EDITORIAL: You better shop around for medical insurance

FresnoNovember 10, 2013 

Secretary of Health and Human Services Kathleen Sebelius and President Barack Obama should be honest about the fact that some will pay more for similar coverage under Obamacare.

KENT D. JOHNSON — MCT

The news stories were damning. "Health insurers across the country," began one, "are dramatically increasing rates and slashing benefits for many of the estimated 17 million consumers with individual insurance policies, while making it almost impossible to obtain affordable alternatives."

Yet another Obamacare horror story, right? No, that was the Los Angeles Times in February 2010, before Obamacare passed.

That is worth remembering as nearly 1 million Californians who don't get insurance through their employer or through a government-sponsored plan (Medicare, Medi-Cal or military), but through the individual market, receive cancellation notices.

In a Monday news story in The Sacramento Bee, "Health sticker shock ahead," one 55-year-old got a cancellation notice saying that he would automatically be enrolled in a more expensive plan. A parent who buys an individual plan for her 18-year-old, because she doesn't carry insurance through her employer, got a notice saying his monthly premiums would go from $72 to $127.

Songwriters Smokey Robinson and Berry Gordy might have the best advice for Californians getting such notices: "You better shop around."

Insurers have an interest in trying to lock people into expensive plans before consumers comparison shop on the new state exchange, Covered California, that opened Oct. 1.

As Insurance Commissioner Dave Jones told The Sacramento Bee's editorial board on Thursday, many insurers are using cancellation notices to steer people to non-exchange plans with narrower doctor and hospital networks and with worse deductibles and co-pays. As an afterthought, they might hint that you can also shop in the exchange.

Individuals purchasing plans in the individual market tend to be self-employed, retirees not yet eligible for Medicare, the unemployed, individuals who are employed but do not take their employer-offered insurance, students and individuals between jobs.

And while those who get insurance through their employer or from a government-sponsored plan (Medicare, Medi-Cal or military) are heavily subsidized, those in the individual market in the past have had to pay the full "sticker price" for their insurance -- without many of the protections of other insurance.

The Affordable Care Act does change things, and that means there will be winners and losers. Jones estimates that 300,000 to 400,000 of those getting cancellations would be eligible for subsidies if they buy a plan on the exchange. Some can get free or nearly free plans once subsidies are factored in.

That leaves 700,000 to 800,000 individuals with cancellations who would not be eligible for subsidies. Some of them can get better insurance at a better price on the exchange. Others will pay about the same for similar coverage.

But everyone, including President Barack Obama and Health and Human Services Secretary Kathleen Sebelius, should be honest about the fact that some will pay more for similar coverage. Why? Because the pool includes young and old, sick and healthy people. Insurers no longer can discriminate.

That's a good thing, but it does mean some people who benefited from the discrimination of the past will pay more.

The Fresno Bee is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service