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Archive for Tuesday, September 17, 2013

Will young, healthy people purchase insurance under the Affordable Care Act?

September 17, 2013

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Nancy Delgado could get health insurance right now through her father's plan. She just chooses not to.

"It's less expensive to just go to the doctor whenever an issue arises," said Delgado, a 21-year-old pre-med student at Baker University in Baldwin City.

Delgado is just the kind of person the Affordable Care Act needs to sign up for its online health insurance exchanges, which begin open enrollment Oct. 1. The 2010 law, often known as Obamacare, has a goal of near-universal coverage in the U.S., but for that to happen many young, healthy Americans will have to buy insurance. Otherwise, experts say, costs may go up for everyone else, such as people with pre-existing conditions, who for the first time will be able to purchase insurance without restrictions.

Beginning next year, Americans will be required to carry some type of health insurance or they'll be fined $95 per adult (up to $285 for a family) or 1 percent of their family income — whichever is higher. The penalty, which will be levied on people's taxes, will eventually go up $695 per adult (up to $2,085 for a family) or 2.5 percent of family income starting in 2016.

But will young, healthy people buy subsidized coverage on the insurance exchanges or simply take the fine? A 26-year-old in Douglas County making $25,000 a year would pay an estimated $144 a month (after a $22-a-month tax credit) to purchase a plan on the exchange in Kansas, according to insureKS.org.

Sheldon Weisgrau, the Lawrence-based director of the Health Reform Resource Project, said the hype that the system will collapse because young Americans won't sign up is overplayed.

"Polls show that young people value insurance and want insurance and haven't bought it in the past because they can't afford it or it's too expensive. To that extent, the amount of the tax credit is going to be important," he said. "There are always people who will believe, 'I'm healthy, I don't need to remain uninsured.' But if you look at the polling data, I think young people get this more than I thought they would, and I'm expecting a lot of them to check out their options."

Mia Hartung, a 20-year-old junior at Kansas University, said that even though she is still on her parents' insurance — the Affordable Care Act allows Americans to remain on their parents' plans until the age of 26 — she couldn't imagine going without coverage.

"I would always have it, just in case. I know I could come down with an injury," said Hartung, a human biology major. "It might be the minimal coverage, but I'll always have something."

Linda Sheppard, special counsel and director of health care policy and analysis for the Kansas Insurance Department, said insurance commissioners, including Sandy Praeger of Kansas, have been concerned all along that the fine in the first year of the law wouldn't be great enough to entice the younger, healthier population to buy coverage.

"I always tell people, It doesn't take a genius to figure out you can't buy a year's worth of health insurance for $95," she remarked. "That being said, if there's someone who really is interested in having health insurance and you're talking about a young person who's maybe early into their work life and has a moderate salary, they may be eligible for a tax credit to pay for private health insurance. At some point, it may make sense."

Even so, people who would have to spend more than 8 percent of their income to buy insurance on the exchanges are exempt from the mandate. Many of those individuals would qualify for the law's Medicaid expansion, which several states, including Kansas, have not adopted.

Even though he was recently billed $15,000 for a two-day hospital stay, KU sophomore Jamie Smith said he will likely continue to go without coverage for the foreseeable future.

"I don't have any money to purchase insurance," said Smith, 28, an unemployed biology major. "I'll probably just pay the fine. What other option do I have?"

Comments

Michelle Reynolds 1 year, 3 months ago

This is a decision adults are making also. With many adults now under employed, purchasing insurance is a luxury. For many myself and many of my friends , and yes we are all have full-time jobs. We are self employee. We can't afford the insurance in this economy. I am a 51 year old woman, the quotes I just got are over $400 a month for basic no frills insurance. no dental, glasses and a $5,000 deductible. So, yes I can get insurance. Just can't afford it in this economy. So, I have to risk it and not get insurance or use the money to pay for gasoline, food and utilities. We need to fix our economy!!

tomatogrower 1 year, 3 months ago

Are you able to check the exchange yet?

akt2 1 year, 3 months ago

Well and then even after you pay hundreds of dollars a month for health insurance, you still have to meet that deductible before many services will be covered. Most offices will run your insurance and expect payment when you check out if you haven't met the deductible. Then that out of pocket charge will be applied to your deductible. And there could be an office co-pay on top of that. Many people still can't afford health care even if they have insurance.

tomatogrower 1 year, 3 months ago

There probably should be something done about frivolous lawsuits, but some of the suits have merits, if the doctor isn't doing their job. What I understand is that it's liability insurance for doctors who settle out of court, then raise insurance premiums more and more. Maybe if they wouldn't cave there would be fewer stupid lawsuits. We need to do something about the liability insurance companies. I wonder how much of the doctor's premiums go towards paying off claims?

average 1 year, 3 months ago

The questions about malpractice/torts are pretty clearly a state-level problem. 99.9% of medical malpractice suits are filed in state (district) courts.

