We’ve learned a lot about Obamacare in the past week. While the trouble with the HealthCare.gov website has monopolized the news, the site will eventually get fixed. What’s here to stay, however, are the lasting changes the Affordable Care Act has made to health care and medical insurance.
Here are the five things we now know about Obamacare that could affect your health insurance and medical care.
1. Premiums Will Go Up for Many
Notwithstanding promises to the contrary, it’s now clear that premiums will be going up for many. Why? There are three key reasons.
First, Obamacare requires all health insurance plans to meet certain standards. The intention behind the rule was to make sure that policies meet what government officials deemed to be minimally acceptable standards. They call these standards “Essential Benefits.” While some view this as protecting consumers, the protection comes at a price. Lower cost policies that do not meet these standards are being cancelled by insurance companies and replaced with more expensive polices.
Second, the policies don’t have any spending caps. While there may be good policy reasons for this rule, it comes at a significant cost that will be paid by those buying the insurance.
Third, health insurance companies can’t charge more if you have a pre-existing condition. While such a rule helps those who previously were uninsurable, it also comes with a cost. The cost is born by those who do not have a pre-existing condition. How? Those who are healthy will pay more for insurance than they otherwise would to offset the cost of insuring those with existing medical conditions.
2. Many Will Lose Their Health Insurance
Contrary to promises made when Obamacare became law, it’s now clear that millions will be unable to keep their current policies. As noted above, Obamacare requires health insurance to cover certain Essential Benefits. The law was written to allow some existing policies to be grandfathered from this requirement, allowing people to keep less expensive policies. Regulations written to implement the law, however, gutted the grandfather provision. According to CBS News, more than 2 million will get booted from their existing converage.
3. You Don’t Have to Buy Through the Exchanges
One fact lost in all the noise is that in most cases one doesn’t have to buy individual health insurance through the exchanges. Consumers can still buy insurance through sites like eHealthInsurance.com. For the moment, however, consumers must go through the exchanges if they qualify for and want to take advantage of subsidies.
4. Obamacare is Immensely Complicated
Obamacare is an extremely complicated law. That fact is nothing new. But the recent problems surrounding HealthCare.gov underscore just how complex the new law is. Perhaps the most complicated aspect are the subsidies. Information must be obtained from the IRS to determine if an individual qualifies for a subsidy, and if so, for how much. This information, along with information about the insured, must then be transmitted to the insurance carrier. The result is a website that thus far has cost more than $600 million to build. That’s less than Facebook spent in its first six years of operation.
5. The Exchanges Offer Limited Choice of Doctors
To keep costs down, many insurance companies in the exchanges limited the number of doctors in the network. The policies tend to have fewer hospital networks, and many don’t have academic medical centers in the network, according to CNN. The result is that shoppers will need to make sure the doctors and hospitals they want are available with the insurance they buy.