use of gender or health status in setting premiums.

At work we have BCBSNC's Blue Options coverage. It's age-banded so every five years the rates go up pretty significantly – for instance when I turned 45 I cost a lot more to insure than when I was 44 – but when I compare my individual rate with the chart of sample plans on the BCBSNC announcement page I see that my premium is more than a 40 year old's platinum plan, but my coverage (70% of cost) is about the same as the silver plan. This leads me to believe that, all things being equal, my individual coverage might be cheaper under ACA than with Blue Options. 

Another factor working against us at the office is that we have a very small group of three families so we have experienced some very steep increases over the last few years as we each breach those five-year age bands. We've been lucky in that our employer has covered our individual coverage premiums – family/dependent coverage is 100% out of pocket – but the only way to continue that each year has been by increasing co-pays and deductibles, and reducing the percentage of expenses covered from 80% to 70%. If the premiums continue to rise at the 10-30% annual rate we've been seeing the last few years then we're likely going to have to start paying a percentage of premiums out of pocket as well.  Combine those increased costs with access to potential subsidies and all of the sudden those ACA rates look more and more appealing, especially if our employer agrees to raises in lieu of health coverage. 

My prediction? Lots of small employers will decide to forego the headaches of administering a health plan and save some money in the process by prodding their folks to utilize the marketplace. That, of course, is exactly what the marketplace administrators want.

Why Maybe Progressives Aren’t Bat—t Crazy

Lex offers a detailed assessment of why the progressives might not be bat—t crazy. I'm so confused.

Here's just a taste of what Lex had to say:

Just how bad has Joe Lieberman crapped all
over the whole debate on health-care reform? Bad enough that right now,
I think it’s time he not only gets no health care, it’s time he gets
intestinal cancer in a part of the world where morphine is as yet
undiscovered. I mean, really, what kind of sociopath do you have to be
to disregard those 45,000 annual deaths and singlehandedly chop up a
bill to create something that:

  • Mandates that every American buy expensive insurance from private
    companies without the choice of a public option and lets the IRS fine
    you if you don’t
  • Severely taxes middle-class health care plans, rather than wealthy individuals
  • Increases insurance premiums about $1,000 a year
  • Increases health care costs
  • Continues to exempt health-insurance companies from antitrust laws, inhibiting competition
  • Provides a sweet deal for pharmaceutical manufacturers while
    denying the government the ability to negotiate for lower drug prices
    for Medicare, something Democrats actually promised three years ago.
  • Apparently won’t let the government import drugs from cheaper foreign sources. I’m told my own junior senator, Kay Hagan, was arguing tonight that this was a “safety” issue, which must come as a surprise to the dozens of other countries that do this every day.
  • Grants monopolies on new biologic drugs so they will never become generics
  • Offers NO public option
  • Offers NO Medicare expansion, even in return for payment, for 55- to 64-year-olds.
  • Limits insurance-company payouts, contrary to President Obama’s promise in September
  • Raises taxes in January while not beginning benefits until 2014.

Really, I'm sooooo confused which makes me believe that the powers-that-be have us just where they want us. 

Why Progressives are Bat—t Crazy

Via Ed Cone comes this interesting piece with an even more interesting graphic about the Senate's health care reform proposal. The graphic compares the projected annual costs of health care (defined as premiums and cost sharing) to a family of four making $54,000 a year in 2016 under three different scenarios: If the Senate Bill is passed, the Status Quo (nothing changes from today's system), Status Quo + SCHIP (the cost of insurance under the status quo if you qualify for SCHIP subsidies).  Basically the annual out of pocket expense for the family under the Senate Bill would be $9,000 while under the status quo it would be over $19,500. The difference is due to a $10,000 subsidy the author identifies in the Senate bill.  He also says that progressives, who generally don't have a problem with "big government," should be all over this thing instead of railing against it.  Here's an excerpt from his breakdown of the "Status Quo" figures:

In 2009, the average premium for a family in the individual market was $6,328, according to the insurance lobbying group AHIP.
However, this figure paints an optimistic picture for two reasons.
Firstly, the average family size in the AHIP dataset is 3.03 people;
for a family of four, that number would scale upward to $7,925, by my
calculations. Secondly, the CBO's estimates are based on 2016 figures,
not 2009, so to make an apples-to-apples comparison, we have to account
for inflation. According to Kaiser, the average cost of health coverage
has increased by about 8.7 percent annually
over the past decade, and by 8.8 percent for family coverage. Let's
scale that down slightly, assuming 7.5 annual inflation in premiums
from 2009 through 2016 inclusive. That would bring the cost of the
family's premium up by a nominal 66 percent, to $13,149. And remember:
these are based on estimates of premiums provided by the insurance lobby. I have no particular reason to think that they're biased, but if they are, it's probably on the low side.

I'm glad to see someone finally putting some digestible figures out there.  While the figures might just be estimates the author at least puts the argument in the proper context.  As someone who has an average healthy family of five (two adults, three children) and who has been in the individual insurance market for years I can tell you that the $19,500 estimate is definitely in the ballpark since we've been dancing in the $12,000-$14,000 a year territory for quite a while.

Out of curiosity I decided to see how this health expense compares to a yearly mortgage expense.  I went to an online mortgage calculator and put in $150,000 for a 30 year loan at 7% interest.  The monthly mortgage payment would be $997.50 which my middle-school level math tells me is a little under $12,000 a year. So the projected "status quo" premium of $13,149 in 2016 is over a $1,000 than the annual mortgage expense on a $150,000 note.  That's truly insane. 

Oh, and the more the insurance is the higher the monthly expense the insured has to report on his loan application and that lowers the amount that he'll qualify for.  That means he and the other average folks like him buy less house, which means the developers have to build smaller/cheaper houses, which means the developer's suppliers sell him less stuff, which means they employ fewer people, and so on.  All so average people can pay out the nose for a piece of paper which tells them that they might not be bankrupted by a horrible illness as long as it wasn't some sort of preexisting condition or didn't happen during a full moon.  That's not just insane, that's bat—t crazy.