Of course, Kansas sharply capped most pain-and-suffering/emotional-distress payouts and passed the rest of the tort reform agenda many years ago. Already happened. A generation ago! As did nearly every other state, by the way, including California. If you don't think the tort reforms passed in the early 1990s went far enough, lobby Topeka to go further.

Hasn't exactly kept medical bills in check, now has it?

Tyler Palmer 1 year, 3 months ago

We still need what we've needed for decades: health care reform. The Affordable Care Act only provided a hole-ladden smidgeon of health insurance reform which isn't really going to do much to tame ever-rising costs of health care and health insurance in the U.S.

The US currently uses all four of the different health care models (The Beveridge Model, The Bismarck Model, The National Health Insurance Model, and The Out-of-Pocket Model....see URLs below) and it's no wonder that a huge part of the costs is the use of so many different models and different insurance providers with their own plans which means a tremendous amount of administrative overhead for care givers to try to process all the paperwork and hurdles associated with all the different models and insurance provider plans.

If the country really wants to fix our broken health care system, a couple of steps in the right direction would be 1) make a single, simple insurance claim form that all insurers must accept to reduce the administrative overhead for provider reimbursement 2) require health insurance companies to be non-profit and raise the percentage of their revenue that must go towards actual care [no more huge rate increases because the insurer is trying to drive up "shareholder value" and profits]. These are only steps in the right direction. What we really need is to pick one health care model and eliminate as much of the the complexity as possible to bring down costs.

Health Care Models: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html or http://www.pnhp.org/single_payer_resource/health_care_systems_four_basic_models.php

The Man Who Was Treated for $17,000 Less http://online.wsj.com/article/SB10001424127887324139404579017113415486176.html

George Lippencott 1 year, 3 months ago

However you want to frame this issue if the young do not purchase insurance we will go bankrupt allowing purchase when some need arises. You can not cover prior conditions without requiring everybody to purchase insurance at the git-go!!!

Bryan Moore 1 year, 3 months ago

I am pretty sure that the insurance companies will still have a once a year open enrollment period in the exchanges just like they do with coverage by an employer. That means you can't just go out and buy insurance when you need it, you have to enroll during one of these periods (usually a few weeks to a couple months). You can't get into a car wreck and buy insurance on your smartphone while you are waiting for the ambulance any more than you could with an employer based plan. I guess if you got cancer in March and wanted to wait until November to start your treatment you could do that. This restriction of course does not count when the exchanges kick off, you lose employer coverage or have a "life change" like getting married or having a child. For those people they can sign up within a certain number of days after the change.

tomatogrower 1 year, 3 months ago

"It's less expensive to just go to the doctor whenever an issue arises," said Delgado, a 21-year-old pre-med student at Baker University in Baldwin City.

In the printed version of the paper there is a story on the opposite page about a woman who got cancer at the age of 24. Now not all young people get cancer, and not all get into accidents, so most could get by without insurance, but it's a gamble I wouldn't want to take. And why isn't she still on her parent's insurance anyway. Even before the ACA, parents could keep their college age kids on their insurance until they were 24, I think. Now it's 26 and they don't have to be in school.

chootspa 1 year, 3 months ago

It was 23, and you had to be listed as a dependent on their tax form back when I was young enough for that. Then there was the long dry spell when I tried not to get sick while trying to work my way up into a job with benefits.

William Weissbeck 1 year, 3 months ago

The Koch affiliated groups are spending tons of money in advertisements to dissuade young adults from enrolling and obtaining insurance. The Kochs know that if too few obtain insurance that that alone can cause Obamacare to collapse. Of course, your tax dollars then have to be spent to in government sponsored ads and programs to counteract the petty political agenda of the super rich.

local_support 1 year, 3 months ago

I have spent my entire adult life without health insurance. (I'm 31) Obamacare finally gives me a chance to purchase affordable coverage. Most young adults who do not have any coverage and a modicum of common sense are going to purchase insurance.

Of course, the irony for me here is that I start a new job next week that provides great benefits on day 1. All I can do is chuckle at the timing, and be thankful that I will have coverage from somewhere.

chicago95 1 year, 3 months ago

The Obama administration announced on September 24 that Kansas will have the third lowest premiums among 36 states for which the federal government will operate exchanges. See http://www.nytimes.com/interactive/2013/09/24/us/health-care-premiums.html?ref=politics&pagewanted=all .

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