Thursday, April 24, 2014
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Skimpy health law plans leave some “underinsured”

By
January 04, 2014 | Leave Comment

WASHINGTON — For working people making modest wages and struggling with high medical bills from chronic disease, President Barack Obama’s health care plan sounds like long-awaited relief. But the promise could go unfulfilled.

It’s true that patients with cancer and difficult conditions such as multiple sclerosis or Crohn’s disease will be able to get insurance and financial help with monthly premiums.

But their annual out-of-pocket costs could still be so high they’ll have trouble staying out of debt.

You couldn’t call them uninsured any longer. You might say they’re “underinsured.”

These gaps “need to be addressed in order to fulfill the intention of the Affordable Care Act,” said Brian Rosen, a senior vice president of the Leukemia & Lymphoma Society. “There are certainly challenges for cancer patients.”

“Cost may still be an issue for those in need of the most care,” said Steven Weiss, spokesman for the American Cancer Society Cancer Action Network. That “makes it critically important for patients looking at premiums to also consider out-of-pocket costs when choosing a plan.”

Out-of-pocket costs include a health plan’s annual deductible, which is the amount before insurance starts paying, as well as any copayments and cost-sharing.

A few numbers tell the story. Take someone under 65 with no access to health insurance on the job and making $24,000 a year — about what many service jobs pay.

Under the health care law, that person’s premiums would be capped below 7 percent of his income, about $130 a month. A stretch on a tight budget, yet doable.

But if he gets really sick or has an accident, his out-of-pocket expenses could go as high as $5,200 a year in a worst-case scenario. That’s even with additional financial subsidies that the law provides people with modest incomes and high out-of-pocket costs.

The $5,200 would be more than 20 percent of the person’s income, well above a common threshold for beingunderinsured.

“Chronically ill people are likely to be underinsured and face extremely high out-of-pocket costs,” said Caroline Pearson, who tracks the health care overhaul for Avalere Health, a market research and consulting firm. “While the subsidies help, there still may be access problems for some populations.”

Under the law, insurance companies competing in new online markets like HealthCare.gov can offer four levels of coverage.

All plans cover the same benefits; the difference is in financial protection. A bronze plan covers 60 percent of expected costs, silver covers 70 percent, gold covers 80 percent, and platinum covers 90 percent.

Bronze plans have the lowest premiums but provide less insurance. Gold plans are the closest to employer-provided coverage. Indeed, members of Congress and staffers who will now get their coverage through the health care law have been steered to gold plans.

Silver, however, is the standard for most consumers. The law’s tax credits to help with premiums are keyed to a benchmark silver plan in each geographical area. And the law’s subsidies to help with out-of-pocket costs are only available to people who get a silver plan.

Avalere found that the average annual deductible for silver plans is $2,567, more than twice what workers in employer plans currently face. Additionally, many silver plans have high cost-sharing requirements for prescriptions, particularly “specialty drugs” to treat intractable conditions such as severe forms of arthritis.

Some plans may offer limited relief by covering certain services before a patient has met their annual deductible. Those services can include primary care, some prescription drugs and routine care for common chronic conditions such as high blood pressure and diabetes.

But Pearson says that won’t help people with high-cost illnesses. “Chronically ill people may still experience significant financial challenges,” she said.

Platinum or gold coverage may be the better option for people with serious health problems. They’ll pay more in premiums, but reduce exposure to out-of-pocket costs.

Obama administration spokeswoman Joanne Peters said the new system is still “night and day” from what patients faced for years, because insurers can no longer turn away those with pre-existing medical conditions, and because the new plans cap out-of-pocket costs. While that limits medical debt, it doesn’t eliminate it.

One of the leading advocates of the health care law says most people will still come out ahead.

“If the question is, will some people find that coverage and care remain unaffordable, the answer is yes,” said Ron Pollack, executive director of Families USA. “There will be some people who feel that way. The overwhelming majority will be far better off, even if what they have is not perfect.”

The Associated Press

The Associated Press

LEAVE A COMMENT

Discussion | No comments

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

.

