ObamaCare’s impact on health costs.

  • 27% of Americans name cost as top health problem; 20% name access
  • Cost and access were tied as top health problem in 2014 and 2015
  • College graduates most likely to cite cost as top health problem

Millions of emergency room patients could face financial ruin — even if they deliberately seek care at hospitals covered by their insurers.

That’s the disturbing finding of a new study published in the New England Journal of Medicine. Conducted by two Yale professors, the study shows that 1 in 5 ER visits involve doctors who are not in the same insurance network as their hospitals. The patients treated by those out-of-network physicians are forced to pay for a portion of their care out-of-pocket. The average out-of-network ER charge is $600.

A bill that size spells disaster for many patients. About half of Americans wouldn’t be able to cover a surprise $400 bill without selling something or borrowing money.

. . .

 

Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies. The class of medicines known as specialty drugs treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers, and hepatitis C. Some medicines can cost $10,000 a month. Even a small cost-sharing requirement means patients could have to come up with thousands of dollars to get the medicines.

. . .

Steven Lopez has gone without health insurance for 15 years, and the Affordable Care Act hasn’t changed his mind. Once again this year he will forgo coverage, he said, even though it means another tax penalty.

Last tax season, the 51-year-old information technology professional and his family paid a mandatory penalty of nearly $1,000, he said. That’s because they found it preferable to the $400 to $500 monthly cost of an Obamacare health plan.

“I’m paying $6,000 to have the privilege of then paying another $5,000 [in deductibles],” said Lopez, who lives in Downey, a suburb of Los Angeles. “It’s baloney — not worth it.”

. . .

According to a recent statistical analysis, medical care determines only about 11 percent of health—far less than individual behavior (38 percent), social circumstances (23 percent), and genetics and biology (21 percent). The preponderance of evidence demonstrates that much of what we spend on health care does not translate into better health outcomes and that collectively we don’t receive nearly enough benefit to justify the costs in higher taxes, higher premiums and lower wages.

As Congress and the incoming Trump administration consider how to replace the Affordable Care Act (ACA), they should focus on the drivers of excessive spending, the primary one of which is comprehensive health insurance. By doing so, President-elect Trump can best attempt to deliver on his promise of “great health care for much less money.”

. . .

Obamacare architect Jonathan Gruber told CNN’s Carol Costello on Monday that it is not possible to just “get rid of the parts” of the health care law that people do not like because that was tried and “premiums went through the roof.”

Costello interviewed Gruber on her show and asked how Americans’ health care premiums would be affected if President-elect Donald Trump repealed parts of the Affordable Care Act that are unpopular after taking office.

“So, let’s say he keeps the parts of the law that people really like,” Costello said. “What would that do to all of our premiums? If he could keep all of the elements that you say that Congress might reject.”

. . .

ObamaCare’s political disciples are dismissive of the tales of woe that ObamaCare has left in its wake, pointing instead to statistics on the reduced rate of uninsured.

Whatever egalitarian ethos that the law’s architects anxiously claim that ObamaCare still achieves, it certainly doesn’t justify the pain that the scheme is causing middle class and families. There’s a very narrow band of Americans who qualify for the law’s special “cost sharing subsidies” who can find ObamaCare plans affordable. Many who fall outside this slim income range are being hammered.

. . .

While Obamacare has brought health insurance to millions of people in the U.S., some in the program are finding that the medical care they need is too expensive to actually use.

Michelle Harris, a 61-year-old retired waitress in northwest Montana, has arthritis in both shoulders. She gets a tax subsidy to help buy coverage under Obamacare, though she still pays $338 a month for the BlueCross BlueShield plan. Yet with its $4,500 deductible, she says she’s doing everything she can to avoid seeing a doctor. Instead, she uses ibuprofen and cold-packs.

“It hurts, but we don’t have that kind of money,” Harris said in an interview. “So I deal with it.”

Open enrollment for the insurance exchanges created by the Affordable Care Act kicks off Tuesday, and there’s a good chance consumers logging on to compare plans will face some sticker shock.

Monthly insurance premiums for popular plans on HealthCare.gov are rising by 25 percent on average next year, according to government data. But the increases will be more dramatic in certain parts of the country, especially for consumers not receiving subsidies, the numbers show.

. . .

As premiums for Affordable Care Act (ACA) insurance plans skyrocketacross the country, the Department of Health and Human Services (HHS) appears to be spinning the bad news by noting that 2017 premiums are about what the Congressional Budget Office (CBO) expected they would be when the law passed in early 2010. However, CBO’s November 2009 estimate of future premiums involved significant and generally unforeseeable errors in key underlying assumptions having nothing to do with the ACA. A valid understanding of the ACA’s effect on insurance premiums would need to account for these errors.

. . .