Insurers are planning rate hikes for 2016 under ObamaCare. ObamaCare being both the reason we know about it, and part of the reason it’s happening. Let’s take a look at some facts and opinions to help us shed light on the 2016 rate hikes of as much as 10%, 20%, or as much as 60%.

Under ObamaCare’s rate review provision insurers must post rate hikes of 10% or more. Here is the complete list of 2016 rate hikes.

Insurers Must Make a Profit

The ACA allowed America to retain a for-profit healthcare system and a for profit health insurance system, while still reforming healthcare. That means insurers need to make a profit (and to be fair, a good public system wouldn’t ideally operate at a loss either). Insurers can jack up rates if they feel they may not make a profit providing health insurance or if they didn’t make big enough profit margins last year. In some states the requirement for insurers to cover everyone who can afford coverage led to losses and less than expected profits. So a number of insurers in a number of states across the country have submitted rate hikes of 10% or more under ObamaCare’s rate review provision.

The Rate Hike Issue By CNN: In Florida, for instance, United Healthcare (UNH) wants to raise the rates of plans sold on the Obamacare exchange by an average of 18%. Individual policies available outside the exchange through United Healthcare or through a broker would go up by 31%, on average, with hikes as high as 60% for certain plans in certain locations.

In Texas, insurer Scott & White is looking for a 32% increase for exchange-based plans, while Humana (HUM) is asking for an average 30% boost for its exclusive provider organization policies, which generally cover only in-network services.

Insurers say they want to hike rates because enrollees are going to the doctor, getting lab work and filling prescriptions more than they had originally anticipated.

Under ObamaCare Insurers Must Disclose Rates of Over 10% For Review

Before the ACA insurers could have just dropped some sick people from their plans, raised prices on sick people, jacked up the price of coverage without anyone knowing, or cut benefits. A few people (those affected negatively) would know, but the chances of seeing an Associated Press article on it was probably slim.

Today, under the Affordable Care Act, all rate hikes of over 10% must be disclosed and reviewed by the state or federal government and posted online for public view (currently at This doesn’t mean hikes can be denied, they just have to be justified.

So today, not only do more people have private insurance than ever, there is also a lot more transparency with rate hikes and plan changes being public knowledge.

Requirements to Cover Sick People Helped Cause the Rate Hikes

Rate hikes aren’t just about sick people digging into profits, there are a number of other factors in play of course (like the cost of healthcare in the first place).. but let’s be honest, having to cover people who actually need to receive more dollars in care than they pay in premiums doesn’t help.

This isn’t a subsidies issue (subsidies just mean tax payers are funding the difference in premiums and out-of-pocket costs) this is a people actually using their insurance issue.

As expensive as we all think insurance is, that price tag doesn’t even begin to cover the cost of healthcare. In the past the health insurance system operated by pushing the sick away and insuring those who were a safer bet. This allowed for affordable coverage, but at a very human cost.

Today everyone must be allowed to purchase insurance and sick people can’t be charged more for it (the other way for insurers to avoid rate hikes). All of these factors together has led to some insurers paying out (or projecting to pay out) more in claims then they made in premiums after operating costs.

The Underlying Costs of HealthCare are Killing Us (Metaphorically)

So insurers are jacking up rates for 2016 because they are losing money covering sick people, most middle income people without subsidies are struggling with the new insurance costs (although the 1 in 2 with a preexisting condition are doing so gratefully), the 2%-ish-ers (not the .0001%-ers, the literal 2%) are paying more taxes, those with subsidies are happy with their new coverage but struggle with out of pocket costs, people in non-expansion states struggle without healthcare options, Republicans struggle to repeal, Democrats struggle to support the law, the economy struggles with interest as federal healthcare spending continues to rise, hospitals struggle to meet new requirements and profit under the ACA, providers struggle with demand outpacing supply… literally we seem to have a system (before and after the ACA) where everyone struggles and costs rise at an unsustainable rate.

