Ted Cruz, Who Said Uninsured Should Just Get Health Care From ERs, Backs Group That Wants ERs To Turn Away Uninsured People
When he was running for office two years ago, Sen. Ted Cruz of Texas insisted that rather than expanding Medicaid, Texas should just let the uninsured get all their health care from emergency rooms. The argument that emergency rooms are an acceptable backup for the uninsured has also been used by Mitt Romney, Heritage Foundation president Jim DeMint and many other prominent Republicans.
But now, some members of the GOP are trying to keep the uninsured from using emergency rooms at all. Georgia Gov. Nathan Deal is pushing Congress to allow hospitals to turn people away from emergency rooms, and Georgia congressman and US Senate candidate Paul Broun – who previously cited ERs to claim that “everyone has access” to health care – has introduced a bill that would allow ERs to treat only patients who they determine have an “emergency medical condition.”
Now, the Madison Project, a Tea Party group that has earned the high-profile backing of Sen. Cruz in its effort to defeat three sitting GOP senators in primaries this year, is also advocating for allowing emergency rooms to turn away anybody not deemed to need immediate emergency care.
In a blog post on the group’s website yesterday, Madison Project policy director Daniel Horowitz writes of taking his son to the emergency room only to encounter a waiting room “full of illegals” (although he doesn’t specify how he knew the citizenship status of his fellow patients), including “adults who, let’s just say, did not look like they were about to keel over.”
My wife and I were entreated to the chaos of emergency room care last night after our two-year-old son slipped while climbing onto a high kitchen counter and banged his head on the floor. He had a massive lump on his forehead and we were concerned about internal bleeding. When we drove to the closest hospital, the waiting room was full of illegals. Most of them were adults who, let’s just say, did not look like they were about to keel over. Opting not to wait all night simply for a decision whether to put our son through a CT scan, we drove for a half hour in the rain to a hospital that was less likely to be full of those who use ERs for regular care.
Thank God our son recovered and there was no internal bleeding, but in a different situation that extra time could have been critical. Also, if you ever wonder why you get hosed with outrageous bills simply for stepping foot in a hospital, look no farther than the “undocumented” costs of illegal aliens.
The solution for this, Horowitz concludes, is to allow hospitals “to turn away people from ERs if they do not have an immediate need for emergency care” thereby “solv[ing] the problem of illegal immigrants using ERs for primary care.”
The problems with illegal immigrants and emergency hospital care also provide us with an opportunity to examine true free market healthcare reform. Any GOP healthcare proposal must be predicated not on “replacing” Obamacare, but on fixing even some of the anti-market federal policies that existed before passage of the monstrosity.
One of those policies is the mandate on hospitals to treat everyone who comes to an ER – including illegal immigrants – irrespective of whether they are suffering from a real emergency. In 1986, Congress passed The Emergency Medical Treatment and Active Labor Act (EMTALA) as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA), which was ostensibly the first act in universal healthcare mandates.
If we ever plan to curb skyrocketing hospital costs and improve access to emergency care, we must address this massive unfunded federal mandate of EMTALA. Among the provisions of Rep. Paul Broun’s Patient Option Act, which is one of the best healthcare reform proposals, are some good reforms of emergency and indigent care. Under Broun’s proposal, hospitals would be allowed to turn away people from ERs if they do not have an immediate need for emergency care. This would solve the problem of illegal immigrants using ERs for primary care.
Could it be that Tea Party leaders like Sen. Cruz never actually thought that emergency rooms were suitable alternatives for the uninsured and were instead just looking for any excuse not to expand insurance coverage?
h/t: Brian Tashman at RWW
Prescription drug coverage isn’t the only issue at stake in the upcoming case before the Supreme Court.
Next week, the Supreme Court will take up the issue of contraceptive coverage, hearing arguments in a closely-watched lawsuit against the Affordable Care Act. Two for-profit companies — the craft chain Hobby Lobby and the furniture-making company Conestoga Wood Specialties — are fighting for their right to withhold insurance coverage for certain types of contraceptive methods based on their religious beliefs. But there’s actually much more at stake than prescription drug coverage.