Solano News

 
Congressman talks Travis, water

By Barry Eberling | From Page: A1, 4 Comments | Gallery

Travis lines up 2 days of aviation excellence

By Ian Thompson | From Page: A1, 1 Comment | Gallery

 
Appreciate how good we have it now

By Angela Borchert | From Page: A2

 
 
Dixon May Fair has deals on advance tickets

By Amy Maginnis-Honey | From Page: A3

 
Garamendi talks love, pro football and Peace Corps

By Ryan McCarthy | From Page: A3, 4 Comments | Gallery

 
Author to sign books at Vacaville Museum

By Amy Maginnis-Honey | From Page: A3

Kroc Center women schedule inaugural Taster Tea

By Amy Maginnis-Honey | From Page: A3

 
Docents to lead paddling tour in marsh

By Adrienne Harris | From Page: A4

Juneteenth committee extends vendors, exhibitors deadline

By Amy Maginnis-Honey | From Page: A4

 
Congressional Art Competition is back

By Susan Hiland | From Page: A4

 
Spilled tomato juice case set for trial

By Ryan McCarthy | From Page: A4, 5 Comments

Theme park welcomes seal pup

By Adrienne Harris | From Page: A4

 
 
Suisun City police log: April 22, 2014

By Susan Hiland | From Page: A12

 
Suisun City police log: April 21, 2014

By Susan Hiland | From Page: A12

Fairfield police log: April 21, 2014

By Susan Hiland | From Page: A12

 
Weather for Thursday, April 24, 2014

By Daily Republic staff | From Page: B12

Fairfield police log: April 22, 2014

By Susan Hiland | From Page: A12

 
.

US / World

Syrian activists accuse Assad of new gas attacks

By The Associated Press | From Page: A1

 
Murder charge for Vallejo man in head-on crash

By The Associated Press | From Page: A5, 1 Comment

California bill reignites affirmative action fight

By The Associated Press | From Page: A5, 3 Comments

 
Andy Lopez protest leads to school campus lockdown

By The Associated Press | From Page: A5, 3 Comments

Navy Cross bestowed on heroic Marine

By The Associated Press | From Page: A5, 1 Comment

 
Airport official: Teen had no clue he was in Maui

By The Associated Press | From Page: A5

US weighs clemency for inmates jailed for 10 years

By The Associated Press | From Page: A6, 1 Comment

 
Gun carry rights expanded in Ga. under new law

By The Associated Press | From Page: A6, 4 Comments

First lady announces one-stop job site for vets

By The Associated Press | From Page: A6, 2 Comments

 
Rail safety effort marred by squabbling

By The Associated Press | From Page: A6, 1 Comment

Small Wyoming town evacuated after gas explosion

By The Associated Press | From Page: A6

 
Bashtag: NYPD Twitter campaign backfires

By The Associated Press | From Page: A6, 1 Comment

Soldier convicted in WikiLeaks case gets new name

By The Associated Press | From Page: A6

 
Lawyer: US man held in Cuba seeks to go home soon

By The Associated Press | From Page: A10, 1 Comment

Captain who left doomed ferry had 40 years at sea

By The Associated Press | From Page: A10

 
Russian social media CEO quits, flees country

By The Associated Press | From Page: A10

Amid Russia warning, Ukraine is in a security bind

By The Associated Press | From Page: A10, 1 Comment

 
Palestinian rivals to try again for unity deal

By The Associated Press | From Page: A10

Camilla’s brother dies in US after head injury

By The Associated Press | From Page: A10

 
State senators get ethics training after scandals

By The Associated Press | From Page: A12, 7 Comments

.

Opinion

Question of the week: Will Flight 370 be found?

By Daily Republic | From Page: A11

 
Be the first and give specifics

By Letter to the Editor | From Page: A11, 2 Comments

What we can do about crime

By Kelvin Wade | From Page: A11, 14 Comments

 
Castro at odds with mentor on deportations

By Ruben Navarrette | From Page: A11

Some Earth Day boos and cheers

By Jay Ambrose | From Page: A11

 
.

Living

Today in History for April 24, 2014

By The Associated Press | From Page: A2

 
Community Calendar: April 24, 2014

By Susan Hiland | From Page: A2

When Joe’s mad at me, he also ignores my 7-year-old son

By Kathy Mitchell and Marcy Sugar | From Page: A9

 
Horoscopes for April 24, 2014

By Holiday Mathis | From Page: A9

.

