Gouged again under Obamacare

November 3, 2016

The news about insurance premium hikes under the Obamacare system shows what happens when the government puts insurance bosses first, writes Elizabeth Schulte.

IT'S LIKE building a house out of sugar and then acting surprised that there's a problem when it rains.

In the case of the Affordable Care Act (ACA), popularly known as Obamacare, the sugar is the for-profit insurance industry, the rain is the people who need health care, and the whole thing is melting into air.

The Obama administration announced last week that average premiums for the millions of people who purchased mid-level health insurance plans available on the ACA's HealthCare.gov exchanges are rising, by as much as 25 percent just in the next year.

The increase will spell hardship for the millions of workers who don't qualify for subsidies or have insurance through an employer--and therefore face a harsh financial penalty of as much as $700 next year if they don't buy a policy through the health care "marketplace" established by the ACA.

According to the Department of Health and Human Services, the average monthly premium for a 27-year-old could rise from $242 to $302--an additional $60 a month, or $720 a year, simply to keep insurance policies that typically have high deductibles and holes in coverage.

The waiting area in an X-ray unit lies empty

In some states, it's even worse. In Arizona, the projected average increase for 2017 premiums was 116 percent; the average in Phoenix was 145 percent.

"It's beyond ridiculous," Leslie Rycroft, a Scottsdale resident who paid $1,100 a month this year for a UnitedHealthcare plan with a $13,000 annual deductible for her family of four, told the New York Times. "All of a sudden you're paying $26,000 a year, just for catastrophic health insurance."

As Rycroft suggests, it's a whole other question if you want to use your insurance. Many people say that while they now have insurance for the first time, the deductibles are so high that they can't afford to use it.

WHILE THE 25 percent increase in premiums is astonishing, the fact that Obamacare is translating in higher costs for workers isn't a surprise at all to opponents of for-profit health care who warned all along that this would be the outcome of the ACA.

Advocates of a universal single-payer health care system--a nationalized system to cover each and every person in the U.S., similar to what exists in other industrialized health and often described by its advocates here as "Medicare for all"--argued that incorporating private insurance companies into the ACA meant that it was doomed from the beginning.

The Obama administration's stated motivation for pursuing reform was that millions of people went without health care in the U.S. But while the ACA included welcome regulations banning some industry practices, barring companies refusing to cover people for pre-existing conditions, the main problem--for-profit health care--wasn't touched.

In fact, the for-profit system was woven into the fabric of the ACA as insurance giants like Aetna and UnitedHealthcare were invited to sell policies to the uninsured through the "exchanges" set up under the law. Workers without health care from employers were forced under the "individual mandate" to buy these policies or pay a tax penalty.

The problem with depending on for-profit insurance companies is exactly that--they're for profit. Since the ACA went into effect, several major insurers have claimed they're losing money being part of the exchanges--and pulled out of the marketplaces in many states, leaving the newly insured high and dry.

Some five states may have only one "choice" for an insurance provider in 2017, and nine more states may have just two.

If anyone is worried about the insurance industry losing money--besides the politicians they shower with money, that is--don't be. They're making plenty.

A Salon.com analysis of regulatory filings found that the top five health insurers--UnitedHealthcare, Anthem, Aetna, Humana and Cigna--spent nearly $30 billion on stock buybacks and dividends from 2013 to 2015.

Despite the right's complaint that Obamacare damaged the health care system, the stock prices for these companies rose after the law was passed--because they gained access to a captive market for their defective products.

Workers are paying a higher and higher price--not just those in the Obamacare system, but everyone who has health insurance, including employee-provided plans.

According to a study by the Kaiser Family Foundation, the average deductible for people whose employer covered their insurance rose $303 to $1,077 between 2006 and 2015.

EARLIER THIS year, a much-needed debate began, not just about whether Obamacare had failed, but what kind of health care system would best serve the people who need it.

Bernie Sanders' campaign for the Democratic presidential nomination introduced the idea of a single-payer, Medicare-for-all system to a new audience of people_and gave confidence to those who long supported it.

The eventual nominee, Hillary Clinton, was forced to discuss the idea of single-payer. Unable provide an adequate defense for her support of for-profit health care, her campaign instead characterized Sanders' position as wanting to "dismantle Obamacare, dismantle the CHIP program, dismantle Medicare and dismantle private insurance," as Chelsea Clinton falsely claimed in February.

Now, with the presidential election winding to a close, that discussion seems a million years old.

Sanders isn't bringing up single-payer anymore--because he's backing the Democratic nominee Clinton who he thinks will make an excellent president. Any critique of the ACA from the left has been discouraged in the interest of electing Clinton. Disgracefully, liberal New York Times columnist Paul Krugman, a loyal Clinton supporter, downplayed the seriousness of the projected premium hike as merely a "pothole" for Obamacare. (Too bad about 10 million people are getting jolted by that "pothole.")

As a result, criticism of the ACA has been confined to the right. Donald Trump responded to news of the premium increase by telling reporters that Obamacare needed to be "repealed and replaced." Trump claimed his employees had told him about having "tremendous problems" with Obamacare, but a company spokesperson had to correct Trump's statement with the information that most of Trump's employees have company-provided insurance.

Bill Clinton himself went off-script last month, calling Obamacare "the craziest thing in the world"--only to have to reverse his comments a week later and promise that he supported the gains of the ACA. (Poor Bill keeps forgetting that Obama is a friend now, and anything that ties Hillary to Obama's popularity, no matter how undeserved, is a good thing for the campaign.)

According to New York Times columnist Jacob Hacker, a liberal coalition has come together in the Progressive Change Campaign Committee to try to convince Clinton and congressional Democrats to introduce a "public option" into the ACA exchanges--similar to a proposal that Democrats bargained away during negotiations with Republicans about the health care law.

But if the proposal is anything like the debate over the watered-down public option in 2009, the health care industry has little to worry about.

Workers won't get the health care they deserve until there's a real debate--and real action--about a system where the first priority is meeting people's needs, not making sure the health care industry's profits are preserved.

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