Health Insurance Premiums, Subsidies, And Mandates Uncertain In The Coming Months


Health insurance has never been such an explosive subject. In the not too distant past, health insurance was a mundane topic consisting mostly of paperwork and bills and not often discussed. Now it’s full of political overtones, steeped in controversy, and something nearly everyone is talking about.

The second open enrollment period begins this Saturday. A “window shopping” function was enabled on the website to allow consumers to begin kicking tires, examining options and prices. The prices fluctuate wildly. In most places there are modest increases — increases that were common long before the implementation of the Affordable Care Act — but in some places prices are declining. Those who take no action will be automatically re-enrolled in their current health insurance plan and may miss out on better prices, better companies, or more comprehensive coverage. Most of the increases are very modest, single percentage point rises, bearing in mind that averages can encompass a very large range and some increases may be steep. Many officials believe that normal yearly increase rates are slowing, perhaps due in part to provisions set forth by the current law. Urban dwellers are more likely to see a decrease in their premiums, while rural consumers are more likely to see an uptick, largely due to the lower number of insurers and difficulty in negotiating with small regional hospitals.

Some states have a preemptive tool in place to help eliminate large spikes in premiums. States such as New York have a health insurance rate review process with a public commentary section. According to the Fiscal Times, insurers proposed a 12.5 per cent increase but after reviewing the data, the state of New York limited the increase to only 5 per cent. States with tools such as these tend to have lower overall rate increases.

Health insurance has more problems than just fluctuating rates, high deductibles, and questionable “options.” As NPR reported, it’s becoming increasingly common for some doctors, who aren’t actual hospital employees, to be out of network even if the hospital they work at is in-network. The three most common are anesthesiologists, radiologists, and unfortunately, emergency room doctors. Many doctors are choosing not to go in-network because insurance reimbursement rates are too low, which often equals big bills for patients.

If there wasn’t enough vitriol surrounding this health insurance mandate, the Inquisitr reports that one of the key personnel involved in designing the complicated law was captured on video claiming that the law was purposefully confounding and relied on the “stupidity” of the voting public for its passage. Many people have benefited from some mandates contained within the health insurance laws. No maximums has meant the difference between life and death for some very sick people. Others have been able to take advantage of the extended ages for being maintained on parental policies. Many are bristling at being forced to choose between expensive policies that they don’t want and fines they abhor. The final score on this is going to be many years away, especially in light of the challenges that are sure to arise. The Republican controlled Congress will be sure to start chipping away at what they find to be the unpalatable health insurance mandates known as Obamacare.

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