Obamacare Going into a Death Spiral?

Obamacare Going in a Death SpiralFolks around the country are signing up for health insurance right now on the Obamacare exchanges, and some are seeing a very confusing set of options, with price hikes, or maybe not price hikes, and with subsidies, or maybe not such generous subsidies. Here is a great take on what’s happening in NC:

Obamacare Customers Look for Better Deals as Prices Rise

Cathy Allen pays less than $5 a month for health insurance through Obamacare’s Health Insurance Marketplace. But to keep her plan next year, her costs would have skyrocketed to $150, said her husband, Richard Allen.

Then the Allens got a call from Cumberland HealthNET, a local health care nonprofit, as the staff checked back with people they initially had helped enroll.

“I was glad they did,” Allen said. “She called me and told me to come in and they would try to help us find a better plan.”

After sitting down with a marketplace navigator, the Allens were able to find a plan that would meet her needs for about a dollar more each month.

This is a common scenario for people who already are enrolled in Obamacare plans, say local application counselors and health insurance navigators.

The prices for some Obamacare plans have gone up by double digits, in large part because not enough healthy people have enrolled to help offset the costs of older, sicker enrollees. Some experts see that as a challenge to the long-term viability of the controversial health insurance program.

Most marketplace customers will automatically be re-enrolled in coverage if they don’t actively update their application or change plans by Tuesday. Those who let that date slip by without double-checking their plans may be paying a higher premium come Jan. 1.

“Many people think they are stuck with it,” said Diasmil Pena, a navigator at Cumberland HealthNET. “They don’t know their options.”

In some instances, said Megan Epert, another navigator there, such customers will cancel their plans altogether because they don’t believe they can afford it. Others, she said, get the renewal letter from their health insurance company but assume it will automatically renew at the same rate.

“We’re advising consumers to come on in, check that out, go on the marketplace, to ensure that they’re getting the insurance they want for the premium they want,” said Francine Chavis, a navigator with Legal Aid in Robeson County. Often, there are comparable plans for a lower price, she said.

Janel Lewis, a certified application counselor with Stedman-Wade Health Services, said she’s had success helping existing customers avoid large premium increases.

“We’re seeing that with everyone who brings a notice to us, we’re able to input their information and end up walking out paying less,” she said.

Last year, she said, many customers favored the flexibility afforded by PPO plans offered by Blue Cross and Blue Shield of North Carolina, the only provider to offer plans in every county during the first year of enrollment.

“That made the difference for some people,” she said.

But this year, she said, Cumberland County residents are flocking to United Healthcare.

“You don’t really have as much to choose from,” she said.

Many consumers really like their insurance company, Pena said, “but it’s just unaffordable for them, so they had to end up switching plans.”

For Cathy Allen, an affordable plan meant sticking with United Healthcare. She’ll now have co-payments for doctor appointments, but “it’s better than not having health care at all,” Richard Allen said.

At 57, Cathy Allen has cirrhosis of the liver and other chronic health problems, and before the Affordable Care Act, she had been uninsured, he said.

“If it weren’t for the Affordable Care Act, she’d probably be dead by now,” her husband said.

“Now she’s got it under control.”

Market ‘in flux’

Marketplace consumers are not alone in the seemingly constant change they experience.

“This is a market in tremendous flux,” said Peter Ubel, a Duke University professor specializing in health policy and economics.

“It’s a market that ultimately depends on everybody being in it.”

But many healthy people have been staying away from Obamacare.

“That leaves insurance companies with very expensive enrollees,” he said.

“And so they raise their premiums, and more people wonder if they should buy insurance.”

Blue Cross and Blue Shield of North Carolina, the largest insurer in the state, requested marketplace rate increases averaging nearly 35 percent.

To read the rest of the article, please visit The Fayetteville Observer.

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