Turbulence on flight Obamacare

Annual changes in prices and policies by insurers are driving many consumers to switch their health plans each year, according to the New York Times. With the opening of the third enrollment season for the Affordable Care Act marketplaces, it’s another shopping season for many consumers.

“Every year I feel like I’m starting all over again and I just dread it,” Gail Galen, a 63-year-old woman living in Warrenton, Oregon, told the newspaper. “My stress level just shoots up.” Galen said she has switched insurers three years in a row because of hikes to her premiums and changes in doctor networks. Source:fiercehealthpayer.com

For many observers this is not a surprise. For those who roundly critized those observers as being obstructionists or simply naysayers it must be disappointing. The reality is that for those of us who have designed, managed and communicated health care benefits for decades this is simply the norm. This has nothing to do with being anti-Obama or even anti-Obamacare. The fact is it is a combination of the impacts of actuarial reality, the design of Obamacare and human nature.

Competition is not the primary driver of premiums. There are too many choices for people to digest and those seeking coverage do not evaluate the link between premiums, the use of health care and out-of-pocket costs (and so many people merely accepted the promises of quality, affordable health insurance without asking how). 

One comment

  1. I totally understand her pain. Every year my employer offers about 6 plans to pick from. Every year I read what is covered and try to pick the best plan for me. Every year a surprise happens to me or someone I work with. Something is not covered, you find that a doctor that was in network last year in now out of network, something was not covered, etc. For me, last year my HMO was listed in the company in the literature but the ID card stated that is really was EPO and I am still not sure what that really means but once again for 2016 the company is calling a HMO.

    After a while you do not change plans because you learn, often the hard way and with some expense, about the plan rules. I have the advantage of having a limited number of plans to choose from and I can ask around work to find someone who may have use the plan the year before for advice.

    But having multiple plans to figure out each year must take a lot of energy in a very limited time to do any research. I feel her pain. I would imagine some people will just give up.


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