The two plaintiffs in these cases object not just to covering specific types of birth control, but also to providing counseling about that birth control. In Hobby Lobby’s lawsuit, for instance, the company states that it does not want to follow the Obamacare provision that forces employers to “provide health insurance coverage for abortion-inducing drugs and devices, as well as related education and counseling.”
The media coverage surrounding the upcoming challenges has mainly focused on the first part of that argument, as reproductive rights advocates point out that women need access to affordable contraceptive methods regardless of their boss’ personal beliefs about birth control. However, the second part threatens to have incredibly far-reaching ramifications for women and doctors in this country, too. Essentially, if Hobby Lobby and Conestoga Wood are successful, they’ll win the right to refuse to extend coverage for doctor’s visits that include discussion about certain forms of contraception, like IUDs or the morning after pill.
“It’s frankly a rather radical idea — the idea that someone can say that if your visit to your doctor is going to receive payment from your insurance company, then your doctor can’t talk to you about certain subjects,” Adam Sonfield, a senior public policy associate at the Guttmacher Institute, explained in an interview with ThinkProgress. “Counseling and education about contraception has been a basic part of a medical visit forever, even before the methods themselves were covered. Before we had prescription drug coverage, we certainly had coverage for the visit to your doctor, and there were never any limitations about what you could talk to your doctor about.”
And particularly when it comes to contraceptive counseling, simply skipping over certain methods isn’t an option. In order to obtain informed consent from their patients, doctors are obligated to explain the full range of optionsavailable.
According to Clare Coleman, the president and CEO of the National Family Planning & Reproductive Health Association (NFPRHA), informed consent is the “bedrock” of medical ethics. “Coverage of counseling is essential. It’s a conversation about intention and life stage as much as it’s a conversation about the actual prescription — in family planning, we have to meet the patient where she is, and find the method that’s right for her,” Coleman told ThinkProgress. “That conversation needs to be careful and detailed before the patient agrees to any medical intervention.”
So, since many doctors wouldn’t feel comfortable limiting the contraceptive options that they tell their patients about, this could force the employees who work for companies like Hobby Lobby to make a difficult choice. If they want their doctor’s visit to be covered by their insurance company, they’ll have to avoid talking about birth control altogether. Or, if they do want to discuss contraception, they’ll have to pay for the visit out of their own pocket. They’ll essentially have to choose between a potential financial burden or a potential health burden.
Or they may not understand what’s at stake in the first place. Coleman pointed out that, in a scenario where bosses are allowed to refuse to cover contraceptive counseling, their employees might not realize those restrictions exist. “Having a white card in your wallet does not mean you understand how your insurance works,” she noted. “The patient will not necessarily come armed with this information.”
To make matters more complicated, companies that withhold coverage for some types of services often resist full disclosure. They may not explain to their workers exactly what their plan excludes, or provide them with a referral to access those services elsewhere.
“It’s an incredible devaluing of the insurance that you as an employee work for,” Sonfield, who recently published a policy review of the central arguments in the upcoming Supreme Court challenges, pointed out. “This is telling you that you can’t use your compensation — your own benefits that you have earned — in a way that your boss objects to. And that is a frightening road for us to be going down, as a society.”
Ultimately, insurance coverage for preventative care, like contraceptive services and regular doctor’s visits, is a benefit that employees earn through the hours that they put in to their jobs. Making employees pay for the full cost of their birth control and their doctor’s visits ends up shifting more insurance costs onto them. It’s somewhat analogous to a salary cut.
And birth control isn’t the only type of medical care that some Americans object to on religious grounds. There are some groups who are opposed to modern health services like vaccinations, blood transfusions, or mental health care. If these upcoming legal challenges are successful, that could open the door for employers to restrict their workers’ coverage for doctors’ visits that include discussion of those topics, too. It’s a slippery slope.
Nonetheless, this particular issue hasn’t received very much attention.
“They’ve really downplayed this aspect of their case. I think it’s gotten buried,” Sonfield told ThinkProgress. “I think the plaintiffs in these cases, along with their supporters, have done an excellent job of crafting the messaging and shaping the debate, and it’s been playing out on their grounds.”