Meanwhile (we all remember that bitter pill article from TIME) the underlying cost of everything healthcare from drugs, to machines, to saline solution, to a hospital gown, is really unreasonably expensive. It doesn’t mean the problem starts and stops there, maybe the problem was with people (us, me and you, employers) being willing to pay those prices. Maybe it was private insurers  being willing to pay those prices under the old system. Maybe it was public insurance (Medicare, Medicaid, TRICARE) being willing to pay those prices. Maybe it’s a bloated billing, claims system. Oh wait wait, maybe it’s people taking a bunch of drugs for everything under the sun and phrama charing more than anyone would ever pay out-of-pocket for stuff no one even heard of 50 years ago. Maybe it’s litigation. Maybe it’s Wall Street. Maybe that $80 ibuprofen was really coated in gold and we aren’t being appreciative of it. Maybe it was a mix of all these things. Or maybe it’s something eluding us.

One thing is for sure though. Bernie Sanders and single payer 2016. (Kidding, sort of…)

Really though, if this is our country and our healthcare system, and everyone is struggling, then at the very least we need to look beyond using ObamaCare as a scapegoat and continue to look at what reforms need to be made. Like it or not we are all in this together and the $3 trillion dollar system succeeds or fails on our backs, so we will need to continue to address the issues until we can all figure out how to provide sustainable quality healthcare to the 99.99% of America.

What do you think?

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Carol Williams on

I paid in on my Medicare for as long as I worked. I retired from my last job of 26 yrs. My husband and I both have to pay now. When I became 65, I was told that I would need to pay 104.90 for Medicare, 113.00 for Blue Cross Blu Shield and 51.10. My husband has to pay 265.00 per month for his bcbs.
. That is $534.00 a month whether I like it or not. I hate Obamacare and now you say you are going to increase the rates again in 2016. Obama doesn’t care about what we pay for housing, transportation or food. He just wants to know of every asset you have. I asked our insurance rep what happened to all the medicare funds that I paid in and she simply replied, the same thing that happened with social security. It was loaned out and never paid back. Just that, flat out. Who was the money loaned to? Why was it not gotten back? Was it loaned to China or just given to them. Obamacare has made it impossible for us to save one dime for anything. Of course, money is no object to him or anyone else who holds government position. If you are just trying to do a job here on what I think, I can’t be upset with you? Why don’t you audit every rep in the House of Representatives and make them pay their taxes? Or make the people who are running for office have to fork over about half of their donations to Obamacare? I know we are not supposed to hate anyone and I don’t but I sure hate what he has done to the hardworking retired people of this United States!! All that money that was taken out of my paycheck for Medicare and for what? Obama needs the ones claiming to be disabled and still working for cash pay up and stop their disability and low insurance payments. I could just go on and on and on. But it’s not going to help anything now is it? What I think will not change a thing. I am ashamed of Obamacare!

robert kimmy on

Obama care is not workig. Under obama care, people are restricted to treatments they can not get and need. Insurance companies are dictating what doctors can and can not do. Doctors across the country are going out of business, while people suffer because of what insurance companies are saying they can and can not do,,,,,, The doctors should be making that decision for their patients. And obama care is NOT affordable to many that need it…… on

Actually all the stuff you are talking about is referring to insurers (as you note in your comment). This stuff was all true before ObamaCare and is still true after. The law actually does a lot to ensure that insurers and doctors have to do more essential treatments and cover more reasonable costs. You can see a full list of everything the Affordable Care Act does here:

paul on

I am looking at going out on my own to start a small business but it’s almost impossible since my rate is now going to be $1,500 per month and my maximum out of pocket for family coverage will be $12,500. I have to look at worse case scenarios with two children and it could cost me $30,000 just for health care. If we don’t go to the doctor and don’t get sick it’s $18,000. How in the world can we expect to survive and pay bills? This is a nightmare. The small amount of people who didn’t have coverage may have it but what about being told 25 times that we would save $2,500 per family. My cost is increasing by $11,000 just to have coverage. on

What you would do in this case is go with a higher premium plan, use cost assistance subsidies for out-of-pocket costs (silver plan only if your income qualifies), or use an HSA. All of these would help you to deal with the costs. Indeed a normal person can’t absorb the full cost of a low premium high deductible family plan. You should not be setting yourself up to absorb those costs and should instead take advantage of at least one of the three aforementioned options.

