Thursday, August 21, 2014

What the Affordable Health Care Act means to me: my insurance rate is tripling … by gimleteye

If not for a phone call I placed yesterday to Aetna, I would not have known that my family's health insurance policy is canceling in 10 days. In 10 days, unless I move fast, I will have a gap in coverage.

The customer representative called it; a result of the Affordable Health Care Act, or as everyone else knows it, Obamacare. So then I called and tried on the new math. (By the way, the customer service rep at was much more helpful and knowledgable than the Aetna rep.)

So far as Aetna is concerned, I don't recall receiving a mailing or phone call notifying me that my family would soon be naked so far as health care coverage is concerned. As an individual payer -- not through a corporate or government employment benefit -- I then discovered that the "health care marketplace" in Florida means my family and I are at the mercy of the big insurance companies, just like we were before the Affordable Health Care Act.

And what those insurance companies are telling me is that my families insurance rate will triple.


In my plan about to expire, I had chosen to pay through Aetna a low price with a catastrophic deductible because that was the only "affordable" plan. What that meant was that my deductible was very high: $10,000 per individual. Having spent more than an hour on the phone and web, evaluating new plans, so far as I can tell, the only additional benefit I will receive for a tripling of my health care cost is the reduction of my deductible to $12,000 per family.

Put the math this way: I will now be paying an additional $9600 per year for the risk of a hospitalization. I was willing to take that risk with my catastrophic, "low cost" health care policy that is now being cancelled by Aetna. I am now being forced by the insurance industry to pay that risk premium, guaranteeing in effect a profit to the insurance company by stripping the risk premium and putting it in their pocket whether I or a family member gets sick or not.

I don't blame President Obama for the crisis now being brought home to me in a very real and startling way. I blame the health care insurance industry, that worked through the Republican Congress to obstruct the only way to guarantee that a citizen like me can be protected: a single-payer health care system.

I've just learned how the Affordable Health Care Act works for those who don't meet the income subsidy limit, or who aren't young and single: it doesn't.


Anonymous said...

Try calling Florida Blue... Same thing happened to me/us and i got a very affordable plan for MUCH, MUCH less money...

Better, more price effective plans exist, and you can sign up immediately because Aetna discontinued your plan...

Aetna is attempting to price itself out of the market so it can withdraw its small/individual product and just offer insurance to major employers.

Call BC/BS or go to There is still time...

Anonymous said...

IMO an objective view for how we got here.
PBS Frontline "Obama's Deal" not pretty and growing uglier.

Anonymous said...

Right. It's not Obama's fault.

Anonymous said...

I am surprised to hear you let Obama and his back room deal makers of the hook. Clearly, the insurance industry was at the table along with the pharmaceutical and hospital players. They all got a big bite of the apple to cobble together what we have now as Obamacare. I think the general consensus coming out of the White House was better a bad deal than no deal as a defeat by the Republicans in Congress would have doomed Obama's second term prospects. Shame on Obama and out congressional leaders for foisting this upon the public in the name of the "AFFORDABLE Care Act"!. Blame the industry lobbyists and corrupted congressional leaders but by no means should you let Obama off the hook. He could have pulled the plug on this deal and gone back to Congress with smaller incremental changes to the health care system, We are again paying the price for his ego and hubris.

Cato II said...

Good luck.

Anonymous said...

Many of us have been proven right on this whole insurance mess. The one omission in your article is the Act basically guarantees the insurance companies reimbursement for any sustained losses.

Perhaps all of congress and the supreme court should have read the whole darn thing before voting to approve it. It's made a huge mess out of a huge mess, and I am in the same situation you are in Gimlete, too old for the young & single and am not poor enough for any type of subsidy! I am self employed too!

Anonymous said...

Switzerland has a similar Obama care system with rapid escalation cost, although administration cost is pegged at 3% average there.
In a few Month's the voters are able to vote on a initiative to introduce single payer system for base insurance with Cadillac private insurance as a addition.
Interesting arguments from the insurance industry's in pre voting propaganda war!

Anonymous said...

If your monthly premium is more than 10 percent of your monthly income you get an exemption to the
Reqt to buy an insurance policy because it's not affordable.
If you don't qualify for a premium subsidy because your income is too high, you can still buy a catastrophic plan
On the marketplace. The HMO's are still the cheapest with companies like Preferred or Coventry.
Your age, income and where you live influences the cost.
Miami Dade has some if the lowest cost policies because of the competition.

Anonymous said...

I urge you to shop around. For 20 years before Medicare saved me, being self-employed I lived a nomadic existence at renewal time. There were always shocks and better deals available somewhere else. I seldom spent more than two or three years with the same insurer. It is perhaps naive to think that Obamacare changed the underlying dynamics for those without special circumstances.

Anonymous said...

Surprise, surprise!

Anonymous said...

Obama Care is a mess. It is clearly not working. I have friends who bought it and now are worried having seen their premiums double and/or tripled.

This is the first legislation of such magnitude, controlling such a large percentage of our GNP that was passed by only one party. That was not wise.

There is a reason why this has never been done until now. Regardless of who or which party is in the White House, it has been proven to be prudent to include both parties when such huge changes are being considered.

And the off-the-wall statements coming from the minority leader did not help: “You have to pass the bill to understand it” was the most ignorant statement even by Washington standards.

This country is not of one or the other party. We are a two party system. Besides when both parties are included, both parties are responsible for any problems that may occur.

