Healthcare After Obamacare

With most health insurance companies having published their rates for 2014, we now know what will change in our plan and how Obamacare really affects us. Overall, health insurance rates will rise 4-6% across the board in our plan (so said HR) because of changes in compliance with the Affordable Care Act (ACA).

For our family however, my employer will be paying $483 every pay period to cover my spouse and I under an Anthem HRA PPO plan. That is roughly $996/month, a $146 (18%) increased cost to the employer. What we personally pay increases from $115/paycheck to $125 (about 9% increase). Since the plan retains most of its features, we can say healthcare will cost us only 9% more in 2014.

The other changes I see include an increase in our out-of-pocket deductible, from $4000 to $6000/year. So the only action we'll take is to increase our emergency fund by $2000. The employer still contributes $4000 into our Health Reimbursement Account (HRA) at the beginning of the year, and how we use the plan remains unchanged. I also notice an emphasis towards expanded preventive care at 100% coverage. There are more women's services, and oddly questionable items like coverage for sex reassignment. Why that in lieu of more important services like fertility treatments? Starting in 2015, we'll be able to unbundle services from our plans; there's plenty I'd strike off right away. I also notice that our dental plan is now capped at $2500, with coverages at 90/60/80 for basic treatment/major treatment/orthodontics. Preventive dental care is always 100% covered. The prescription plan and other benefits do not change.

So I'd say come next year, we are paying a little bit more for healthcare but getting a little less service. Not bad, considering the stories we've heard about people seeing insurance costs double or tripple on the private market (about 12% of the insured). While most have blamed Obamacare for these increases, the truth is that healthcare is expensive to begin with (around $900/month for a family), and its costs rise every year.

Rather than focus on access, I think healthcare reform should have first addressed why the costs are so high (see this PBS Newshour analysis, for example). Second, decoupling insurance from employment would squarely make it a market problem, much like automobile or renters insurance work. Then would it have been appropriate to consider how people access healthcare and how it is delivered. I wouldn't even mind reviewing so-called entitlements to care that ultimately someone else pays for. So whether it is Obamacare causing the price hikes or not, there is a chronic problem in US healthcare that will continue to haunt us regardless of regulation and taxation.