The $2,500 is for the average family. Essentially it is looking at those who would get cost assistance (the average family makes less than 400% of the Federal Poverty Level.. this leads to savings). If you make less than that, again we strongly suggest going with a Silver plan with Marketplace cost assistance. If your deductible is high, go with an HSA, that should help drop your taxable income and potentially qualify you for more savings. Now you are saving money. Now consider doing all of this with a higher premium plan to avoid those high deductibles and out-of-pocket costs. Doing this will help you to realize savings as well.

Brad on

He said his “out of pocket for family coverage will be $12,500” That sounds like a bronze plan to me. How much more deductible can one take one? on

Very true max is $13,200 for 2015. It’s hard to offer specific advice unless a person says what region they live in, their family size, and their household income after deductions. When we don’t have all the puzzle pieces we tend to just offer general advice. Think our suggestion was to look into Silver plans with high deductibles to take advantage of all the cost assistance options and to actually lower the deductible for a slightly higher premium.

(The overall spending with an HSA, cost assistance, and Silver plan is in many instances what will provide the best value. Potentially crunching those numbers, especially over time with tax breaks taken into account from the HSA, would most likely lower the overall projections.)

Kurt Acord on

The “subsidies” you referred to come from taxes that others are forced into paying – right?

I keep falling back to the comments made by Jonathan Gruber – who was an integral contributor to writing the ACA – essentially, the White House had to lie to get the ACA by the OMB. That is an embarrassment for the Democratic Party, especially for those politicians that said “pass the bill to find out what’s in it.” on

I don’t see subsidies, taxation, and regulation as “force” (implying negative connotations). It is just sort of how government works, doesn’t mean they got it 100% right this time though. Think we all agree on that.

I get what you are saying generally, but read our summary of the law and the law itself, and you’ll realize what Gruber said is just poorly spoken truth. The law is long, the average person has no interest, and even if they did neither politicans or people seem overly concerned with going through the thing line-by-line. True today as it was in the past, this is what Gruber said “glibly”.

Do yourself a favor and skim through the summary, I think it gets pretty clear that no one is really having a conversation about its contents outside a few provisions. If anything I agree this is a core problem.

This doesn’t justify anything, just puts it in perspective. But to the topic of the page, rate hikes are looking low for this year! That is great news.

Sandra Metcalfe on

Oh spare us the bologna please!!! Rate were not going up this high before Obomacare. Don’t insult our intelligence.
The trouble with the federal government is that it’s running us instead of the other way around. on

They were, it was part of “the health care crisis” that was causing the uninsured rate to rise steadily over time. There is a ton of data just a google search away. But here is one of many articles, this one focused on employer premiums, that illustrates that what we say is true.

Joy Steinhauer on

I’ve been paying for private insurance since 2005. Before ACA, my premiums started at $500 plus & they were increasing as much as 25% a year. Everyone complaining about ACA should be complaining about the greed of the insurance companies & the absorbent over inflated cost of healthcare.

nasim akhtar on

medical group is very strong and fraud business organization, and crook. Now being mandatory purchase, the insurance company is minting money and suck up the money from every household. the insurance company should be abolished, this should be like k-12 school type subsidized. the concept of health insurance should be abolished from profit industry concept. it should be just general health type insurance, not high premium and high deductible. I pay my house mortgage, after i get paid from my work. but look at the health insurance, it takes my money before i get this. this is stupid thing made for middle class by president Obama to give a big hit to the middle class family.
look how democracy working, they find if the bill will pass in congress, if not then they are oiling the senators. if they find it will pass then they will go for a vote!

John Wyatt on

ACA is still a horrendous system no matter what. It needs to be dissolved into a much more competitive system that opens the state borders. Healthcare savings should be brought into play. And that ugly option of creating a (sales?) tax for a low end coverage of all people, such as checkups and basic care for colds, minor infections and simple broken bones should be created. Face it, the homeless and indigent and just plain lazy will never voluntarily enroll and Democrats are complete egotistical fools for believing they can do that in a capitalistic society. Lets find a way to regulate costs and provide insurance for tiered levels of catastrophic care.Make it clear what is covered and what is end-of-life without age entering the equation. But GET RID OF OBAMACARE!!!!!!! Oh- and remove those godforsaken income tax refunds or create Healthcare Savings Account with that money. You have no idea how oppressive that thing is. Curse the fools who think this helps the populace!!!!

