Even though Obamacare will spend billions of taxpayer dollars subsidizing health insurers to enroll more people, many of the newly insured can’t use their new policies, according to the New York Times:
“I’ve had one doctor appointment since I got this insurance, and I had to pay $60,” Ms. Shabazz told Daniel Flynn, a counselor with the health network, the Health Federation of Philadelphia. “I don’t have $60.”
Mr. Flynn spent almost two hours going over her Independence Blue Cross plan, which he explained had a “very complicated” network that grouped doctors and hospitals into three tiers. Ms. Shabazz, who has epilepsy, had not understood when she chose the plan that her doctors were in the most expensive tier.
“None of that was explained when I signed up,” she said. “This is the first I’m hearing it.”
This kind of story is not news to readers of this blog. How was this allowed to happen? Most of Obamacare’s subsidies are tax credits paid to insurers to reduce beneficiaries’ premiums. Some money is allocated as cost-sharing subsidies, but obviously not enough to solve Ms. Shabazz’ challenges. Even these cost sharing subsidies are not very transparent to beneficiaries. Rather, they reduce deductibles and co-payments, and are calculated through the same wonderful software powering the Obamacare exchanges. Also, they are only available if you get a Silver Plan — not a Bronze, Gold, or Platinum Plan. Please don’t get a headache thinking about this stuff.
What do both these subsidies have in common? They go to health insurers, not to beneficiaries. Wouldn’t things have been a little easier to understand if at least some of that money went to beneficiaries for direct health spending? If they don’t have a Health Savings Account (HSA), Flexible Spending Arrangement (FSA), or Health Reimbursement Arrangement (HRA), how about giving them a debit card that can only be used for health spending — like SNAP cards (food stamps)?
That would hardly solve all the problems of Obamacare — but it might give Ms. Shabazz a little control of her medical destiny.