Obamacare: The cost of merely enormous premium increases is lack of access

Written by . Posted in 2014 Campaigns, Featured

Published on September 26, 2013

renMy old boss Robert Novak often liked to refer to Henny Youngman — the comic who, when asked how his wife was, would answer, “Compared to what?”

That’s a bit before my time. When President Obama talks about premiums under Obamacare being lower than expected, I think of the old Ren and Stimpy sketch on the “littlest giant.” He was the smallest of his kind — merely enormous.

When you’re comparing things, you can come up with a lot of misleading language, and that’s precisely what Obamacare’s defenders are doing now to avoid a conversation about “rate shock.” As President Obama noted, the premiums on the exchanges will be lower than expected — what he leaves out is that for the very patients the exchanges absolutely must attract, they will be much higher than they are today.

Obamacare’s defenders won’t have as easy a time discussing the even more important reality of “access shock,” which is becoming an issue in a number of states. In order to keep rate increases “merely enormous” in the face of expanded coverage, insurers are making ends meet by reducing their coverage in terms of access to doctors and hospitals. By restricting customers to a narrower network, they can save money. If you’re had a hard time seeing a doctor recently, you ain’t seen nothing yet. And if you like your doctor, you might not be able to keep him.

In Missouri, the average 27-year-old man that the Obamacare exchanges must attract in order to survive faces a premium increase of 104 percent compared to what’s available now, if he goes to that market for insurance. The average 27-year-old woman faces an increase of 29 percent. But those prices don’t reflect all the costs. In order to prevent even more dramatic increases as a result of the law’s many coverage mandates, insurers are restricting access to some of the biggest providers in the state.

As The Washington Examiner’s Conn Carroll noted on Twitter this morning, Kaiser Health News is carrying this item right now:

Patient advocates say the exclusion of one of Missouri’s top hospital systems from policies offered by the region’s biggest insurer under the Affordable Care Act could hinder treatment for some patients and force others to switch doctors.

The network for the Anthem BlueCross BlueShield plans, which will be sold through Missouri’s “Obamacare” marketplace, does not include BJC HealthCare and its 13 hospitals — among them Barnes-Jewish Hospital, the area’s premier academic medical center, and St. Louis Children’s Hospital.

People joke that if you thought health care was expensive before, wait til it’s free. Obamacare won’t be free, and it will be very expensive not only in terms of the premiums paid, but also the toll it takes on access to quality care.

Like many of the other problems with Obamacare, this one was anticipated and discussed by conservatives, who were ignored.

I place little or no faith in the idea that Republicans, currently out of power, are going to lay a glove on Obamacare this year. But the battle won’t be lost if Obamacare isn’t stopped right this second. Sometimes people need to learn the hard way about the policies they’ve voted for. Access shock is one a problem that people are going to notice, and with public opinion already moving heavily against the law, voters will have the opportunity to throw the law’s supporters out of office next fall so that it can be repealed.