My Brother’s Obamacare Experience

My brother is individually insured in California. Here’s what’s he says about what will happen to his insurance plan:

More details on my forced insurance changes for 2014 (this is the complete summary provided by my insurer – I’m not cherry picking details):
Premiums: same.
Deductible: $3K -> 5K.
Doctor copay: $40->60.
Specialist copay: $40->70.
Urgent care: $40->120.
Lab: 100% coverage->70%.
Xray: 100% coverage -> 70%.
Emergency outpatient: $100->300
Outpatient surgery: 100% -> 70%
Inpatient hospitalization: 100% -> 70%
Generic drugs: $10->$19
Preferred brand drugs: N/A ->$50
Non-preferred brand drugs: N/A->$75
Acupuncture: N/A -> $60.

So basically, I get brand-name drug option and cheaper acupuncture in exchange for an extra $2k+ out of pocket when I lose my current plan and am forced to switch to this one. So much for “bending the cost curve” “your premiums will go down” and “if you like your plan, you can keep it” and other wild fantasies from the Organizer-In-Chief of the “reality-based community”.

Of course, some people lose and some people gain from Obamacare: that’s the whole idea. Dueling anecdotes about the law’s consequences don’t really tell us much about how much “society” will gain or lose. But the redistribution of wealth from the healthy to the sick that the law accomplishes also takes away many people’s freedom, and if you care about the freedom of the individual, every anecdote matters.

6 thoughts on “My Brother’s Obamacare Experience

  1. Uh… the proper comparison isn’t “What will I pay compared to What do I pay now under my employer’s plan?” It’s “What will I pay compared to What would I pay as an individual in the insurance market before Obamacare for comparable coverage?” Your brother’s post doesn’t answer that.

    1. Okay. I misread this initially, and your brother WAS making the sort of comparison I had in mind. And yes, it looks as if the quality of his coverage is going down considerably.

      That said, I’m still curious about whether this is an apples-to-apple comparison. There’s supposed to be a sliding subsidy for individuals making less than 4X the official poverty level income, for example, when buying insurance on the state insurance exchange. Is your brother taking this into account, assuming he qualifies? And if he doesn’t qualify, because his income is over 4X the poverety level, and he already has existing insurance which seems to meet his needs, why is he bothering to deal with the exchange?

      Or am I still missing the point, and he’s actually pointing to changes that his insurance company is imposing upon him, without any real reference to Obamacare? In which case I guess I say “Ouch! Sorry, I know it hurts.” But I ought to add that insurance companies have been cutting back benefits and increasing charges for quite a few years now, for quite a lot of people — most people in fact — and it’s one of the chief reasons people have been trying to change the health insurance business for the past 40 or 50 years.

      1. He won’t qualify for subsidies, AFAIK. He’s individually insured, so it’s quite plausible that PPACA is responsible for the changes, since it makes dramatic changes specifically to that market, esp. in a state like California that lacked strong community rating.

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