ThinkProgress reached out to Hobby Lobby’s legal counsel, the Becket Fund for Religious Liberty, to confirm the company’s opposition to certain types of contraceptive counseling and ask how this type of objection would be implemented in practice. The communications department refused to comment.
From Sonfield’s perspective, the issue of contraceptive counseling proves that some of the central claims about employers’ religious liberty — namely, that practicing their deeply-held religious beliefs isn’t about infringing on their workers’ freedoms — just aren’t accurate. “We often see statements that this case is not trying to interfere in women’s choices, and is not trying to interfere in the doctor-patient relationship, because it’s just about the employer’s involvement. That’s just patently not true.”
“Your employer shouldn’t be able to intercede in the medical decisions that are right for you,” Coleman noted.
Source: Tara Culp Ressler for ThinkProgress
WASHINGTON — Legally married same-sex couples just gained a little more recognition in the eyes of the federal government.
The Department of Health and Human Services announced Friday that, starting with the 2015 plan year, insurance companies that provide coverage to opposite-sex spouses must also offer that coverage to same-sex spouses.
"In other words, insurance companies will not be permitted to discriminate against married same-sex couples when offering coverage," Matthew Heinz, the director of LGBT outreach at HHS, wrote in a blog post.
The clarification to the agency’s rules stems from last year’s landmark Supreme Court ruling that the federal Defense of Marriage Act, which defined marriage as between a man and a woman, is unconstitutional. The update applies to all Qualified Health Plans, which are plans that meet the minimum standards of the Affordable Care Act and are certified by the state or federal exchange where it is purchased.
Heinz notes that it’s already the case that married same-sex couples must be treated equally when it comes to seeking financial assistance for buying coverage through the health insurance marketplace, regardless of where they live. So, for example, if a same-sex couple who is legally married in Massachusetts moves to a state like Texas, where gay marriage isn’t recognized, that couple must still be treated the same as an opposite-sex married couple when it comes to seeking financial help for purchasing coverage.
WASHINGTON (AP) — This could be the year that things finally turn around for President Barack Obama’s health care law. Yet it could start with another round of glitches that vex consumers and leave Republicans crowing, “We told you so.”
The law’s major benefits take effect with the new year, along with an unpopular insurance mandate and the risk of more nerve-racking coverage disruptions.
Big improvements are in store for some, including Howard Kraft of Lincolnton, N.C. A painful spinal problem left him unable to work as a hotel bellman. But he’s got coverage because federal law now forbids insurers from turning away people with health problems.
"I am not one of these people getting a policy because I’m being made to," Kraft said. "I need one to stay alive."
What’s good for millions like Kraft is secured through what others see as an imposition: requiring virtually every American to get covered, through an employer, a government program or direct purchase of a plan.
But the biggest health care headlines early this year could come from continued uncertainty over the insurance program’s messy rollout.
The consumer-facing side of the HealthCare.gov website appears to be largely fixed — with 2.1 million enrolled through federal and state websites. But on the back end, insurers say they are still receiving thousands of erroneous sign-ups from the government.
That means early in the year insured patients could go for a medication refill — or turn up in the emergency room — only to be told there is no record of their coverage.
One of the main worries is over certain error-tainted enrollment records that insurers call “orphans” and “ghosts.”
"Orphans" are sign-ups that the government has a record of, but they do not appear in insurer systems. Insurers say those customers never left the government’s "orphanage" to "go and live" with the carrier they selected.
"Ghosts" are new customers that the insurer does have a record of, but whose information mysteriously does not appear in the government’s computers.
The Obama administration says the rate of such errors has been reduced dramatically, and insurers agree. The catch is that the volume of sign-ups has surged in the meantime, which means even with a lower error rate the number of problem cases keeps growing. And there is no automated way to clear up mistakes quickly.
Obama had envisioned that the arrival of the Affordable Care Act’s major benefits in 2014 would be like a national seminar, showcasing his philosophy that government can and should smooth the rough edges off an unforgiving economy for struggling working people.
The goal was that in a midterm election year, Democrats would be able to point to millions of newly insured Americans, thanks to subsidized private plans and an expanded version of Medicaid. Media reports would feature compelling cases of people handed a lifeline.
