Subsidies
are available to help low- and moderate-income people pay premiums, but
no financial assistance is available to a family of four with annual
income over $98,400.
Optima, a division of Sentara Healthcare, invited customers to share their personal stories on its Facebook page, and they obliged, with a fusillade of plaintive and sardonic comments.
Bill Stanford, who works for a floor-covering business in Virginia Beach, said,
“Optima Health Care just raised my premium from an absurd $1,767 a
month to an obscene $2820.09 per month,” which is more than the mortgage
payments on his home for a family of four.
“At
an average of $60 per visit,” Mr. Stanford said, “I could visit the
doctor’s office 45 times a month for the premium that I’m paying. I
think we will probably drop our insurance and get a gap policy.” Such
short-term insurance is meant to fill temporary gaps, but typically does
not cover maternity care or treatment for pre-existing medical
conditions.
Mr. Dudley said in an
interview that Optima, a Virginia company, felt an obligation to
continue serving Virginians when larger national insurers were pulling
back. But, he said, Optima is affected by the same factors destabilizing
insurance markets elsewhere. These include President Trump’s decision
to terminate certain federal subsidies
paid to insurers and doubts about the future of the requirement for
most Americans to have insurance — the individual mandate, which would
be eliminated by the Senate Republicans’ tax bill.
And
in the Charlottesville area, Mr. Dudley said, costs are high because
many people receive care from an expensive academic medical center at
the University of Virginia.
Carolyn L.
Engelhard, director of the health policy program at the university’s
School of Medicine, acknowledged that teaching hospitals often charged
more. But another factor, she said, is that Virginia has not regulated
insurance rates as aggressively as some other states.
Consumers are feeling the effects.
“Obamacare
helped me,” Ms. Griffith said. “I had a pre-existing condition, could
not get insurance and had to pay cash, nearly $30,000, for the birth of
my first baby in 2010. For my second pregnancy in 2015, I was covered by
Obamacare, and that was a huge financial relief.”
But the costs for next year, she said, are mind-boggling.
She
and her husband, both self-employed, expect to pay premiums of $32,000 a
year for the cheapest Optima plan available to their family in 2018.
That is two and a half times what they now pay Anthem. And the annual
deductible, $14,400, will be four times as high.
“I
have no choice,” Ms. Griffith said. “I agree that we need to make
changes in the Affordable Care Act, but we don’t have time to start over
from scratch. We are suffering now.”
Jill
A. Hanken, a health lawyer at the Virginia Poverty Law Center, said,
“People who qualify for premium tax credits are finding very affordable
plans with low premiums, and those consumers are quite pleased.” But she
added: “For people who don’t qualify for tax credits, the cost of plans
has truly skyrocketed. They can’t afford or don’t want to pay the high
premiums.”
When the Affordable Care
Act was adopted in 2010, Democrats like Nancy Pelosi, who was then the
House speaker, said the law would make it easier for people to switch
jobs or start their own businesses because they would not have to worry
about losing health insurance.
“We see
it as an entrepreneurial bill,” Ms. Pelosi said, “a bill that says to
someone, if you want to be creative and be a musician or whatever, you
can leave your work, focus on your talent, your skill, your passion,
your aspirations because you will have health care.”
And for a few
years, Mr. Dixon said, that idea was appealing. “I would not be an
entrepreneur if it were not for Obamacare,” he said.
With soaring premiums, that option is less attractive.
“When
I saw the insurance prices for 2018, my initial instinct was to try and
go back to my previous employer,” Mr. Dixon said. “But that would just
smell of desperation.”
source : https://www.nytimes.com/2017/11/16/us/politics/obamacare-premiums-middle-class.html
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