Mike on

My family of three had individual Blue Cross PPO for years. We could barely afford it, but we kept it, and we went to our doctors sparingly but knowing we had a safety net. Two years ago is was $400 per month for the monthly premium with an accumulated family deductible of $6,000. Once met we were all covered. The final year it was $450, which included a new ACA tax of $25. It was cancelled last year. The most similar cheapest BCBS Bronze plan was about $800. We couldn’t afford that, so we got Temp insurance with PPO, which doesn’t meet minimum benefits, but we were able to get exemption certificates to avoid the fee for last year, but we have no way to qualify for exemptions next year. For 2016, BCBS WILL NOT EVEN OFFER their PPO on the individual market because they would have needed a more enormous price hike. Their lousy HMO with only 25% of the doctors in their PPO was about $650 last year and will probably be at least $700 for 2016. I have been trying to research each doctor on their list of available Primary Care Physicians, and not a single one of our current doctors can identify and recommend a doctor on the short list I have been showing them from BCBS.

We just barely don’t qualify for subsidy. Next year we might, but it would be perhaps $75 a month. I guess we need to make sure we don’t work just enough extra to lose that $75? The whole thing is messed up. The bottom line is that I totally get the significance of having coverage for pre-existing conditions and no benefit cap. The problem is that I resent being forced on the up-sell. We can’t afford 2 for the price of 1.5. We don’t have the extra 50%. Our budget struggled to handle $400 and then $450 per month. We don’t have an extra $3,000 more a year for premiums on top of the $5400 we were paying. BTW our home and mortgage is worth right at the average for our city. Our child goes to public school. We control our costs very responsibly. Having the government set what type of insurance we MUST buy and then having the audacity to say that above 400% of poverty we should be able to afford it or pay a fine is not only disgusting; it’s criminal.

I admit I was cynical about the ACA from the beginning, but there were brief periods in the course of these last 5 years where I got my hopes up when I read about the ACA, thinking I would put aside my way of thinking if it could actually be better for our family, but each time when I looked into the details, I saw I had been reading spin and lies: distortions of the facts meant to draw in people too lazy to read the details or incapable of understanding them. I wanted reform of our healthcare 5 years ago. I was a fool to even consider that our government might provide it.

Logan on

Similar situation as what “Mike on September 12, 2015” wrote. Had PPO Silver single coverage with BCBSofTx since the beginning of Obamacare. Last year the premium raised 66%, while irritated I paid it as I do not want to be without insurance. Recently received the letter stating that my current health plan would be discontinued on Dec 31, 2015. In addition to this knowledge they have picked out a similar plan for me…a HMO-Plus. While the premium has dropped $15, the new plan is nothing like I had with an even more stratospheric deductible. On this new plan, I will not have coverage until I have met my deductible. None of the doctors I have seen are in this. The closet acute care facility is 45 min away. I am still searching for an Internist or what they will now call my “PCP”. I have started to look around at other policies however the ratio of premium to deductible seems out of whack. Not sure what I will do at this point as I know that health insurance is vitally important at this stage of life. Thank you for letting me vent. I hope others know they are not alone.

Ron Kabalin on

Just received my 2016 rates. Premium increased, Deductibles increased $1000, Co pays increased $20, Pharmacy co pays changed from copays to 100% coinsurance. I went from crppy insurance to really crppy insurance and paying more.

Debbie Lowrance on

Blue Cross Blue Shield of Texas was there in the beginning of Affordable Care Act. How is it they are unable now to cover PPO Plans that will effect several families in the State of Texas. It seems like to me, that no one did their job. This is just more of the same by insurance companies being allowed to take the cream off the top and run when they want. This is not going to be the same insurance that the high risk pools offered to us in the State of Texas. This is just another lie in my opinion. No one really cares to deal with the real problems. We pay taxes, have citizenship yet people can come into this state of Texas and get healthcare for NOTHING!!!!! Not fair. on

People don’t get healthcare for nothing in Texas. They refused Medicaid expansion so only those making between 100% and 400% of the poverty level get assistance. Furthermore no one can get Medicaid in Texas that hasn’t been a legal resident for at least 5 years.

