My Health Insurance Premium Is Going Down


Michael Cain

Michael is a systems analyst, with a taste for obscure applied math. He's interested in energy supplies, the urban/rural divide, regional political differences in the US, and map-like things. Bicycling, and fencing (with swords, that is) act as stress relief.

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29 Responses

  1. Avatar Saul Degraw says:

    My health insurance premium went down but only because I finally got regular employment where they offer subsidized healthcare instead of free lancing.

    If I stayed in the ACA/Covered California, my premiums would have gone up about 40 dollars. I am somewhat morbidly curious about when they would have gone down if I stayed in Covered California for life.Report

  2. Avatar Damon says:

    My health insurance co pays rose @ 20%, like they have every year. They also removed the “best” plan due to costs, forcing everyone in that plan to take a step down in plan benefits.

    And of course, the Medical Savings Plan still prohibits me from buying OTC meds with it. Thanks ACA!Report

    • Avatar Troublesome Frog says:

      Your copays or your actual overall rate?Report

      • Avatar Damon says:

        Co pays. They’ve been jacking it every year by similar amounts, “nugging” folks to cheaper plans. Now they are just removing certain plans.Report

        • Avatar Troublesome Frog says:

          Without commenting on your case specifically, I want to say that’s probably a good thing overall. A huge part of the problem with the health insurance world was that it was all-you-can-eat cheap stuff on the front end and major surprises and headaches when you got hit by a truck or found a tumor. I think a lot of the plans covering less and less day to day stuff is probably being driven by cost cutting to deal with the fact that the companies are increasingly on the hook for maximum payouts when something really bad is happening.

          I’ve often said that the phrase, “Most people are happy with their insurance,” tells us nothing because most people are happy with their insurance as long as it pays 100% of their kids’ annual doctor visit fees. People with cancer are the people who really know what their health insurance is worth, and my experience is that the satisfaction rate was way lower in that cohort. My hope is that this shift may make “most” people a little less happy and make the people who explore the deep end of the pool much happier.Report

          • Avatar Damon says:

            I’d say an even bigger part of the problem was the separation between the consumer of services and the payer. Thanks WW2. Health insurance should never have been allowed to be linked with employee benefits via the employer.Report

            • Avatar Troublesome Frog says:

              The two definitely go hand-in-hand. My one and only reason for supporting the ACA was that it provides a mechanism for us to pry ourselves away from employer-sponsored health insurance plans. When I hear, “Oh no! Employers will just dump their employees onto the exchanges!” I think, “Good! The sooner, the better!”

              If we can get to where stable health insurance markets are the norm, it becomes at least theoretically possible to ratchet down the incentives for the employer plans and eventually make them go away. Without it, we’re stuck with them forever.Report

              • Avatar DensityDuck says:

                The issue is that the ACA contains fines and fees specifically intended to prevent employers just dumping employees onto the exchanges.Report

              • Avatar Michael Cain says:

                But IIRC, they’re fixed. On days when I’m feeling cynical, I think that this is one of the things Chief Justice Roberts has on his mind in supporting the ACA. Big corporations replace shopping across multiple states for health insurance plans that have shown a long-term trend to double-digit inflation rates with a simple fixed payment to the federal government.Report

    • Avatar Troublesome Frog says:

      Also, I have no idea why we have HSA, MSA, HRA and FSA options with different rules for solving roughly the same set of problems. At the very least, they should all be good for the same types of expenses. For example, OTC drugs are no problem for an HSA or FSA.

      We seem to me moving in the right direction, but the whole system is still a godawful mess.Report

      • Avatar Damon says:

        Well, on the Flexible Spending Account, what you put into it pretax, you must spend by year end or so, and you cannot use it for OTC meds. For a HSA, I believe that you can carry that with you to other employers, but the money may not be pretax.

        From my perspective the ACA has only effected me negatively, and I can only point to the OTC issue specifically, because I can’t tease out any differences between the actions of my company and the effect of the ACA very easily.Report

        • Avatar Kim says:

          The OTC was put on there because people were buying WAY too much asprin at the end of the year (and probably reselling it).

          It was an exploitable loophole.

