Kathleen Sibelius has become Vanna White touting the big prizes available for fall ObamaCare enrollment. The government is spending millions in your tax dollars to meet the enrollment projections. The liberal media is predicting far greater enrolments than the target of 7-8 million citizens.
First, let me say, Sibelius is no Vanna White. Her flat tone does not match the energy and enthusiasm of those pros who are hired to whip up excitement for contests. Plus, she’s not the most appealing public figure in all aspects. Google her little prize pitch and judge for yourself.
Second, as a skeptic of all things ObamaCare, I was curious to see for myself how this enrollment would work. It starts in October, so it’s right around the corner. Past experience has shown me that even the best government programs suffer from the usual flaws of the bureaucracy. Complexity beyond belief.
So, I set out to test the process. Illinois has decided to join the states that will offer insurance through the exchanges. I decided to find out how a family living in Illinois could get the necessary facts now to get enrolled by October 1st. In my theoretical family there are two adults, ages 44 and 43, smokers both, with one child.
Try it yourself: http://kff.org/interactive/subsidy-calculator/
I found several sites that provided information, but only one Kaiser Family Insurance, that gave a system to calculate the cost of this exchange insurance to my hypothetical family. I went there an input the data above, age, etc. Here’s what I got back.
Results
The information below is about subsidized exchange coverage. Note that subsidies are only available for people purchasing coverage on their own in the exchange (not through an employer). Depending on your state’s eligibility criteria, you or some members of your family may qualify for Medicaid.
- Household income in 2014:
- 179% of poverty level
- Unsubsidized annual health insurance premium in 2014:
- $14,384 $4,156 of which is due to a tobacco surcharge
- Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy:
- 5.34% (before accounting for the tobacco surcharge)
- Amount you pay for the premium:
- $6,026 per year (which equals 17.22% of your household income and covers 42% of the overall premium)
- You could receive a government tax credit subsidy of up to:
- $8,358 (which covers 58% of the overall premium)
Bronze Plan
The premium and subsidy amounts above are based on a Silver plan. You have the option to apply the subsidy toward the purchase of other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).
For example, you could enroll in a Bronze plan for about $3,564 per year (which is 10.18% of your household income, after taking into account $8,358 in subsidies). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.
Out of Pocket Costs
Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $4,500. Whether you reach this maximum level will depend on the amount of health care services you use. Currently, about one in four people use no health care services in any given year.
You are guaranteed access to a Silver plan with an actuarial value of 87%. This means that for all enrollees in a typical population, the plan will pay for 87% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required.
Other Coverage Options
Because Bronze level coverage would cost more than 8% of your household income, you may instead opt to purchase catastrophic coverage. With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ($12,700 in 2014). However, preventive services are covered with no cost sharing required.
Children under the age of 19 may also be eligible for coverage under Medicaid or the Children’s Health Insurance Program (CHIP), depending on your state’s eligibility requirements.
Got all that? It’s just a wild guess, but I think the government and the states like Illinois will need to hire a few thousand new employees to explain what this means. I defy any of you who read this to tell me what it will cost my hypothetical family for insurance based on the information I received for the various plans.
So there may be far more than 7-8 million who would like to enrol in the ObamaCare exchange program, but there may be only a few thousand who can understand what it covers and what it costs. This is what you get when you put the IRS and the government in the insurance business.
Just think what the average telephone wait time will be for those who call to get this explained. And, consider the person on the other end of that phone who will be responsible for explaining. That person at the Post Office or License Bureau who hates every one who steps up to the window. Getting that jerk off her phone will be job one.
I don’t have a crystal ball and can’t see what the enrollment numbers will be. But, I have a lot of business experience that tells me this is truly a train wreck. There will be a lot of angry people who try to enroll and find they have no idea about what it costs and what it covers and won’t sign up until they do and won’t find anyone who can answer those questions.
Instead of spending millions to promote this program, Kathleen needs to spends billions hiring people who can explain it.
By the way, if you are not sure whether this country should follow Obama into battle in Syria, check this please: https://www.youtube.com/watch?v=GfHSPLW63Gg
