RSS feed for entries


There’s a new definition of “Affordable”

At least there seems to be in the “Affordable Care Act.” Charles Ornstein writing for ProPublica:

“[I]n much of the country people have yet to really see what the cost-sharing will look like in these plans, and they may be surprised for find out that the deductibles and co-pays in bronze and silver plans are higher than what one would find in typical employer-provided health benefits,” Larry Levitt, senior vice president of the Kaiser Family Foundation, said in an email. [Note: subsidies are based on silver plans. People who want better coverage pay the difference themselves. Also note: many doctors and hospitals are not in-network and out-of-network care costs more and has no cap on out of pocket costs.]

“I think it remains to be seen whether people see these plans as offering them good protection against catastrophic health expenses — which they do — or are disappointed that they won’t generally provide much coverage for occasional visits to the doctor or prescriptions,” Levitt added.

Chris Jacobs, a senior policy analyst at the conservative Heritage Foundation, brings up another point. The sequester law, which calls for spending cuts in the federal budget, requires reductions to the cost-sharing program. But the Obama administration has not said how it will carry those out — whether it will cut the cost-sharing subsidies or make insurers absorb the cuts.

“Someone (either carriers, consumers, or both) isn’t being told by this administration that they’re going to have to pay more — billions of dollars more,” Jacobs wrote to me.

Ken Wood, a senior adviser to Covered California, [said that] … “Even with high deductibles, consumers stop paying retail for health care since they get the advantage of the health insurer’s negotiated rates, and no plan has a higher out-of-pocket maximum [for in-network costs] than $6,350 (per person) [in addition to premiums],” he said. “That is a lot of money, but it probably will not drive people into bankruptcy. “

Let’s hope that the “Patient Protection” part of the Patient Protection and Affordable Care Act hasn’t likewise changed its meaning. If it has, “Patient Protection” means “the kind of care you get under PPACA probably won’t kill you.”