          As far as I know, both my FSA and HSA are allowed to buy OTC, so long as they have a prescription (must prove it was doctor’s orders)Report

          • Avatar Troublesome Frog says:

            When I had a flex account a few years ago, OTC was fine, but then they closed the “aspirin loophole” (clearly something critically important that needed to be handled). One thing I don’t get is why the FSA dollars have to be use it or lose it. If you do away with that, you do away with the aspirin problem as well.

            HSA dollars carry over and are generally pretax. I honestly don’t understand why FSAs exist at all. Then again, allowing us to buy healthcare on a tax privileged basis is insane at the most fundamental level, so maybe I’m just trying to fix something that will never make sense.Report

          • Avatar Damon says:

            Yeah, another loophole I didn’t know about so couldn’t take advantage of….

            Frankly, I really don’t see that as a problem. Unless I was buying sudafed. Zomg the horrors!Report

            • Avatar Troublesome Frog says:

              You don’t need to go to all of the trouble to get Sudafed. Methamphetamine is easily available 24 hours a day without an ID, and can be converted in to pseudoephedrine. Win!Report

              • Avatar Glyph says:

                I’ve heard that if you are on vacation and have terrible sinus congestion due to a bad cold, and you have a friend with an Adderall prescription who will throw you one, that stuff works like gangbusters, for hours and hours. Free and clear breathing, no runny nose, the works.

                Pity about the whole “amphetamines can be pretty addictive” thing, because man, they DO work.Report

        • There’s now a $500 carryover for some FSA plans.Report

      • Avatar Michael Cain says:

        I have no idea why we have HSA, MSA, HRA and FSA options with different rules for solving roughly the same set of problems.

        At the risk of hijacking the discussion on my own post… In the US, government assistance comes with restrictions. Lots of restrictions. There is a portion of the political class whose price for passing some form of assistance is almost always to limit how much assistance, what it can be used for, and who can get it. Using the tax code to implement assistance — eg, allowing the use of pre-tax dollars — is just such a restriction, limiting the benefit to people who are generally employed.

        The larger-scale version of your question is why does the federal government buy health care for people using all of Medicare, Medicaid, CHP+, the VA, Tri-Care, and the employer share for government civilian employees? Why not just pay some portion of the bills for health care for all those people? The revenue sources are, in practice, immaterial — that’s just accounting and the computers are damned good at that. Why not use that scope for leverage on service providers? “Our clients are (roughly) 50% of your business, we pay promptly, and since we can print money we’re good for it; we insist that you give us at least the best price that you give anyone else.”Report

        • Avatar Troublesome Frog says:

          The latest example I’ve seen of this was a discussion with a friend who knows people in the marijuana business in Oregon. They’re allowed to operate, but they’re limited in the number of days per week they can be open. As far as I can tell, there’s no actual practical reason for this to be the case. It’s probably just a concession that was extracted somewhere as part of the legalization process.

          “You want it to be legal? Fine. But you can only do it 4 days per week. And the ceilings of all marijuana stores have to be 5 feet 2 inches high so most people have to stoop down while they’re buying it. Suck on that.”Report

          • Avatar Damon says:

            This structure allows the legal pot industry to form a lobby group and pay off the politicians to change the hours to something better for them. That’s why it was crafted that way. 🙂Report

    • Avatar notme says:

      Liberals accept your thanks as they know what is good for you. It gets even better. According to Heritage, ACA premiums are going up. Just be happy you don’t live in NC.

      • Avatar Troublesome Frog says:

        Insurance rates are going up??!? I want to go back to the good old days when they went down!Report

        • Avatar Troublesome Frog says:

          To answer this a little less flippantly: Yes, rates are going up. They go up every year. They’ve been going up every year forever. The interesting questions are:

          1) How much, and how does that compare to historical trends?
          2) What variables are driving the rate increase.

          To write a juicy article, you start with a dataset that has increases ranging from negative numbers up to the high 20% range and then you write the headline, “Rates are up by as much as 28%.” You could have written, “Rates drop by as much as much as 15%” if your audience prefers to read that news. Kevin Drum summarizes the technique well.

          Anyway, I haven’t had time to go through the Heritage data in detail yet (manual data entry is a bit of a pain), but one thing that strikes me is the enormous range in price changes (again, from -15% to +28%). Part of this is due to small numbers being changed by small amounts in absolute terms, and part of it is that the states seem to vary wildly. Alaska, for example, is a mess.

