Is the dust ever going to settle in health insurance?

Since the inception of the Affordable Care Act (ACA) for Healthcare there seems to be an ongoing instability that has caused quite an array of reactions from joy to anger.

People that at one time were denied insurance for “preexisting” conditions now have access to coverage by law.  Yet, the costs have to come from somewhere.  The “somewhere” is all of us.  Add the facts that many people are statistically more unhealthy than 10, 20 or 30 years ago and you have a rising cost of healthcare that may be unsustainable and changing for years to come.


People ask us “what are my options” – the answer is fewer than ever before.  Individual policies have higher deductibles and cost more in premiums because of simple mathematics. Some people that qualify for a Premium Tax Credit, to lower premiums, (on exchange or ACA only) are finding the costs too high, and the coverage too low, for even basic healthcare coverage.  The real issue is that many people have no choice but to go uninsured, which leaves them in a terrible predicament should a catastrophic event happen in their health.  The answers for those with lower income can be more promising, because the Premium Tax Credit can cover most of the premiums.  That, however is a limited amount of citizens.

In one case the premium to a 50 year old single man who made about $25,000 per year would have been approx. $700 for a HMO policy with a major carrier and a 3500.00 deductible and maximum out of pocket per year.  With his Premium Tax Credit the policy premiums per month came in at 280.00.  Not too bad.  As that same person gets closer to the approx $46,000 (plus or minus a few $$) the Premium Tax Credit gets less and less until that approximate level where there’s no longer a reason to use the Tax Credit for premiums.  This is just one case, and in ALL cases the options are limited.

Next on the hit parade is the costs and coverage for group insurance in 2016,  those will play out more clearly as we see the premiums rise in 2016, AFTER open enrollment starts November 1st.

Stay tuned and call us at Insurance Benefits Resource Group as soon as possible – don’t wait!

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