DJR on

So can you get it free. Use the same approach as illegals. Go to the ER give a false name and address, they annoy ask for more just like with illegals. If everyone did this we could shut down obamacare and big insurance. I am already doing it and it works on

I admire your gusto, but people shouldn’t confuse the for the profit healthcare system, with health care reform legislation, with immigration. Also, just to be a good person it’s worth using respect when talking about any other person. Also, the idea of not having coverage is really dangerous for some people who need it. So inciting people to not obtain coverage sounds like a dangerous game.

Susan Maddox on

I have been paying higher and higher cost since obama care started. I have had to go down in coverage to keep some coverage. I cant pay anymore than I am paying. Enough is enough.

sowhat on

Hmmm….that’s odd. I have been paying more for insurance every year even BEFORE Obamacare.

Reg on

“Insurers can jack up rates if they feel they may not make a profit providing health insurance or if they didn’t make big enough profit margins last year” So, what are the profit margins? So many ways to pad the books… looking around I don’t see the big insurance guys hurting.. and about that competition between the insurance providers it’s kind of a joke isn’t it?

JV on

My 2014 platinum plan was $505mo. In 2015 the price is $635mo. In 2016 ( again same plan ) they tell me will cost $828mo. HAHA. Such a deal. on

Wow that is very expensive, typically if you crunch the numbers you’ll get a better deal out of lower tier plans matched with an HSA. That being said it’s not going to be true for everyone.

@Uva_Be on

Been searching and not affordable health insurance. I was shocked how much we paid, doing our 2015 taxes this year. $812 a month? We had switched to employer paying 40% because it was more affordable to buy our own Blue Cross plan, with a better deductible. Back to the employer because it was barely, like $46.37 a month cheaper, last year 2015. Now in 2016 they are taking $464. per paycheck and Blue Cross is $600 – $735 per month, similar Blue Cross plan (slightly higher deductible. 11k for two of us, versus 12.5k ).
How can it be more expensive with employer paying 40%?!

G Zucker on

My insurance costs went up so much that in order find a plan with a premium I could afford, my family’s deductibles soared to an unattainable value. So, essentially, we are paying a tax so that other people can get health insurance. Every month, by law, I have to pay into a system and never receive any of the benefits offered by health insurance. By not meeting our deductible, I have to pay full price for any doctor or dentist visit that goes beyond a well-check. If I am going to pay full price for office visits, I shouldn’t have to pay a monthly premium.

D J R on

It is time for the people to stand together and just say NO to obamacare. Hold the press to what he promised no more that $1500 costs. you can keep your doctor, you can keep your insurance. If everyone dropped their insurance and use the ER at local hospitals we can swamp the system and also stop the insurance companies in their tracks. As far as the penalty fees go they cannot collect them from you the IRS cannot go after you or your property that can only hold any tax refund you are getting. So make sure you always owe just a little and tell the govt to goo pound sand. I will guarentee you 6 months of this and the system will collapse. No more obuttheadcare. I have dropped my insurance and I use walk in ER Clinics when the need arises. I never pay and I never have to prove who I am, I use the same rules they apply to illegals. They cannot get any information from you that you do not want to give. Illegals do it all the time they give false names and addresses. LET’S SHUT DOWN THE SYSTEM.

jr23 on

no mention here when the final phase of aca come in i 2017-18 there will be a total of 20 taxes, some are tan tax, medical equipment is taxed even when used in animal care,generic and name drugs are taxed anyone paying health ins is taxed and the amount goes up every year
any co and unions that did provide great insurance will be taxed
etc. required pre existing was one thing but your required to purchase 30k of drug rehab notice all the rehab centers advertising cost savings was even looked at,there is a mandate of 80% spent on care. so co have 20% margin in that they must have reserves because if during the year theses mor ill than estimated they still have to pay. insurance was at one time you paid in and it was thar for emergencies they invested your premiums as part of comprehensive coverage.
and not all ihealth insurance are stock for profits bcross and blue shields used to be all not profits and many still are and there used to be mutual ins co rate payers were the owners. if aca did any thought that’s would have been the way to go but then gov would not controll it.the federal government should never be in medicine just look at the VA failure thats the fate of us all if there allowed to continue
if you think the english system is any good do some research esp the fortunatly failed and stopped liverpool procedure

