The Affordable Care Act with all its Federal and various State exchanges now available for purchasing mandated health insurance has produced the unintended consequence of priming the supplemental health insurance market for all those individuals not yet old enought to apply for Medicare. In order to control annual insurance premiums, and at the same time limit future cost liabilities, the Obamacare Bronze, Silver, and Gold plans stipulate substantial deductibles and co-payments as a condition to obtaining health insurance coverage. Upon paying the premium for even a Bronze-level coverage plan, for example, the beneficiary is forced to pony-up for onerous, out-of-pocket costs in excess of $5,000 per year in order to meet that plan’s delineated deductible and co-pays. In essence, the beneficiary has simply bought expensive “catastrophic health care insurance,” and nothing more. He or she first must annually pay several thousands of dollars in out-of-pocket expenses to see a doctor before the insurance coverage kicks in.
Government manipulation of our health insurance financial risks is not new. In 1964 when Medicare was legislated to provide health access for those aged 65 years and above, it had its own deductibles and co-pays as well…and still does. For example, Medicare Part B will cover only 80% of negotiated costs for provider services. To fill that remaining 20% gap, the AARP and other organizations sponsor multiple, supplemental health insurance plans for seniors in order to cover some to all of the remaining annual costs for this portion of medical care.
Bottomline, cost containments shaped by Medicare have been the overall model for Obamacare. First, Americans under age 65 years must either purchase an approved ACA plan directly, or through their employers, or prove that the total premium expense is too financially onerous. Those who have chosen to enroll in an ACA plan must then also possess sufficient means to cover the plan’s deductibles and other costs, such as copayments and taxes. Similar to what had happened after Medicare went into effect, a robust market for supplemental Obamacare plans is expected to surface and mitigate all of those out-of-pocket, mandated ACA expenses. It has been estimated that the supplemental health insurance marketplace will increase over 1,000% within the next eight years because of Obamacare. Those entrepreneurs who wish to become part of this expanding business should now consider getting in on its ground floor.
For another viewpoint on universal health care delivery and insurance coverage, please visit, Spirit Made Smaller. The Alpha-Omega program detailed in the novel’s chapter twelve may be interesting for our politicians to consider.