Cost Woes Continue Keeping Patients Away from the Doctor

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One year after the roll out of the Affordable Care Act, widely known as Obamacare, the debate still rages. Is it working to make healthcare coverage more affordable for millions of Americans? Is it inadvertently preventing employers from hiring full-time employees due to new regulations for businesses? Overall, is it helping Americans find affordable health insurance?

According to a recent CBS News/New York Times poll, 51 percent of Americans disapprove of the Affordable Care Act (ACA) while 41 percent approve of the new law. Partisan lines are clearly drawn in the sand when it comes to the ACA – 67 percent of Democrats approve of the law, while 83 percent of Republicans disapprove of the president’s signature achievement.


Why Can’t Many Americans Afford to See a Doctor?

medical_billing_advocate-78Based on news reports, it would seem that healthcare premiums are either skyrocketing or plummeting, depending on the reporting source of news. For most people, healthcare premiums will rise. However, directly citing the Affordable Care Act as the sole blame for increases may be overkill as it could be merely a function of inflation and annual rising prices. The cost of medical care and equipment seems to rise year after year, and health insurance premiums are at least somewhat correlated with these costs.

However, a recent analysis from PricewaterhouseCoopers (PWC) throttles the loudest voices on both sides of the debate. Healthcare premiums did increase like the Republicans warned, –however, premiums didn’t skyrocket. Many Democrats told us that premiums would go down and, at least on average, that didn’t happen, either.

According to the analysis by PWC, the average rate increase was 7 percent. They also predict an 8.2 percent increase next year in Washington D.C. and in the 29 states that have released data. Healthcare costs do seem to be rising, but it may be difficult to actually determine how much, if any, of that increase is from the implementation of the ACA.

What’s more, many people are opting for health insurance plans that offer lower premiums. Unfortunately, higher co-pays and deductibles usually accompany these lower premiums. It’s typically a tradeoff – pay less now, pay more later. Some young and healthy individuals may opt for the lower premiums, because they don’t anticipate going to the doctor much while some who may have pre-existing conditions will not want higher out of pocket costs and will therefore opt for higher premiums.

A poll conducted by the Associated Press-NORC Center for Public Affairs Research found that 29 percent of Americans enrolled in a high deductible plan avoided going to the doctor because of the associated out-of-pocket costs, even when they should have due to an illness or injury.


More Healthcare Plans, Lower Premiums?

medical_billing_advocate-77Health and Human Services Secretary Sylvia Burwell recently stated that the number of insurance companies offering plans in 2015 on the Affordable Care Act’s exchange marketplaces will increase to 248. This represents a 25 percent increase and could bode well for the cost of healthcare premiums.

More competition usually means lower prices; however, only time will tell whether the availability of these companies will be widespread or simply serve to increase competition in specific areas of the country. Burwell also said that Americans should learn what to look for when shopping for a plan in order to get the most benefit. Many consumers are signing up blind to what they actually need.

Furthermore, the ACA requires preventative care to be covered at no additional charge, and it seems some are not getting that. In fact, the same study showed that 24 percent of people did not carry out their routine preventative care because of the cost.


Do More People Now Have Healthcare Under the Affordable Care Act?

medical_billing_advocate-25In May, Gallup released a survey showing that those covered by health insurance increased by more than 8.9 million in the past year. A New England Journal of Medicine study was cited by The Health and Human Services Department that estimated some 10 million adults have gone from being uninsured to having healthcare coverage.

On August 15, Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, told the House Oversight and Government Reform Committee that the number of Americans who have enrolled in the new ACA marketplaces and paid their healthcare premiums stands at 7.3 million. The numbers vary, but they do seem to indicate that Americans have responded to the ACA by enrolling in healthcare plans.

Young adults, those between 18 and 34, need to sign up in order for the law to support itself. Obama’s stated goal was for young adults to account for 40 percent of the exchange enrollments. Has this number been reached? It seems that the 40 percent figure has not been achieved, but that some young people are generally searching for plans and signing up. According to the U.S. Census Bureau, the rate of uninsured young adults (ages 18-34) has dropped from 28.1 percent in 2009 to 25.2 percent in 2013.

Between 2012 and 2013, the number of uninsured young adults dropped by 367,000. Because Open Enrollment started on October 1, 2013 and many young adults signed up after the start of 2014, it can be reasonably and safely assumed that the percentage of uninsured 18-34 year olds has decreased further.


More Numbers on the Affordable Care Act

In June, had a headline that read: “3,137-County Analysis: Obamacare Increased 2014 Individual-Market Premiums by an Average of 49%.” Their methodology involved using an average of the five least expensive plans in a specific county prior to the rollout of the ACA and then taking an average of the five least expensive plans on the Affordable Care Act exchanges in each county.

medical-advocacy_162136106This methodology took into account pre-existing conditions and health problems in the prices prior to the implementation of the ACA, and it did not use the subsidized prices in the costs under the ACA.