That’s indeed happening, but it seems to be only part of the story. The Republican portrayal of “Obamacare” as government inept and out of control appears to be unfolding right alongside.
Legal challenges still lie ahead for the health care law. Supreme Court Justice Sonia Sotomayor, acting Tuesday night on a request from an order of Catholic nuns in Colorado, blocked implementation of portions of the law that would have forced some religion-affiliated organizations to provide health insurance for employees that includes birth control. Several other Catholic groups won similar stays in the lower courts.
Although the stated goal of the law was to cover the uninsured, at least 4.7 million insured people had individual policies canceled because they didn’t measure up to new requirements. That forced an apology from the president, who had famously promised that if you like your health plan, you can keep it. The administration says it believes most of those people have secured new coverage.
That “bad product,” Schock said, is hurting President Barack Obama’s credibility with the young people that voted him into office.
"Young people helped put the president in office, and with this health care law, he’s pushing them into years of less choice, fewer opportunities, and larger bills," he said. "This isn’t how it was supposed to be."
Obama touted 500,000 December enrollments through the federal health care exchange in a Friday press conference, although no official enrollment totals for the month were released.
h/t: TPM LiveWire
The Family Research Council is upset that Obama administration allies are working to enroll LGBT people – who are disproportionately uninsured — in health care plans because they are “a high risk pool fed by even higher risk behavior.”
In an email to members today, FRC president Tony Perkins got into an especially punny mood (even for him!) to attack the program, Out2Enroll, and especially its alliance with a weekly drag show in Louisiana. “If the law lacked legitimacy before, wait until a cast of cross-dressing men get through with it!” Perkins writes.
Jeremy Hooper notes that Perkins is wrong when he says the White House “funneling” money to the independent effort.
H/T: Right Wing Watch
Michigan lawmakers passed a controversial measure on Wednesday that will ban all insurance plans in the state from covering abortion unless the woman’s life is in danger. The law, which takes effect in March, will force women and employers to purchase a separate abortion rider if they would like the procedure covered, even in cases of rape and incest.
Supporters of the “Abortion Insurance Opt-Out Act” argue that it allows people who are opposed to abortion to avoid paying into a plan that covers it. Opponents have nicknamed it the “rape insurance” initiative, because it would force some women to anticipate the possibility of being raped by purchasing the extra abortion insurance ahead of time.
“This tells women who were raped … that they should have thought ahead and planned for it,” said Senate Minority Leader Gretchen Whitmer (D-East Lansing) during debates. “Make no mistake, this is anything but a citizens’ initiative. It’s a special interest group’s perverted dream come true.”
The Michigan State Legislature first passed the measure last year, but Governor Rick Snyder (R) vetoed it, saying he does not “believe it is appropriate to tell a woman who becomes pregnant due to a rape that she needed to select elective insurance coverage.”
But the anti-abortion group Right to Life of Michigan was able to collect more than 300,000 voter signatures on a petition this year to force a second vote on the measure. Having been passed by both chambers, the bill automatically becomes law now, even without Snyder’s approval.
Chris Hayes opened his show with an editorial tonight and I’m right there with him. I’m sick to death of the media coverage comparing the rollout of the Affordable Care Act to Katrina. I’ve had it with the Republicans doing everything in their power to do real damage to real people’s lives with their sabotage and obstruction and like Hayes, I’m fed up with these weak kneed Democrats thinking that they can distance themselves from the law politically if they wanted to.
As Hayes noted during the opening to his rant, Media Matters had a very simple rebuttal to the talking point about Obamacare vs. Hurricane Katrina. Here’s some of the rest and it was definitely a breath of fresh air from what has dominated the better part of his own network’s broadcast time.
HAYES: If you’re anything like me, you’ve watched the last several weeks unfold with a potent mix of rage, frustration and exasperation and I will confess, as I’ve followed the coverage and immersed myself in the stories, here in the studio every day, I find myself pissed off at just about everyone.
