Obamacare’s Newly Insured Can’t Use It

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.

Comments (14)

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  1. Thomas says:

    I don’t think much of the adverse effects of Obamacare was explained to recipients. I imagine they were told they were getting health insurance and a subsidy to make it affordable for them. However, I bet there was very little explanation about her networks “three tiers.”

    • John R. Graham says:

      I do this for a living. If I had to figure out “three tiers” of providers in my health plan, I would jump out the window after about ten minutes trying to figure it out.

      (Any and all readers of this blog who are ready to comment: “Go ahead, give us all a break”, please consider it posted.)

  2. Perry says:

    The longer this goes on, the more flaws will be turned up in this boondoggle. Having health insurance does not ensure health care.

  3. Jay says:

    “Please don’t get a headache thinking about this stuff.”

    Too late!

  4. Matthew says:

    It really is a shame that once people enroll in these plans, they get hit with these complexities. But no one would enroll if you explained all of the loopholes and regulations to them beforehand.

    • John R. Graham says:

      The Obamacrats never would have hit their numbers: “Over 8 million enrolled!” – if all the loopholes and regulations had to be explained to the recruits.

      It would have taken a whole day to sign up each person!

  5. Frank says:

    It is sad to hear stories like this. But I imagine that is impossible to assume that EVERY newly enrolled person will know exactly what is going on.

  6. James M. says:

    “They go to health insurers, not to beneficiaries.”

    This is the issue with Obamacare. It makes sure that insurers remain financially solvent at the expense of the beneficiary.

  7. Deets says:

    With the O administration desperate to sign people up, I seriously doubt policies, fees, copays, etc. are being explained in full.

  8. Big Truck Joe says:

    Wait till the Deductibles, that weren’t well explained, kick in. Now that’s done real money.

  9. Erik says:

    Vouchers will never be an acceptable answer to health care expenditures no matter how you wrap it.

  10. Bob Hertz says:

    In a longer article on the same sad case, it appears that Mrs Shabazz makes $19,000 a year in good times and recently lost her job.

    So she cannot afford any deductible at all.

    But in her state and 26 others, stingy legislators did not expand Medicaid. She had to go to the Exchanges, where economically she did not belong.

    I really like the idea of medical food stamps, which are proposed here.

    However, in order to free up money for office visits, etc. there may have to be some reduction at the other end of health insurance. Maybe the coverage has to have an annual limit, as was true before the ACA.

    The Minnesota Care plan for years covered office visits with no deductible, but would only cover hospital bills up to about $10,000. Big deal in my view. If the hospital bill goes over that for the poor people on Minnesota Care, they would likely declare bankruptcy anyways or the bill would eventually be forgiven.

    • John R. Graham says:

      No deductible at all? I wonder about that. Not even one dollar? There are some who believe that everyone needs to share at least a little financial obligation.

  11. Lowell says:

    This is what happens when you sell healthcare as an unlimited resource of little value, when in fact healthcare is a limited resource of great value. Americans have been sold a bill of goods-
    they expect the best of care-on demand-and expect someone else to pay for it.

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