kim on

I don’t even know where to begin. The heath care system in this country is sucking people dry. It begins with a copay every time you see a doctor…that’s a complete rip off, then you have a simple x-ray, still gotta pay couple hundred towards that bill, Oh, this one got me this summer. Preventative colonoscopy but only when you turn 50?
( like 49 year old couldn’t have cancer) But the kicker is that insurance companies only pay for it if its normal. One silly polyp and your paying thousands toward your “preventive colonoscopy”. Even the doctor shook his head! Oh wait, I’m sure you’ve all heard this one “Sir, you’ll need to pay 1,200 before you have surgery because you haven’t met your 7,000 or higher deductable..yet. My husband lost his job and as I sit here and look at my companies health insurance it’s 1,200/family a month and this is on a teachers salary. So yea, I’m all for Bernie Sanders. He sees people struggling and wants to see real change. The struggle is real and insurance companies, pharmaceutical companies and hospitals/doctors are the problem. This country is so greedy! I so wish I lived in a country where they treated everyone equal when it came to our health. We wake up each day hoping we don’t have to get sick, hoping if we do have to see a doctor or God forbid an emergency that the bill in the mail won’t bankrupt a family. So Obamacare, if your still making changes talk to Bernie Sanders and start going in the direction where everyone can get equal care. UGH!!!

Travis Harper on

Not a single comment from someone thankful for Obamacare? Looks like Obama should solicit members from to post on here. on

You are more likely to find positive comments on the stories about ObamaCare saving lives than the rate hikes of 2016 page.

Peyton on

Fact: {Atlanta, Georgia}
Pre ACA plan with 2 adults and 4 children – Coventry $5,000 deductible HDHP then 100% with max 2 deductibles per family – Premium $500/month
ACA plan with 2 adults and 4 children – Humana $6,350 deductible but plan won’t pay till you meet 2 deductibles so real deductible is $12,700 – 2015 Premium $1,000/month
ACA plan with 2 adults and 4 children – Humana or Aetna $6,450 deductible – 2016 premium $1,300/month {Blue Cross of GA is even higher}
I don’t qualify for a premium subsidy because my income from line 37 is $130,000 probably in 2016.
My premiums have almost tripled in 3 years. This is not the “Affordable” care act. on

Yikes, yeah that is rough. At your income i’d take the lowest premium (decent insurer) plan and put $X a month in an HSA. You’ll save what like almost .40 on the dollar by lowering your taxable income. Still $500 extra a month is a LOT… but 6 people covered for $500 a month pre-ACA seems like you were getting a way better deal than most.

I’m 33 and healthy, I was paying something like $250 a month pre-aca for comparable coverage. If there was 6 of me that would be like I was getting a worse deal than you pre-ACA, that doesn’t seem fair either. Actually I find that kind of frustrating, so I get how you feel. My rates didn’t change much under the ACA, so I didn’t get the shock on that end.

Maybe one of the big problems here is the discrepancy in pricing for everyone. Seems like it needs to be locked down at a lower amount. Don’t know where the money to eat those costs for the insurers are going to come from though. Obviously we need some healthcare reform now more than ever. Reform, not repeal, in my opinion.

Maurice Saoirse on

I believe you have hit the nail on the proverbial head: it is all of the above.: irresponsible insurance companies; greedy doctors, hospitals, surgical instrument manufacturers, Pig Pharma, over prescribing of over priced drugs, etc. etc.

At least Medicare controls some of those costs by refusing to pay some of the outrageous prices for some procedures, but, thanks to congressional republicans, when Part D of Medicare was passed, they made it ILLEGAL for Medicare to negotiate drug prices.

Medicare for all or some sort of universal or single payer system is the ONLY answer, imho.

Lori Felts on

I still say the gov could have just fixed what we already had out there, rather then disrupting 7 million peoples insurance, and causing many to end up with more expensive premiums, and more out of pocket cost, most insurance companies are just following what the law says, not all are greedy and such. I myself had to switch Dr. because of ACA. and I have heard from many people that they are paying much more now.