I’m angry at a White House that failed to properly implement the single most important law they’ve ever passed, or that anyone has passed in a generation, that handed their ideological and political enemies ammunition, which they are now gleefully firing off at anything that moves, including, stalwart progressive allies and politicians who backed the White House and vouched for the law with voters.
For those of us on the single-payer left, the entire spectacle is particularly maddening, since many of us spent years noting the drawbacks, complexities and Rube Goldbergian nature of the entire Romneycare mandate and subsidies model. Those of us who worried that without a public option, insurance companies would use the law to manipulate and panic consumers. Those of us who worried about that, but ultimately embraced, celebrated and rejoiced at that ACA as a massive step forward on the long march for justice.
I’m also angry at a mainstream media, that due to a combination of gullibility, privilege and sloppiness has managed to elevate the story of a very small sliver of the health insurance market into a national panic, while largely allowing the names and faces and fates of the millions of poor people who will be denied health care by Republican governors to remain anonymous and untold.
But most of all, I’m quite simply appalled as I watch a Republican party and a conservative movement not even pretend to hide their glee, and schadenfreude over problems with the law they have done everything in their power to sabotage, destroy and discredit.
Hayes went on to take Jonah Goldberg to the woodshed along with other conservatives who are talking about what “great news” it is that people are going to be denied access to health care. Hayes final criticism was for the wobbly Democrats who are trying to back away from the law and he wrapped things up with this reminder for all of them.
HAYES: There is no separating yourself from this law. That goes for all of us on the left. If you think the ACA can go down and leave you unscathed, you are sorely mistaken. We are all in the same boat. […]
Health care is something every single person uses and every time, in every country a society has decided to reform the delivery of it, it has been done against the kicking and screaming and sabotage and backlash and rage of entrenched interest and reactionaries.
There is a reason almost a centuries’ worth of presidents and congresses tried and failed to pass health care reform. There is a reason passing and maintaining the Affordable Care Act has been so arduous; because it is the most ambitious piece of social legislation in this country in a generation.
And so amidst the deserved criticisms and bad press and the undeserved hysteria and shameful gloating, one thing is clear.
The only path left for those of us left committed to the goal of health care for all is forward. No retreat. No surrender. No going back. The only way out is through.
This won’t be the last battle. Others will come and there will be more after that and there’s never, ever going to be some calm final equilibrium where everything works and no one’s trying to take health care away.
There is only struggle today, tomorrow, forever, because nothing worth doing ever came without it.
Generation Opportunity, a nonprofit financed with $5.04 million from a fund controlled by the Koch brothers’ lobbying team, just launched a new television advertisement to kick off an anti-Obamacare campaign. The ads, which provides no actual information about healthcare reform and instead seem designed to scare people away from doctor visits, have already been dissected by many in the media. What’s more revealing is Generation Opportunity’s real agenda, which was explained to Yahoo News in a story unveiling the new campaign (emphasis added):
Their message: You don’t have to sign up for Obamacare. “What we’re trying to communicate is, ‘No, you’re actually not required to buy health insurance,’” Generation Opportunity President Evan Feinberg told Yahoo News in an interview about the campaign. “You might have to pay a fine, but that’s going to be cheaper for you and better for you.”
So, the big idea here is that young people should decline health insurance? Having no health insurance is “better for you?” When a car accident happens, or someone is sent to the hospital needing critical care, who picks up the bill? For slash-and-burn Koch groups, that doesn’t seem to matter.
Notably, the young men and women hired by Generation Opportunity are provided health insurance, says organization’s communications director David Pasch, who spoke to TheNation.com over the phone. Lucky them.
Here’s the current graphic being displayed at healthcare.gov, guaranteed to produce aneurysms in every member of the congressional tea party caucus. Obamacare is now live. Huzzah!
The exchanges are now open for business.
Anti-Affordable Care Act (ACA) group Generation Opportunity placed a misinformed op-ed aimed at Millennials in at least a half dozen local papers in an effort to prevent younger Americans from enrolling in the Affordable Care Act ’s individual exchanges.