          So the question we need to ask is, what is it about Obamacare that turns some states into socialist hellscapes and others into great places to live? It’s almost as though there are multiple variables at work.Report

  3. Avatar Morat20 says:

    My insurance stayed roughly the same, but the deductibles jumped about 500 bucks.

    Which, like you, beats the years and years of double-digit increases. I’ve got no sympathy for people griping about rate hikes now. Where were they for the last decade or two? Uninsured? Because that’s been the freakin’ status quo for at least 10 or 15 years.

    Of course, my company switched to HDHP (they’re self-insured, hire two providers to administer networks) which neatly saved them a chunk of money. OTOH, I’m pretty sure they lost tons of productivity (my personal anecdote: First year on my HDHP, with a maxed out HSA, my wife needed two surgeries. The first in march. It takes a full YEAR to fill your HSA, and her surgery was three months in. I about went broke trying to pay for it. Furthermore, it ended up being out of network. The company lost a couple of months of my full productivity because I was worried about bills).

    Fun fact: My HDHP premium + maxed out HSA = my premium for the previous year’s non-HDHP with a moderate FSA allotment. I’m paying exactly what I was, out of pocket, except now the first half of the year any major medical problems send me scrambling for cash.

    End of this year? I’ll end with an empty HSA, so I’ll get to do it again NEXT year. (Stupid out-of-network crap. The surgical center was literally INSIDE the doctor’s office. How can one be in-network and not the other? Don’t even get me started on the difference between what I paid and what they billed. Fun fact: The surgery needed to be repeated, this time in-network. Same doctor, different facility. They billed my insurance 1/4 as much for the in-network surgery, which itself was about 500 more than the actual cast cost of the out-of-network that I paid. Insurance still thinks I paid 5 times that. And people are all like ‘Shop around’. HOW? The numbers change, thousands of dollars worth, depending on who you ask. For the same office. The same doctor. The same procedure. And it’s billed in chunks. Surgeon here, facility there, anesthesiologist there… don’t know what it costs until the bills arrive in the mail and nobody will give you answers up front).Report

  4. Avatar Troublesome Frog says:

    Everything was basically flat here, following the trend of lower growth for the past couple of years.Report

  5. Avatar Stillwater says:

    My wife and I actually had (well, have, for one more month anyway) insurance thru the co-op. We were sad to see it close down. I read quite a bit about it and still don’t know exactly what happened. The HealthOP claims that the federal gummint had promised to extend either loans or subsidies for cooperatives to get their legs under em, but the feds say they didn’t. It strikes me as sorta implausible that the co-op management woulda punted that badly, so there’s more to it than I’ve been able to discover.

    The fact your insurance premiums went down is a very good sign. Of something. I wonder if Kaiser’s price went down too.?? We both currently have Bronze plans, and a couple years ago the +/- comparable Kaiser plan was only about 8% more than the HealthOP price. So now I’m curious if that price went down as well. It’d be nice to think the ACA is making insurance companies pay more attention to their negotiated rates and such, and that that’s the cause of this (perhaps temporary) decline in price.

    Alsotoo: I’m very curious to see what becomes of this CO single payer initiative.Report

    • Avatar Michael Cain says:

      Alsotoo: I’m very curious to see what becomes of this CO single payer initiative.

      I’m particularly interested to see how it’s marketed, and received, in the rural parts of the state. It doesn’t address the fundamental problem in rural health care — lack of providers — but it does presumably deal with the ACA’s problem in rural areas. Which is that the insurance companies aren’t interested in those areas, resulting in few choices and high prices. Single payer reduces the choices further, but should result in the rural folks getting the same premium as the Front Range suburbs.

      OTOH, the results of Kynect and the Medicaid expansion have been quite popular in rural Kentucky, which just voted for a new governor campaigning on dismantling those.Report

  6. Avatar El Muneco says:

    (Stupid out-of-network crap. The surgical center was literally INSIDE the doctor’s office. How can one be in-network and not the other?

    Admittedly, it’s much more of a first-world problem than your situation, but my optometrist is in-network, while the lab that fills the prescriptions isn’t. Their receptionists share a desk.Report

    • Avatar Troublesome Frog says:

      I like hearing from people about how they basically had to post a family member as a guard to their hospital room and turn away any doctors who aren’t in network and try to get in to see them. I imagine it’s something like The Walking Dead with lab coats. They smell unrestricted billable hours…Report