On Friday the president used the long-awaited resignation of Health and Human Services Secretary Kathleen Sebelius to again claim victory for his namesake health law. “She got it fixed, got the job done,” Obama said. Right.
Sorry, there is plenty of more bad news ahead.
It’s not called SebeliusCare, and she wasn’t to blame for most of its problems. The horrors were mostly baked into the law, with some made worse by the president’s dishonest hard sell to get unsuspecting Americans to sign up.
Obama claimed Friday that 7.5 million people have enrolled in exchange coverage. In fact, perhaps 20 percent haven’t paid their first premium and therefore aren’t covered, according to estimates by RAND Corp. and Goldman Sachs.
The bigger question is how many will keep paying premiums. That’s got the American Medical Association, a chief ObamaCare booster, so worried that it’s sending warnings to its members.
Why the concern? First-time insurance purchasers, especially those living paycheck to paycheck, will be shocked by ObamaCare’s high deductibles, about $3,000 for the silver plan (the most commonly selected) and $5,000 for the bronze plan (the most affordable).
Basically, you’ll have to pay thousands out of pocket for appointments, tests and prescriptions until you reach your deductible.
Millennials who heard Obama say on “Between Two Ferns” that they can buy a health plan for the price of a cellphone contract won’t be laughing when they realize what the $5,000 deductible means. (It’s like a cellphone contract that makes you pay $5 a text for your first thousand texts.) Rather than pay thousands out of pocket for care while also paying premiums, some will quit paying premiums.
That’s why the AMA is worried. Section 1412 of the health law gives consumers a 90 day “grace period” before their subsidized plan is canceled for nonpayment. But insurers only have to keep paying doctors and hospitals for 30 days. The next 60 days of care are on the care provider. The AMA says “it could pose a significant financial risk for medical practices.”
Consumers reeling from ObamaCare premium shock are in for another jolt when the 2015 rates come out.
Overall, consumers had to pay far more for individual plans this year. In some states (Delaware and New Hampshire), rates went up 90 percent or even 100 percent, according to a newly released Morgan Stanley analysis.
And insurance executives already are warning about double- or triple-digit hikes for next year. “I do think it’s likely premium-rate shocks are coming,” said Chet Burrell, CEO of Care First BlueCross BlueShield. Aetna CEO Mark Bertolini, one of the first to raise the alarm, said increases “could go as high as 100 percent.”
In most states, insurers will be setting their 2015 rates in June, but the administration is doing everything possible to keep the grim news under the radar until after the November elections. It even postponed the beginning of the open enrollment period until Nov. 15.
Losing on-the-job coverage
But there’s no way to hide the impact on the 25 million to 30 million Americans who could lose coverage in the coming months.
For the same reasons that millions of policies in the individual market were canceled last year, employers who buy plans in the small-group market will have a hard time renewing their old plans this year. Many will have to choose between providing the more costly ObamaCare benefit package or dropping coverage altogether.
Count on employers with low-wage work forces (such as retailers, hoteliers and restaurateurs) to push employees and their families into the exchanges.
Protests over cancer care
Cancer is the leading cause of death in America and our No. 1 health fear. But access to the nation’s top cancer centers is becoming a hot-button issue, as ObamaCare enrollees are finding how few choices of hospitals and doctors they have.
Many plans exclude all specialty cancer hospitals, even though research shows that women with ovarian cancer, for example, live a year longer when they are treated at high-volume cancer hospitals instead of local facilities. But insurers say they’d have to raise premiums for exchange plans even higher if this growing outrage over access to cancer centers forces them to broaden their networks.
The president said Friday that ObamaCare has “turned the corner.” Not exactly. Senate Minority Leader Mitch McConnell says he hopes the confirmation hearings for Sebelius’ successor, Sylvia Mathews Burwell, “will be the start of a candid conversation about ObamaCare’s shortcomings.”
That could take a while.