In
yesterday’s New York Times, Robert Pear reports on a little known fact about Obamacare: the insurance packages available on the federal exchange have very high deductibles. Enticed by the low premiums, people find out that they’re screwed on the deductibles, and the co-pays, the out-of-network charges, and all the different words and ways the insurance companies have come up with to hide the fact that you’re paying through the nose.
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For policies offered in the federal exchange, as in many states, the annual deductible often tops $5,000 for an individual and $10,000 for a couple.
Insurers devised the new policies on the assumption that consumers would pick a plan based mainly on price, as reflected in the premium. But insurance plans with lower premiums generally have higher deductibles.
In El Paso, Tex., for example, for a husband and wife both age thirty-five, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium less than $300 a month, but the annual deductible is more than $12,000. For a forty-five-year-old couple seeking insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month has a deductible of $10,000.
In Santa Cruz, Calif., where the exchange is run by the state, Robert Aaron, a self-employed 56-year-old engineer, said he was looking for a low-cost plan. The best one he could find had a premium of $488 a month. But the annual deductible was $5,000, and that, he said, “sounds really high.”
By contrast, according to the Kaiser Family Foundation, the average deductible in employer-sponsored health plans is $1,135."
It’s true that if you’re a family of three, making up to $48,825 (or, if you’re an individual, making up to $28,725), you’ll be eligible for the subsidies. Those can be quite substantive at the lower ends of the income ladder. But as you start nearing those upper limits (which really aren’t that high; below the median family income, in fact), the subsidies start dwindling. Leaving individuals and families with quite a bill, as even
this post, which is generally bullish on Obamacare, acknowledges.
Aside from the numbers, what I’m always struck by in these discussions is just how complicated Obamacare is. Even if we accept all the premises of its defenders, the number of steps, details, caveats, and qualifications that are required to defend it, is in itself a massive political problem. As we’re now seeing.
More important than the politics, that byzantine complexity is a symptom of what the ordinary citizen has to confront when she tries to get health insurance for herself or her family. As anyone who has even good insurance knows, navigating that world of numbers and forms and phone calls can be a daunting proposition. It requires inordinate time, doggedness, savvy, intelligence, and manipulative charm (lest you find yourself on the wrong end of a disgruntled telephone operator). Obamacare fits right in with that world and multiplies it.
