Republicans must be feeling plucky these days. After a year they finally have a legislative achievement. Of sorts. After a year of strike outs. A tax bill passed by both the House and Senate. A two-run lead in the sixth inning, but the game isn’t over yet.
A merged tax bill has to be crafted in conference and passed by both houses of Congress, dodging sniper fire from Never-Trump Republicans as well as vote-no Democrats. Or the House can cash in their chips early by passing the Senate bill in its current form, skipping conference and sending it to the President for his signature.
The Senate bill repeals the Obamacare individual mandate but the rest of the Obamacare beast is still alive and kicking. Congressional efforts to repeal Obamacare earlier this year went the way of accusations of Russia hacking the election. Meaning nowhere. What now? Another lump of coal for Americans relying on Obamacare for their insurance?
Let’s take a look under the hood of Obamacare for 2018 and see how the engine is running. For those getting insurance through their employer or through one of the myriad government programs such as Medicare or Medicaid, no worries.
Not so for those who insure themselves or their family through an Obamacare exchange plan. According to recently-released federal data, “Some 29 percent of enrollees will only have one insurer offering policies, up from 20 percent this year and 6 percent in 2016. Eight states will have only one insurer, up from five states this year.”
So much for “if you like your insurance, you can keep your insurance.” Only 130 insurers will offer exchange policies in 2018, down from over 230 two years ago. Large insurance companies, including Aetna and Humana have exited Obamacare, while Anthem has greatly downsized its participation. Less choice. Merry Christmas.
Premiums are rising too. “Premiums for the benchmark silver Obamacare plan will soar 37%, on average, for 2018.” This is on top of a 25 percent increase the year before. And 13 percent the year before that.
Meaning, “A 27-year-old will pay nearly $5,000 a year, on average, for the benchmark silver plan.” Quite the chunk of the 27-year old’s income. And that’s just for the insurance premium. Don’t forget the deductible and copay. More on that shortly.
There are subsidies available to defray some of the premium cost, but it’s still unaffordable for many.
How fast are wages going up for those buying this insurance? Like the 27-year-old person? Two or three percent per year? How does that math work out? Happy Hanukah.
HMO plans will be almost half of the available plans in 2018. Limiting doctor and hospital choice, at least if you want your insurance to pay for it. PPO plans, with greater choice, are declining to only a quarter of available options.
Once you have an insurance plan and are paying the hefty premiums, you are not home free. Back to those out-of-pocket expenses. Bronze plans, the least expensive, have an average deductible of about $6,000 with the silver plans at $4,000.
So that 27-year-old will be paying $5000 for her silver insurance plan but will have to shell out another $4000 before the insurance plan pays anything. Now we are up to $9,000 for the struggling millennial. And that’s per year. And rising each year too. Happy Kwanza.
Last but not least is the copayment. This is on top of the premium already paid, and deductible reached and paid. For our 27-year-old who is already 9 grand in the hole on premiums and deductible, he will have a 30 percent copay on any additional costs. If he had a bronze plan, his copay would be 40 percent. The costs continue to add up. Happy Festivus. Ready to air some grievances?
This all assumes in-network care. If our 27-year-old blows out her knee on the ski slopes and doesn’t want her local orthopedic surgeon to do the repair, instead opting for the clinic in Vail where Lindsay Vonn and Kobe Bryant have their surgeries, it will be out-of-network and insurance may not cover anything. Happy New Year.
Paul and Mitch were unable to herd their cats to get rid of Obamacare. Maybe they can herd effectively on taxes. Or maybe not. If they do get tax reform done, Obamacare is still out there and in need of euthanasia. Rather than complaining about Trump’s tweets, how about Congress getting to work and doing their jobs? Starting with Obamacare.
Brian C Joondeph, MD, MPS, a Denver-based physician and writer. Follow him on Facebook, LinkedIn and Twitter.
The views and opinions expressed in this commentary are those of the author and do not reflect the official position of The Daily Caller.