The Campaign Spot

Obamacare’s Next Big Problem: High Deductibles, High Co-Pays

Another Campaign Spot reader describes his odyssey in attempting to buy insurance through the exchange sites:

First, I used Internet Explorer. Chrome and Firefox still don’t get me in.

I finally got in yesterday after more than 100 unsuccessful attempts dating back to Oct. 1. Our local navigator said I was one of only two people they know of who were able to access the site in a 20+ county area.

The site is designed to keep you from seeing anything other than your own options. You have to verify your identity and check a box testifying that everything you submitted is true under penalty of perjury before they’ll let you look at your options. So you can’t search around hypothetically to see how bad the young and healthy are getting abused. It’s hard enough to find your own options.

It’s still mega-glitchy. I was able to access my account again this morning, but I can’t find the options I had yesterday, so I’m going from memory here.

I’m in Texas. As a 50 year old non-smoker, I have (or did yesterday) 46 plan options from three insurers. I’m not eligible for catastrophic coverage since I’m over 30 and not indigent. And there were no platinum plans offered to me. The bronze, silver and gold plans ranged from $202 a month to $586 a month. I searched just for myself, not family coverage. The story going forward is going to be that the low-cost plans are garbage. Plan after plan had $5,000 and $6,000 deductibles before they pay a penny in benefits, and even then you’d still be on the hook for 40% of your bill. Once you get to the $350/$400 a month range, there are a few plans with $1,500 and $2,000 deductibles. One silver plan (I think in the $450 a month range) had zero deductible, but sky-high copays and all kinds of limitations. Many of the plans only cover “in network” care and don’t pay a penny for anything out of network. And staying in networks can be a big challenge. If you go to an orthopedic surgeon who’s in network, great, but you can easily find out after the fact that the anesthesiologist he used isn’t in your network.

The deductibles on the low-cost plans are the real scandal here. The administration will surely trot out a long line of cancer patients and people with other terrible medical problems who got treatment in 2014 with coverage they weren’t able to buy in 2013, but there are going to be far more working poor and middle class people who still have to scrape together a decent premium after the subsidies, pay it faithfully, then get sick and go to the doctor, only to find out their policy doesn’t cover anything until they’ve paid a $5,000 deductible. I predict a LOT of dissatisfied lower income premium payers.

If most people’s long wait will end with a menu of bad options — high premiums, high co-pays, high deductibles — then maybe the web site’s inability to display options isn’t a bug, it’s a feature!

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