Generation Opportunity’s op-ed ran in at least a half-dozen newspapers over the weekend of September 28, including in Nevada’s Las Vegas Review-Journal and Florida’s Sun-Sentinel. The piece was authored by former unsuccessful Congressional candidate from Pennsylvania and president of Generation Opportunity — a Koch-brothers backed anti-Affordable Care Act group — Evan Feinberg. The editorial attempted to frame the ACA as a “bad deal for young people” and urged them to “opt out” by claiming it will cost them a lot of money and that it “relies on a system of generational redistribution”.
Generation Opportunity was recently responsible for the misleading and intimidating ad that showed a menacing Uncle Sam performing medical exams; a spot labeled by news organizations as not only ”creepy" but "irresponsible and dangerous" in spreading health care falsehoods.
had my annual physical exam this week, and since I had to take time off work to do it, I figured I’d at least get a little bit of research done since I knew I wanted to do some kind of essay about it today, given the exchanges open for business in two days. So I queried my doctor about what he’s hearing from patients when they talk to him about Obamacare. Do they have questions? Are they confused by any particular part of it?
He just sort of shook his head and sighed. Understand that this is Idaho, and he’s a doctor. So he’s pretty much a Republican. But he’s a very frustrated Republican who keeps hearing his patients recite back to him Fox News talking points. They think government is going to dictate what kind of care they can get. They think they’re losing their freedom. And don’t get him started on death panels. Yes, death panels. Still. He talked to me about the real death panel experiences he’s had. The ones with the insurance companies. Like last year when he had a patient in her sixties with early stage liver cancer. She was a fantastic candidate for a relatively new, very effective treatment in which the tumor is cauterized in a minimally invasive procedure. Nope, her insurance company said. It’s not an approved procedure, so she didn’t get it. And she didn’t make it.
We all know those kinds of stories. Presumably, even the people who are duped in to believing that there really are death panels in Obamacare either have been or know someone who has been screwed over by their insurance company. And yet, this new law that will rein in some of the worst abuses of those insurance companies is scarier to them than the status quo. Because they just keep hearing the myths. So let’s go through it one more time, those persistent myths that just won’t go away. Because in just a few days the exchanges open, everybody’s talking about it, so that makes now a really good time to inject some truth.
Let’s head below the fold and talk it out.
Almost all of the big lies are aimed at, as usual, the people who are the “haves.” That’s why the people my doctor has been talking to are so scared. That’s why they’ve been talking about losing “freedom.” They’ve been listening to Fox News and hearing that Obamacare is going to take what they already have away from them.
Obamacare will take the insurance I have away.
Let’s just get this straight: If you already have insurance, Obamacare is not taking it away. If you do lose it, it’s because your employer has dropped your coverage. It’s true that some employers might drop it, either to make a political point or because it would cost them less to pay the penalty for not providing coverage than to continue to carry it. But that’s not something Obamacare is forcing them to do.
Obamacare won’t let me see my doctor anymore.
Trust me, the government doesn’t care what doctor you see. If you have insurance, and you have a primary doctor, that won’t change unless your insurance company decides it will change. The power to force you to find a new doctor is something insurance companies have always had, and still do.
The IRS will control my health care.
That’s a persistent and difficult one to shake. Everyone hates the IRS, so it’s easy to believe the worst here. The IRS has a big role: It’s going to be verifying how much of a subsidy you’re going to be getting to help pay for insurance if you purchase it on the exchange. If you already have health insurance, the IRS will have nothing to do with it, with you, with your health care. They don’t know who your doctor is. They won’t see your medical records. They don’t care about your medical records.
It’s taking Medicare money away from me.
Scaring old people is the easiest and favorite thing for Republicans to do. Obamacare will not make you pay more for your Medicare, it will not take it away, and if you’re on Medicare, you don’t have to do anything at all on Oct. 1. But if you are on Medicare, you will see some additional benefits from Obamacare: more preventative care services and more savings on prescription drug coverage.
Obamacare is going to ration my health care (a corollary of death panels).
Your insurance company already rations your health care, but much of that’s changed with Obamacare: you can now get preventive care services without having a copay; you don’t face annual or lifetime caps on how much your insurance company will pay out for you if you get seriously, chronically ill; your insurance company can’t deem a condition “pre-existing” and refuse to cover it.
