Affordable Care Act 'not so affordable' for some

12:04 PM, Oct 3, 2013   |    comments
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SACRAMENTO, CA - The Affordable Care Act is said to benefit the millions of uninsured Americans by lowering the cost of health insurance. But some are vilifying the health care law, saying it is anything but affordable.

When Don Hayes of Sacramento received his insurance renewal packet from Kaiser Permanente in the mail, he was shocked.

"I was outraged!" Hayes said. "I looked at it. I said, 'there's got to be something wrong!'"

Haye's eyes weren't fooling him. The letter from Kaiser Permanente stated his insurance rates would be going up 91 percent in 2014, a difference of more than $200 per month for Hayes.

"That $200 per month increase is the difference between paying the rent or not paying the rent, or putting food on the table or not putting food on the table," Hayes said.

Hayes considers himself a healthy 53-year-old man who rarely goes to the doctor. He said his individual, private plan with a high deductable through Kaiser Permanente worked for him, but that's all about to change.

"[Kaiser Permanente] said it doesn't meet the requirements - my current plan - of the new Affordable Care Act," Hayes said.

In a statement, Kaiser Permanente said, "the effect of health reform on any individual's premium depends a great deal on the kind of coverage they currently have. Some provisions of the Affordable Care Act may contribute to premium increases, while others may contribute to reductions in premiums for the coverage that will be available starting in 2014."

"I don't blame Kaiser at all. They're just trying to comply with the new law," Hayes said.

In 2014, insurance companies will be required to cover more health care services. Rate differences between older and younger Americans will be narrowed, and those with pre-existing health problems can't be turned away, but someone needs to pay for those changes.

"As a result of these improvements, the cost of coverage - in the form of the monthly premium - will increase for some members, simply to pay for the expanded coverage," Kaiser said.

Hayes said he does have the option of getting on his wife's insurance plan, but because of the new health care provisions, that wouldn't be a financially smart move for his family.

"The spouse rate is actually even more than this current rate with the 91 percent increase," Hayes said.

Hayes suspects he is not alone, calling the Affordable Care Act anything but affordable.

"Everybody is now finding out what's in the 2,000-page nightmare Affordable Care Act," Hayes said. "I want it repealed. Get rid of it. It's a disaster."

"All consumers should be aware that they may be eligible for financial assistance to help reduce their cost," Kaiser said. "The federal government will provide financial assistance in the form of advance premium tax credits and cost sharing reductions to help lower-income families pay their premiums. Assistance is based on a variety of factors, including family size, income, location, as well as the cost and benefit design of the plan chosen." 

BELOW: Read the full statement released from Kaiser Permanente:

The effect of health reform on any individual's premium depends a great deal on the kind of coverage they currently have. Some provisions of the Affordable Care Act may contribute to premium increases, while others may contribute to reductions in premiums for the coverage that will be available starting in 2014.

The law mandates more comprehensive coverage starting in 2014. This means more services will be covered by insurance.  As a result of these improvements, the cost of coverage - in the form of the monthly premium - will increase for some members, simply to pay for the expanded coverage.

While it may not apply to this individual, it's important to note that people with some of the more expensive coverage plans - HIPAA, conversion, high-benefit plans, perhaps some with COBRA - may see lower premiums next year. Rate differences between older and younger Americans will be narrowed, likely resulting in lower rates for older individuals. Also, the millions of Americans who have not been able to buy insurance because of existing health problems will be able to buy insurance and pay the same premiums as everyone else.

Even though this individual does not believe he is eligible for financial assistance, we would encourage him to confirm that. All consumers should be aware that they may be eligible for financial assistance to help reduce their cost. The federal government will provide financial assistance in the form of advance premium tax credits and cost sharing reductions to help lower-income families pay their premiums. Assistance is based on a variety of factors, including family size, income, location, as well as the cost and benefit design of the plan chosen.

News10/KXTV

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