Heritage Foundation - Let Me Debunk Your Myth - Let Us Compare Your Report With Real Facts

Heritage's Report : http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare


Heritage's Talking Point :

Health Insurance Premiums will be increasing for all due to obamacare and esp. Young people as more burden will be on them.

Now as OBAMACARE ALLOWS parents to keep their children in their plan till the age of 26 Yr, let's compare what is the premium for a young adult age of 27.

Now according to your own report, $215 will be avg premium for an adult in California aged 27 year.

So here's what i did :

First of all, i visited coveredca.com and entered following information :




As you can see, i have entered age as 27 Year Old, Income as $500k (which is way above the subsidy limit of 400% poverty level) and entered pincode as 90310 which is in LosAngeles County. Median Household income is $46500 per year.

Now i got the gold 80 plan nearest to your $215 figure. This gold 80 plan costs around $226.



Now i visited many critics favorite health insurance quotes website : ehealthinsurance.com and entered following information :



As you can see i entered same information. I selected 2013 as the coverage year so that i can know the pre-obamacare insurance plans.

I got many results but i sorted out by applying the filter "20-30% coinsurance" so that i can easily compare gold 80 (which has 20% coinsurance) and these other plans.



Now lets compare each and every plan :

1) Anthem Plus 5000 Vs Obamacare Plan

Monthly Premium (O) - $226 | Yearly - $2712
Monthly Premium (A) - $178 | Yearly - $2136 (Plus a clause that premium can be changed from 7th month)
Result : Just looking at the premiums A Plan wins!

Coinsurance (O) - 20%
Coinsurance (A) - 25%
Result : O Plan wins as it has less coinsurance


Deductible (O) - $0
Deductible (A) - $5000 and another $500 for drugs
Result : O Plan wins as it has no deductible.

Office Visit for Primary Doctor (O) - $30
Office Visit for Primary Doctor (A) - $30


Office Visit for Specialist (O) - $50
Office Visit for Specialist (A) - $50
Result : Tied

Generic Prescription Drugs Co-Pay (O)- $19
Generic Prescription Drugs Co-Pay (A) - $15
Result : A Plan Wins

Brand Prescription Drugs Co-Pay (O) - $50
Brand Prescription Drugs Co-Pay (A) - $40-60 (After $500 medical drugs deductible)
Result : O Plan wins!

Preventive Care (O) - Free
Preventive Care (A) - Free
Result : Tied

Emergency Room (O) -$250
Emergency Room (A) - 25% after $5000 deductible
Result : O Plan wins! (Tip : A Simple sprained ankle bill can be $24,110)

Lab Test/X-Ray Co-Pay (O) - $30 to $50
Lab Test/X-Ray Co-Pay (A) - 25% after $5000 deductible
Result : O Plan wins! (Tip : An x-ray can cost upto $30k Link: http://www.newchoicehealth.com/x-ray-cost)



Total Out Of Pocket Cost (O): $6350
Maximum Out Of Pocket Cost (A) : $4500+$5000+$500 = $10000

Net Cost (TOOPC + Premium ) : (O) - $9062
Net Cost (TOOPC + Premium ) : (A) - $12136

Winner : Obamacare Plan
Total Savings : $3000+ with better coverage and benefits.

1 IMPORTANT THING TO NOTE IS THAT ALL 6 PLANS WITH I FOUND ON EHEALTHINSURANCE.COM WITH 20-30% COINSURANCE HAD A DEDUCTIBLE OF $1000 TO $5000. SOME PLANS WITH $1000 DEDUCTIBLE WERE EVEN CHARGING $230-$260 WHICH IS HIGHER PREMIUM THAN OBAMACARE PLAN WITH LESS BENEFITS. [WE ARE NOT EVEN CONSIDERING OBAMACARE SUBSIDIES FOR PEOPLE UP TO 400% POVERTY LEVEL]

I have not even considered the following things in the above report :

1) Obamacare allows your children to be in your health till till the age of 26

2) Obamacare has extra preventive care benefits for women and children while most of the current plan doesn't have.
(Read more here : https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=2)

3) Obamacare provides insurance for people with pre-existing conditions

4) Obamacare provides subsidies for people earning up to 400% of poverty level.

5) Obamacare ends the lifetime payment limit for insurance companies. (Some companies have a limit of spending x amount for 1 person in his/her lifetime).

6) Obamacare also mandates insurance companies to have at least $2M yearly limit (which excludes essential health benefits)
[Read more : https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/ and https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=9 ]

7) Obamacare mandates insurance companies to spend 80% of insurance money (or even 85% in some cases) for health payments. If your insurance company fails to do that, you get a refund at the end of the year.

8) Obamacare extends free healthcare to the poorest people (133% of poverty level). Although, only half of the states have implemented that.

9) Obamacare mandates insurance companies to charge same co-insurance for out-of-network emergency room services.

10) Obamacare Cracks Down on Frivolous Cancellations of insurance coverage done by some companies.



THUS, DO NOT TELL ME NOW THAT OBAMACARE IS INCREASING YOUR HEALTH COST. IT IS DECREASING PREMIUMS EVEN FOR THE RICH PEOPLE. A 27 YEARS OLD GUY EARNING $500K LIVING IN LOS ANGELES COUNTY CAN NOW GET A BETTER HEALTH INSURANCE AT $225 PER MONTH INSTEAD OF $230-$260 PREMIUMS WITH $1000 TO $3000 DEDUCTIBLES AND DON'T EVEN GET ME STARTED FOR PEOPLE WITH PRE-EXISTING CONDITIONS OR EARNING UP TO 400% POVERTY LEVEL.

I ADVISE EVERYONE TO READ THIS ARTICLE : https://www.healthcare.gov/how-does-the-health-care-law-protect-me/