The Independent Payment Advisory Board, the supposed death panel, is prohibited in the law from rationing health care. It’s right there in black and white: It cannot make "any recommendation to ration health care … or otherwise restrict benefits or modify eligibility criteria."
This is a government take-over of health care in America.
We should be so lucky. Your insurance company won’t be going out of business, turning all your records over to the government. The insurance industry will continue to flourish, albeit with some new regulations that even the people propounding this one like, number one being no more pre-existing conditions.
There are a lot more, really crazy, chain-email type ones like “you won’t get cancer treatment after age 76,” or “government workers will force their way into your home to inspect it,” or “this is the biggest tax increase in the history of the world,” or “Obamacare creates a database of people’s sex lives.” Occasionally, PolitiFact is useful debunking lies. They do a good job with these and a handful of others.
But the lies directed toward the uninsured are the ones that really expose just how immoral Republicans are. They are trying to convince people, particularly young people, that it’s better to go without the protection of health insurance to make a political statement.
When uninsured Americans begin enrolling in Obamacare’s new health care exchanges on Oct. 1, the overwhelming majority — 95 percent — will face health care premiums that are 16 percent lower, on average, than the government had previously projected, according to a new report released on Wednesday by the Obama administration.
In the 36 states where the federal government supports or fully runs the Health Insurance Marketplace, a 27-year old who does not qualify for tax credits will pay, on average, $163 for a plan that covers approximately 60 percent of health care expenses (a so-called bronze-level plan), while a 27-year-old with an income of $25,000 could pay $83 dollars per-month after subsidies. Individuals up to 30 years old will also have the option of buying cheaper catastrophic coverage outside of the marketplaces, though they will not qualify for subsidies. A family of four in Texas with an income of $50,000 would pay as little as “$57 per month for the lowest bronze plan after tax credits,” the report finds.
Premiums vary across the country, however. While states like Wyoming and Indiana will experience some of the highest premiums, Tennessee and Kansas will see lower costs. The uninsured in Florida and Texas — two states where Republican lawmakers have staunchly refused to implement the law — will see premiums “roughly in line or lower than health insurance costs in many other exchanges across the nation.” The national average for a midlevel policy is $328 a month before subsidies.
Under the law, individuals and families with incomes between 100 and 400 percent of the Federal Poverty Level ($11,500 to $46,000 a year for an individual, or up to $94,000 for a family of four) could qualify for premium tax credits and cost-sharing subsidies. The Congressional Budget Office projected in May that out of the seven million who are expected to enroll in the exchanges in 2014, six million will qualify for subsidies.
Ninety-five percent of the eligible uninsured will have the choice of at least two insurers carriers, which will offer health care plans at various levels of coverage: bronze, silver, gold or platinum. In the 36 states surveyed by the report, the uninsured will have a choice of 53 different plans, on average, and 1 in 4 insurance companies offering insurance will be doing so for the very first time in 2014.
“The more choices you have, the lower the premiums,” a senior administration official said. “States with few insurance companies who didn’t get a lot of new competitors this coming year, still have higher premiums.” The report found that states with “the lowest premiums have more than twice the number of insurance companies offering plans than states with the highest premiums.”
While no single factor is responsible for the lower-than-expected premiums, a senior administration official told ThinkProgress that previous estimatesconducted by Congressional Budget Office may have “underestimated the fact that we have robust competition in the marketplaces” and “we’ve done a pretty good job of slowing the health care cost growth, which has filtered through the marketplace, [and] through the employer-based health care system to Medicare and Medicaid.”
Health care costs are now growing at the same rate as the rest of the economy, while annual premiums for employer-sponsored family health coverage grew 4 percent in 2013, significantly lower than in years past. A report out earlier this month estimated that nearly 6 in 10 uninsured Americans will be able to purchase insurance for less than $100 each month.
Fox News misleadingly claimed that the government is “sticking it to men” because some men’s insurance premiums will rise under the Affordable Care Act (ACA). But Fox’s attack obscures the health insurance market’s existing discrimination against women and the fact that the ACA bans the widespread practice of gender rating, which charges women more than men for insurance coverage.
Typical RNCTV lies and sexism.