With Obama Care, the Democrats excluded any input from the Republicans and now they are left with a mess that belongs to them and the Republicans cannot be blamed for the disaster.

Additionally, for a new President to arrogantly and insultingly push this huge change through without consulting with the other party displayed a level of arrogance never before seen in our country and was bound to fail.

If we look at history, we will discover that every president and every congress worked together to get things done. In fact, many became fast friends. That this president chose to proceed on his own was bound to be disastrous.

This is one of the reasons why presidents should be elected who have a substantial amount of executive and political experience to understand, among other things, that one party cannot or should not be expected to control the county. That is not the way our country works.

The President should understand that there are three branches of government and the Congressional House is where writes fiscal policy is written. It is the duty of the president to move any mountain necessary to work with his opposition in Congress. To believe that having his pen and telephone so he can do as he wishes I think is rife with arrogance. That Congress does not agree with him does not give him any Constitutional authority to use that pen and telephone to do as he pleases. Being president is hard work and compromise takes hard work and time.

Evidently this president did not understand the difficulties of being president.

Armando said...

You remind me of a hostage who doesn't blame his captor for kidnapping him.

I am in the same boat. My premiums have also tripled. And I do blame Obama. This is his plan. He pushed for it and he signed it into law.

The fact is you can't give free and subsidized healthcare to 49% of America without jacking up the cost on us working people.

Anonymous said...

remember when odumbo told us that we would save an average of $2500 per family. he is the biggest liar in history. he should be impeached for his compulsive lying.

Anonymous said...

I blame both sides of the aisle. Sure we have a two party system--one wants Obama to fail and the other wants Obama to succeed. Not exactly what I would call fair.

We had to start somewhere and if both parties would sit down and do what is the most equitable solution for all parties, we could take care of the problems with what is currently in place.

Jorge said...

Obamacare was passed with only Democrat support. It was rammed through by Pelosi and Harry Reid without compromise. Every Republican opposed it, voted against it, and predicted this outcome.

Put the blame where it belongs: on the Democrats and the Dear Leader. The Republicans had nothing to do with this partisan disaster.

Anonymous said...

It's Rick Scott and Repubs who are to blame, not Obamacare. They choose not to review and control rate hikes. From PolitiFact:

The Republican Party of Florida said Obamacare "prevents (Florida) from regulating insurance."
That’s not at all the case. The Affordable Care Act says if states can regulate premiums, they should. States only have to bring laws up to minimum Obamacare requirements. The federal government only intervenes in states that don’t have effective rate review programs -- something Florida can do on its own but won’t, thanks to the 2013 law passed by the Republican-led Legislature.
The state GOP not only misrepresented the terms of the Affordable Care Act, but it also implied the Democratic president’s signature law was to blame for the state’s (temporary) regulatory woes. It was mostly Republican lawmakers who spearheaded that change to Florida law, after the state rejected a $1 million federal grant to help improve the process. Most other states regulate insurance rates without the difficulty the Republican Party of Florida claimed.

Anonymous said...

Obamacare - actually the Affordable Care Act is not a "mess." It has helped millions get affordable healthcare many for the first time in their lives. The premium subsidies have helped the working poor and middle class in particular. 1 million in Florida alone.
It is the law. What is a mess is the misinformation spread by special interests and the politicizing of health care a basic human right. Florida also needs to expand Medicaid.

Anonymous said...

I left Florida two years ago and my rates are through the roof, too. It has nothing to do with Florida state government. I voted for Obama twice and I agree with him on most issues, but the Obamacare law is very flawed.

Anonymous said...

ok so the status quo was ok with you but you don't blame Obama for a law that he proposed, pushed and signed. You sound like you have battered wife syndrome. I am agnostic on ACA- I don't think it's as awful as the right says nor as wonderful as the left sings. I don't want to insult you because I don't want to troll but your thinking on this is less than sound.

Gimleteye said...

Interesting comments, readers. I have more research to do. My point is that the insurance companies are the ONLY ones benefiting from Obamacare, if my experience trying to get new insurance is an indication.

In the past few years, with aging parents requiring hospitalizations etc., I've spent a lot of time in ER's and with doctors. The health care system was a mess before Obama, and more of a mess because of the power of the intermediaries in the process: the insurance industry.

How is Obama to blame for that?

Anonymous said...

In the free market, there is at least a chance that the health care "mess" would get fixed. Under government rule it will never get fixed. Prepare to suffer! Thanks to "the smart people that know how to fix everything in my life” my health insurance has also tripled.

Anonymous said...

If you don't like paying health insurance try paying health care bills without insurance. Or about not receiving healthcare at all?

Anonymous said...

You have a little slewed view, if you think that ONLY the Insurance Companies gained under the ACA...

Have you read the ACA? I have, and I for many years was the CEO of a HC insurance co. Here are a few facts:

FACT: NO ONE can be denied coverage, no matter how sick they are.

FACT: Insurance companies can no longer MAX out your benefits. There is no lifetime max.

FACT: Insurance Companies must now spend a designated amount of total premium on medical care. Any shortfall must be returned to members.

There are many other benefits. And, many other restrictions on Insurance Companies. READ THE LAW and the REGS.

Stop spouting Fox News or TeaParty talking points. Facts exist, look for them.

CATO said...

This is what happens when you stick government into an industr. Industry has money for lobbyist and contributions and the consumer will always get the shaft.
BOTH Parties are guilty. Gimspierre take off your partisan blinder Obama and the pachyderms are equally to blame for your plight and mine.