When I read all the complaints nationwide about how bad Obamacare1 insurance actually is -- especially related to deductibles -- I didn't believe it. I figured it must just be right wing ideologues who are just as bad as the lefty goo goos when it comes to lying to people. If nothing else I figured, RomneyCare was pretty good insurance until it ended. And Obamacare is just like RomneyCare the left constantly reminds me.
As of January 1, 2014 those who need it in Massachusetts cannot get RomneyCare (top of illustration) any more. It's being replaced by Obamacare even here in Massachusetts (bottom of illustration; sorry hard to read but you can read it here if you enter some random data and make your birthdate 10/26/1950 and your zip code 02638).
I was surprised to see that even in Massachusetts Obamacare is lousy inurance2. Both plans3 are HMOs and include “free” physicals (which I assume includes a DRE for men because it includes an OB/GYN for women; but that’s not true for Medicare so it might not be true for this other government monstrosity)
- The first thing to note is that the December 2013 RomneyCare full price ($466 a month) policy4 at the top of the illustration has a $250 annual deductible. But the January 2014 Obamacare full price ($467 a month) policy beneath it in the illustration has a $2000 annual deductible. Effectively for the same benefits, Obamacare costs about $150 more a month ($2000 minus $250 divided by 12) but luckily that only applies if you are unlucky enough to have to use the insurance. (On the other hand, if you don’t use the insurance you just paid $5400 for a physical – see first bullet.)
- The 2013 Romneycare policy has a $5000 out of pocket (OOP) max; the 2014 Obamacare policy has a $6250 max which could cost a beneficiary another $1250 before insurance protection is complete depending on the type of health care service needed
- ER Visit:
- RomneyCare in 2013: You pay $150 (according to the about to be retired Massachusetts Healthcare Connector web pages for RomneyCare). Period. That's it.
- Obamacare in 2014: You pay anywhere from $350 to $2350 depending on how expensive the ER visit is and how much you've otherwise paid against your $2000 annual deductible when you go to the ER
- The hospital
deductible is $1000 in 2014 vs. 35% co-insurance in 2013 (potentially that's a
better deal under Obamacare if you stay multiple days in the hospital) but in
general Romneycare was better insurance. Take for example a typical $5000
hospital bill assuming you have not spent anything else OOP against the annual
- Under RomneyCare in 2013: You pay $2562.50, the annual deductible of $250 and the hospital-stay deductible of $1000, plus $1312 (35% of what’s left after the deductibles)
- Under Obamacare in 2014: You pay $3000, 20% more, including the annual deductible of $2000 and the hospital-stay deductible of $1000
- All doctor visits cost $25 this year under RomneyCare; they will cost $30 for your PCP and $50 for a specialist next year under Obamacare; these seem to apply in either case even if the annual deductible has not been satisfied (we at least have a Munchkin here if we don’t have a “donut hole”)
- It looks like generic drugs are expensive in both plans (more expensive under Obamacare; but who cares, just go to Target or Stop and Shop and pay cash)
- Outpatient surgery – which is becoming the norm – cost 35% under RomneyCare and $750 under Obamacare; the math is as with a hospital stay, almost always better under RomneyCare this year than Obamacare next year but varies depending on what it’s for
[And – as you can see from the way the deductibles are structured -- Obamacare even has a "donut hole." How come the lefties are not explaining that to people?]
1I call the law the Patient Protection and Affordable Care Act (PPACA) of 2010 as Amended by... (I can never remember the whole name--something about education). The insurance enabled by PPACA is Obamacare.
2This is a comparison of fully priced Neighborhood Health RomneyCare (Commonwealth Choice) premiums for a 62 year old living on Cape Cod and wanting a Commonwealth Choice policy starting December 1, 2013 vs. the full price Neighborhood Health Obamacare insurance starting January 1, 2014. I purposely chose policies from the same insurer that cost almost the same to see how different they are in terms of benefits.
3The 2013 plan is a so-called Bronze plan. The 2014 plan is a so-called Silver plan. In general that means nothing except to goo goos; look at the prices and the benefits not at what the goo goos tell you to look at. But there is some kind of crazy benefit in Massachusetts where the state gives out even more of a subsidy in addition to the IRS’ if you buy a Silver plan. The specifics across different insurers may not be the same directionally (but I doubt it; I chose Neighborhood Health at random because the prices were almost exactly the same beginning at almost exactly the same time).
4These comparisons are somewhat just an academic exercise because only a few tenths of a percent of people in Massachusetts ever bought Commonwealth Choice policies like the 2013 example above through the Health Connector under the now repealed RomneyCare laws. A more useful and detailed examination would compare Commonwealth Care policies (the limited insurance that Massachusetts made working poor people use from 2007-2012, which many doctors would not accept) and see how that compares with Obamacare with subsidies Given that Commonwealth Care was pretty good insurance except that no one took it and only a few insurers offered it, it looks like none of the comparisons will be pretty.