The corpse of health care reform wasn’t even cold before we got a letter from our insurer telling us our premiums were about to increase 40%, to $1,026 a month.
This is for a policy that has a $5,000-per-person deductible ($10,000 family). Eight years ago, when we first secured coverage, the premium was less than $250 a month.
We’re not alone. Our insurer, Anthem, is jacking rates on thousands of its policyholders, as this Los Angeles Times article attests. California’s insurance commissioner says he’s “very concerned.” I’ll bet.
Anthem is blaming this on rising health care costs. Insurance agents are saying Anthem’s trying to rid itself of less profitable policies.
Anthem does offer policies with even less coverage that might save us some money on monthly premiums, but we’d have to go through underwriting again—and our insurance agent doubts we’d pass.
Why is that, you might ask? Do we have cancer, diabetes, heart disease?
No. Neither of us is overweight. We don’t drink or smoke, we exercise regularly and we’re in excellent health.
But I’m over 40, and my husband is over 50, and we each take a prescription medication. Mine’s for an underactive thyroid. My husband’s cholesterol is a little high.
That’s it. But that’s enough to prevent us from getting new insurance.
There is nothing about this situation that isn’t insane.
I don’t believe insurance should cover every sniffle and check-up. I was fine with paying most of our family’s health care costs out of pocket, as long as we had protection against catastrophic expenses. But I also expect insurance companies to hold up their end. When they cherry-pick their customers, drop those who are sick and jam through eye-popping rate increases, they aren’t providing insurance in any real sense of the word. They’re not pooling risk; they’re evading it.
The good news is that we can afford this increase, and probably a few more to come. Others can’t. One of my friends got a notice that her premium is going up to $500, and she can’t pay it. She, like many of Anthem’s other customers, will be going bare.
Kathy Kristof writes in this thoughtful column that the reason health care reform is dead is that Congress doesn’t understand what insurance should really do.
So instead of getting what we needed—coverage that’s available, affordable and there when you need it—we got squat.
UPDATE: The Los Angeles Times is reporting that the Obama Administration has called on Anthem to justify these huge price increases. Health and Human Services Secretary Kathleen Sebelius, who used to head the National Association of Insurance Commissions, wrote that Sebelius said that Anthem’s “strong financial position” made the increases “even more difficult to understand”:
These extraordinary increases are up to 15 times faster than inflation and threaten to make healthcare unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy.
A grim survey by the Commonwealth Fund found that seven out of 10 working-age women are uninsured or underinsured, leaving them with medical debt or problems accessing care because of the cost.
And that was before the recession kicked into high gear.
The results are from the Commonwealth’s 2007 survey of 2,616 adults. The survey has an overall margin of sampling error of plus or minus two percentage points. (That basically means the survey is scientifically accurate, for those of you who fell asleep during statistics class.)
Women are far more likely to be affected by rising health care costs than men because women have lower average incomes and higher out-of-pocket costs and are more likely to seek care, the fund reported.
Here are the lowlights:
- 52 percent of women had any one of four problems getting needed health care because of cost compared to 39 percent of men: did not fill a prescription; did not see a specialist when needed; skipped a recommended medical test, treatment, or follow-up; or had a medial problem but did not visit a doctor or clinic.
- 45 percent of women accrued medical debt or reported problems with medical bills in 2007, compared to 36 percent of men.
- Women were also more likely to skip tests and screenings: almost half of women (45%) delayed or did not receive a cancer screening or dental care because of costs, compared to 36 percent of men.
- The proportion of women earning $40,000 – $60,000 who spent more than 10 percent of their income on out-of-pocket health costs increased from 21 to 41 percent between 2001 and 2007; 17 percent of women with income over $60,000 had high out-of-pocket costs in 2007.
- About one-third (34%) of women with incomes of $60,000 or more reported problems getting needed care because of cost, as did 23 percent of men with similar incomes.
- Six in ten women with moderate incomes (between $20,000 and $40,000) report being unable to pay medical bills, being contacted by a collection agency for unpaid medical bills, changing their way of life to pay medical bills or paying off medical debt over time, as did almost half (46%) of middle-income women. About 50 percent of men with moderate incomes and 32 percent with middle-incomes reported medical bill problems.
For more on health insurance, read:
If you’ve lost your job, you may be able to keep your health insurance thanks to the American Recovery and Reinvestment Act that President Obama signed into law last month.
If you elected to take COBRA — which lets laid-off workers continue with their former employer’s coverage for up to 18 months — the government will now subsidize 65% of COBRA premiums for up to nine months. The subsidy is limited to workers laid off from Sept. 1, 2008, to Dec. 31, 2009.
COBRA is not cheap. The average monthly COBRA premium for individual coverage is $388, or about 30% of monthly unemployment benefits, says the Families USA Foundation. The monthly COBRA premium for family coverage is $1,069, or about 84% of benefits. So getting those premiums reduced by 65% is a big savings.
Employers and health plans will be sending notices to former employees about the aid plan, and the U.S. Department of Labor will post updates on their Web site HERE.
The California Society of CPAs – the nation’s largest professional, non-profit state association of about 33,000 CPAs – suggests going through this checklist of questions when deciding what to do about COBRA:
- Can you get coverage through your spouse or domestic partner’s employer?
- Can you continue your coverage through COBRA?
- Find out if your state has any laws or programs that can help you
- Find out if you are eligible for Trade Adjustment Assistance and the Health Coverage Tax Credit that comes with it
- Ask if you or any family members are eligible for Medicaid, the Children’s Health Insurance Program or VA coverage
- If you can’t afford COBRA and can’t get help through any public programs, shop carefully for insurance on the individual market
- And finally – realize that you may not be eligible for COBRA. (If your employer had fewer than 20 workers or went of out business completely and no longer has a plan – you don’t qualify.
Check out some of my previous columns on this topic:
The corpse of health care reform wasn’t even cold before we got a letter from our insurer telling us our premiums were about to increase 40%, to $1,026 a month.