This figure – 49 percent – represents a significant increase for healthcare shoppers if it actually gives us a true image of what Americans are finding when they shop for healthcare coverage. Because their study seems to be substantial, it is certainly worth a look.

The nonpartisan Congressional Budget Office (CBO) has not officially assessed the budgetary impact of the Affordable Health Care Act since the summer of 2012. At that time, they predicted that the law would reduce deficits by $109 billion in the next decade, from 2013 to 2022. However, things have changed since they released that prediction. The initial rollout saw computer glitches and security issues along with numerous attempts by the Republicans to repeal the law.

President Obama has delayed enforcing portions of the law, such as the employer and individual mandates, which also increases the potential costs. Because of these issues over the past year, the 2012 numbers are in need of updating.

Because the Affordable Care Act is a complicated law, the numbers describing its effects can also get quite complex. The more complex the numbers, the easier it is to twist them to a specific point of view.

One thing seems to be constant, those who tend to be more liberal and vote Democrat more often seem to find healthcare premiums to be lower than expected and less than their previous plans; those who tend to be more conservative and vote Republican more often, tend to find healthcare premiums much higher than before the ACA. That’s a strange phenomenon that could only be possible in our highly divided blue state/red state nation.


The Future

Only time will tell if the Affordable Care Act is a success or a failure. Real numbers are needed to continually assess its effect on our nation’s economy. There are still millions of Americans without healthcare and millions who can’t afford coverage. With the price of healthcare still rising, unemployment still an issue, and persistently stagnant wages, this is unlikely to be changed significantly by the ACA.

However, at the one-year mark, it seems as if more people are signing up on the government exchanges. People are searching for healthcare, especially young people and those with pre-existing conditions. Nonetheless, a true picture of the premium price is a bit more elusive.

One year is not enough time to assess a law with this much potential impact on our society. A completely nonpartisan study may have to be performed on the price of healthcare plans, across states, gender, age, and health conditions before a true accounting of the law can be rendered.

Filed under: Resources, Save Money, Obamacare, Medical Debt, Healthcare in Politics, Hospital Bill Review, Affordable Care Act

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8 responses to “Cost Woes Continue Keeping Patients Away from the Doctor”

  1. Linda says:

    My name is Linda. I’m 50 years old. I’ve had Obamacare for two years. Now that I really need it, I can’t afford to use it. The deductible is almost half of what I made last year. I haven’t gone to the doctor for many pre-existing conditions, and previously treated conditions, because of cost. I was injured at work last year. Couldn’t afford to miss work to go to the doctor. The clinic that I used to go to, before insurance, cost me $10 a visit by income. After insurance, it was $45 a visit. My meds went from $4 to $10, because I had insurance. Between my boyfriend’s moms health(who passed away two weeks ago in March of this year) and only one vehicle, he didn’t work before. Now he is working, but he don’t make as much as I did. I’ve applied for ssdi/ssi. Between the insurance deductible, the cost of many doctor’s appointments, and many more test and procedures needed. We can’t afford it with rent ,car payment, and car insurance. Our finances have been devastated.

  2. Janet says:

    My son’s fiance cannot afford to pay for insurance. She has asthma and cannot get medicine for it without medical care. She had it last year, it ran out and she did not get the notification. She applied, and she is now working part time and she care make her car payment and insurance, food. She cannot afford lodging, and they denied her. I guess they think that she should walk to work and back home. This is in Frederick County Maryland. Is this right? What can she do, she has had a tumor taken out of her heart years ago and needs help.

    • says:

      Hi, Janet. Thank you for reaching out. Many facilities will give discounts to people who do not have health insurance, and sometimes these discounts are pretty significant. Also, it’s not unusual for facilities to offer some sort of charity care assistance program for those who are in need of care but who can’t afford to pay. You must qualify for this assistance, though, and she will need to inquire about it. The important thing is that she receives care if she needs it. If she incurs medical bills, we will be happy to review them. Our Consumer Division can be reached at 855-203-7058.

  3. Janet says:

    She has been denied several times because she moved for a few months to help her dying father. Now no matter what she does, they deny her.

    • says:

      Hi, Janet. Have her give us a call so that we can get more information and try to assist. 855-203-7058.

  4. Melody says:

    I have a son who is 25 right now and under our health plan. He will also be a part-time student in college this fall. He does not work enough hours to be able to afford health care from his employer at minimum wage. In March 2018 he will be 26 years old. If sign-up are in October what should he do? He will also be having some work done before he goes off our insurance around the first of January. What are his options for affordable health care, he’s in relatively good health. Does he need to sign-up in October or can he wait until he’s 26? If he waits until he’s 26 in March what are his options,, cost? What happens to young adult in this situation?

    What are his options and any ideas?

    Thank you for your help!

    • says:

      Hi, Melody. Give us a call at 855-203-7058 so that we can get more information and try to assist.