Entertainment

TVGrid

By Daily Republic Syndicated Content | From Page: B5

 
Jodie Foster weds artist Alexandra Hedison

By The Associated Press | From Page: A7

Singer Chris Brown’s DC trial delayed for months

By The Associated Press | From Page: A7

 
Performing dogs go big after $1 million TV prize

By The Associated Press | From Page: A7

Amazon snares classic shows in deal with HBO

By The Associated Press | From Page: A7

 
.

Sports

Mustangs swim to sweep of Indians

By Marcus Lomtong | From Page: B1 | Gallery

 
Warriors, Clippers to meet in Oakland for Game 3

By The Associated Press | From Page: B1

Sharks confident with chance to sweep LA Kings

By The Associated Press | From Page: B1

 
Girls soccer update: Armijo, Vanden on way to playoffs

By Paul Farmer | From Page: B1 | Gallery

A’s reject 10-year Coliseum lease offer

By The Associated Press | From Page: B2

 
Prep softball: Vanden rolls to 14-0 win over Fairfield

By Daily Republic staff | From Page: B2

 
Prep badminton: Unbeaten Mustangs cruise past Crushers

By Daily Republic staff | From Page: B2

Prep boys golf: Vikings suffer SCAC loss to Panthers

By Daily Republic staff | From Page: B2

 
Sanchez’s slam in 11th helps Giants beat Rox 12-10

By The Associated Press | From Page: B2 | Gallery

Prep track: Armijo girls get win in MEL 4-way meet

By Daily Republic staff | From Page: B2

 
Perez helps Rangers sweep A’s with 3-0 win

By The Associated Press | From Page: B2 | Gallery

Party a century in the making for Wrigley Field

By The Associated Press | From Page: B2

 
Emmert supports more efficient, effective NCAA

By The Associated Press | From Page: B3

Phelps having fun in his return to swimming

By The Associated Press | From Page: B3 | Gallery

 
Suns’ Dragic honored as NBA’s Most Improved Player

By The Associated Press | From Page: B3

Seahawks to open NFL season vs. Packers

By The Associated Press | From Page: B3

 
Oldest living ex-MLB player dies in Cuba at 102

By The Associated Press | From Page: B12

 
.

Business

Wellness programs grow more popular with employers

By The Associated Press | From Page: B5

 
Sales of new US homes plunge 14.5 percent in March

By The Associated Press | From Page: B6

Buffett disapproves of Coca-Cola’s pay plan

By The Associated Press | From Page: B6

 
Amazon snares classic shows in deal with HBO

By The Associated Press | From Page: B6

US stocks edge lower after a six-day rise

By The Associated Press | From Page: B6

 
Facebook 1Q results soar; CFO to step down

By The Associated Press | From Page: B6

Apple increases stock buyback, will split stock

By The Associated Press | From Page: B6, 1 Comment

 
.

Obituaries

Phyllis J. Miller

By Nancy Green | From Page: A4

 
Dondi Martin

By Nancy Green | From Page: A4

.

Comics

Rose is Rose

By Daily Republic Syndicated Content | From Page: A8

 
Garfield

By Daily Republic Syndicated Content | From Page: A8

Pickles

By Daily Republic Syndicated Content | From Page: A8

 
For Better or Worse

By Daily Republic Syndicated Content | From Page: A8

Peanuts

By Daily Republic Syndicated Content | From Page: A8

 
Wizard Of Id

By Daily Republic Syndicated Content | From Page: A8

Dilbert

By Daily Republic Syndicated Content | From Page: A8

 
Baldo

By Daily Republic Syndicated Content | From Page: A8

Blondie

By Daily Republic Syndicated Content | From Page: A8

 
Baby Blues

By Daily Republic Syndicated Content | From Page: A8

Beetle Bailey

By Daily Republic Syndicated Content | From Page: A8

 
Sally Forth

By Daily Republic Syndicated Content | From Page: A8

B.C.

By Daily Republic Syndicated Content | From Page: A8

 
Frank and Ernest

By Daily Republic Syndicated Content | From Page: A8

Get Fuzzy

By Daily Republic Syndicated Content | From Page: A8

 
Zits

By Daily Republic Syndicated Content | From Page: A8

Cryptoquote

By Daily Republic Syndicated Content | From Page: A9

 
Crossword

By Daily Republic Syndicated Content | From Page: A9

Word Sleuth

By Daily Republic Syndicated Content | From Page: A9

 
Bridge

By Daily Republic Syndicated Content | From Page: A9

Sudoku

By Daily Republic Syndicated Content | From Page: A9