{"id":1523,"date":"2013-10-10T08:35:12","date_gmt":"2013-10-10T12:35:12","guid":{"rendered":"http:\/\/chirblog.org\/?p=1523"},"modified":"2013-10-10T08:38:01","modified_gmt":"2013-10-10T12:38:01","slug":"dont-be-fooled-aca-coverage-a-better-deal-for-just-about-everyone","status":"publish","type":"post","link":"https:\/\/chirblog.org\/dont-be-fooled-aca-coverage-a-better-deal-for-just-about-everyone\/","title":{"rendered":"Don\u2019t Be Fooled \u2013 ACA Coverage is a Better Deal for Just About Everyone"},"content":{"rendered":"
First, Affordable Care Act (ACA) opponents charged that premiums for the new marketplace health plans would be too high<\/a>, and consumers would face \u201crate shock.\u201d But then states and federally facilitated marketplaces (FFMs) started to publish premium rates and they were actually lower than projected<\/a>. So \u00a0critics pivoted to a new argument, conceding that marketplace coverage might, indeed come with low premiums, but the trade-off would be high deductibles<\/a>, high cost-sharing, and narrow networks.<\/p>\n Such claims neglect to mention that marketplace plans are actually a much better deal for most consumers, compared to what has, up to now, been available. Pre-ACA, consumers faced a \u201cwild west\u201d when buying health insurance, and many were shut out entirely because of high costs or pre-existing conditions. And for those that could buy coverage, it was often like swiss cheese<\/a> \u2013 full of holes. What good is insurance that you can\u2019t rely on when you get sick or injured?<\/p>\n As CHIR faculty documented in a recent report, Real Stories, Real Reforms<\/a>, the insurance coverage that has been available to individuals buying it on their own falls far short of the typical employer-based plan. They have not only faced higher premiums than those with employer-offered coverage, but also much higher deductibles<\/a> and other forms of cost-sharing, such as co-payments<\/a> and coinsurance<\/a>.<\/p>\n A Commonwealth Fund<\/a> survey<\/a> published in 2009 found that 60 percent of people with health problems reported it \u201cvery difficult\u201d or \u201cimpossible\u201d to find a plan with coverage they needed, compared to about one-third of respondents without a health problem. And in fact, over half of individual market plans sold today don\u2019t meet the minimum coverage standards in the ACA. Before the ACA\u2019s reforms went into effect, coverage on the individual market was inadequate for many reasons, including:<\/p>\n Under the ACA, insurers are no longer allowed to impose pre-existing condition exclusions, and they have to provide comprehensive coverage of basic benefits like maternity, hospitalization, prescription drugs, and doctor visits. And there\u2019s an annual cap on consumers\u2019 total out-of-pocket costs ($6,350 for individual coverage, $12,700 for families). These reforms mean that insurance will do what it\u2019s supposed to do: be there for them when they get sick or injured so they can get the care they need and be protected from financial harm.<\/p>\n Many of the marketplace plans will include deductibles and other forms of cost-sharing. Consumers need to shop around and decide what plan is right for them. But one thing is for sure \u2013 they\u2019ll get a better deal than just about anything they could have gotten before.<\/p>\n","protected":false},"excerpt":{"rendered":" Some are questioning the adequacy of health insurance on the new marketplaces. But such concerns neglect to mention that these new plans will be a far better deal compared to what, up to now, has been available. Sabrina Corlette takes a look at the comprehensiveness of health insurance coverage, pre- and post-ACA.<\/p>\n","protected":false},"author":2,"featured_media":509,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16,13,304,35,269,156,148,289,104],"_links":{"self":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/1523"}],"collection":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/comments?post=1523"}],"version-history":[{"count":4,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/1523\/revisions"}],"predecessor-version":[{"id":1527,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/1523\/revisions\/1527"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/media\/509"}],"wp:attachment":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/media?parent=1523"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/categories?post=1523"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/tags?post=1523"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n