As Marketplace Opens, Realities Collide
Monthly premiums for health insurance policies obtained under federal and state-run health care exchanges are rising as much as 25 percent or more in the coming year.
Equally disconcerting: even more insurance carriers are exiting the marketplace, sometimes leaving enrollees with just one insurance provider to buy from.
Sen. Wilton Simpson, R-Trilby, said consequences from the Affordable Care Act - commonly called Obamacare - have reached crisis proportions that will only worsen in the next year.
"You've got this massive program to social-engineer health care and now, no one can afford it," Simpson said. "You have to completely repeal it."
But Seven Rivers Regional Medical Center CEO Austin Brown said "millions of people are able to sign up for insurance who otherwise wouldn't have access to care, or who would face a financial crisis due to medical bills."
"There are always questions concerning changes to premiums, deductibles and out-of-pocket limits before open enrollment launches each year," Brown said. "This will always be the case as insurers enter and exit different markets. But what is consistent, year-to-year, is the value of the marketplace."
About one-third of U.S. counties will have only one health marketplace insurer next year, according to the Associated Press.
The federal Department of Health and Human Services (HHS) maintains that enrollees in the marketplace health plans can still find affordable rates by shopping around on the exchanges.
"(The) overwhelming majority of marketplace consumers would be able purchase coverage for less than $75 per month, just as they could in 2016," the department stated in a press release.
HHS secretary Sylvia Burwell said there is financial assistance available to help people.
"Millions of uninsured Americans qualify for financial assistance, and so could as many as 2.5 million Americans currently paying full price for off-marketplace coverage," Burwell said. "I encourage anyone who might need 2017 coverage to visit HealthCare.gov and check out this year's options for yourself."
On the plus side, the HHS said that because of the marketplace, "the share of Americans without health insurance fell to 8.6 percent, the lowest level in our nation's history."
Simpson said among Obamacare's flaws is that, in most case, it prohibits people from crossing state lines to purchase insurance. That discourages competition and drives up costs, he said.
Simpson said he wants a health care plan that allows smaller businesses that don't qualify for group insurance to join larger co-ops, such as the Farm Bureau.
Simpson said the government's intent all along was to make health care so unaffordable that the U.S. will be pushed toward a socialized, single-payer system similar to that used in Canada and many European nations.
That, he said, would be sad because the American health care system was the envy of the world before the government decided to take it over.
"You had a private, competitive system that was working," he said. "What we've done is destroy that private system in favor of this government bureaucratic system."
State Rep.-elect Ralph Massullo Jr. called Obamacare "a death spiral to the insurance industry" that will become a catastrophe within a couple of years without intervention.
"The original idea, and how it was sold, is that it was an ancillary insurance where people could keep their doctor and the insurance plan they had," Massullo said. "We found out both promises were not going to be fulfilled by the government."
A key component of Obamacare was that more young people would sign up and subsidize the older folks who are bigger insurance users. That never happened, he said, and the result is rising costs and insurance companies bailing out.
Massullo said he would like to see an insurance plan that allows for interstate commerce, an expansion of medical savings plans and more regulation reforms.
Kaiser Health News (KHN), in a press release, said the majority of enrollees will be protected from premium increases this coming year because 8 in 10 receive subsidies based on income/household size. As premiums rise, subsidies increase, according to KHN.
KHN also projects any changes to premiums or deductibles will vary widely state to state, and in some instances, even county to county.
To help make health insurance affordable, the government uses household income to determine who is eligible for financial assistance. This aid might include advanced tax credits to help pay for premiums, or discounts on co-pays and deductibles.
Ernesto "Tito" Rubio, health officer for the Florida Department of Health, Citrus County, assured residents that his agency's core medical services will not be compromised regardless of the federal health program. Those services include immunizations, environmental public health and preparedness, communicable diseases, women's reproductive health and obstetrics.
"We stand ready to provide those services to our county no matter what happens with the Affordable Health Care Act," Rubio said.
Contact Chronicle reporter Michael D. Bates at 352-563-5660, [email protected] or via Twitter @mdbchronicle.
* People eligible for health insurance who choose not to purchase coverage not only pay a penalty when filing their tax return, but also forfeit financial help with health care expenses throughout the year.
* The penalty is either 2.5 percent of income or a predetermined rate, whichever is higher. The 2016 penalty was $695 per adult and $347.50 per child, with a maximum fee of $2,085.
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