Dale Wrazen on

Obamacare is a failing idea…not well planned…and will cripple America in a short amount of time. As for raising rates (bait and switch almost, no?)… I saw THAT coming too! It was insane for the government to think that Americans would be FORCED, by LAW, to purchase health insurance and NOT use it! So, more people getting lab work and physicals and prescriptions because they now have insurance should be a slap in the face to the government.. not to us. Obamacare is a moronic plan…will always be…and, yes, I hope the republicans throw this thing out entirely. It’s a joke, and once again, the rest of the world is laughing AT us!

Lori Felts on

I don’t believe this was a good idea to begin with, we already had plans out there, they could have been fixed instead of disrupting millions of peoples plans by taking them away, but apparently this administration didn’t care about that, now many are having trouble with a lot of it, and I know of many who are paying much more, then they did with the policies they had. I myself had to switch doctors because of this, I really liked my doctor. now to find out so many are going to have to pay much more this coming year, what happened to affordable care for every one. I am on a limited budget because of what Obama & congress are doing to SS & SSD my house payment takes up most of my pay, like this only lady, have little left at end of month, and even though I am on medicaid that doesn’t matter, as I will probably have to pay more for my meds next year. this is rediculas He could have just spent the money to fix what we already had, like with medicaid they help out people with pre-exciting conditions as that part was a good think, (as I have one) but other wise I think it was a bad choice, if it has to stay then fix it, if not then put some thing in it’s place that will work much better.

Jeff Martin on

Blue Cross Blue Shield of North Carolina has been approved for a 32% hike in premiums
for 2016. Who can afford that kind of price increase? My Marketplace Insurance is going
to increase by 150% for 2016. These percentages are staggering, and there is no way the current healthcare system can exist as it currently is. I hope every American will commit themselves to forcing the kind of change that brings the Insurance/Doctor/Pharmaceutical companies under the kind of regulation that can actually
make these services affordable. It is an industry that is too vital, too important to be left to the forces that put excessive profit above all else.

Heather in Florida on

Our state didn’t expand medicaid. We are 150% of the PV level, our premium was affordable $33 a month for 2 full time working adults age 50 ,making under 30K yr. The copays and deductibles were TOTALLY something else. I just got diagnosed with a chronic autoimmune disease. I could NOT afford to have the tests my dr. ordered. I can NOT afford to see my specialist as often as they would like to see me because of the copays. Never mind that NONE of the meds that were prescribed me were covered, so I am suffering without medication. We have to wing it as we have been doing for the past 30 years of marriage and pay out of pocket for the little care that we do get because the insurance plans that are affordable are REALLY NOT affordable between co-pays, deductibles and pout of pocket costs.
Now we received notice, we are being forced to pay 7 times that amount in premium for 2016. We CANNOT afford over $200 a month Or we pay $2100 to the govt in a fine. This is ludicrous, this is almost 10% of our income, how are we suppose to eat, pay for utilities, drive a vehicle, gas insurance, etc. keep a roof over our heads. Our housing alone is 40% of our income. Weve been paying taxes for 36 yrs and look what it has gotten us,, NOTHING.

Susan on

Our company employs 102 people.
We must offer and pay for health insurance in 2016, 91% of the premium. We paid a fine in 2015.

Our company has not made a profit for 5 years, so this may shut us down. In addition, if we do not have 75%sign up, BCBS will rescind the plan offered, so will our company still have to pay a fine if we offered a plan but did not get participation and the insurance co no longer offers the insurance plan?

Who can we talk to for help?
We need help please! on

You are in a situation where you have to comply with the mandate. But starting this year you can use the SHOP for group health plans (you may find a better option). I assume you have less than a 100 FTE with 102 employees.

It doesn’t matter how many sign up, it only matters how many sign up or opt-out. Everyone can opt-out and you still comply with the mandate. They just can’t not be offered coverage and then shop on the individual marketplace with subsidies.

Do another read over the employer mandate page:

Sandy Burgess on

I think the costs are shameful. There is little difference after the ACA as far a costs.
We are the only civilized country and the richest country that does not offer insurance to its citizens as a right. We can spend Trillions for weapon systems, politicians let billions of $ be spent on campaigns, but let many of us literally starve. There is no justification. Period. It was my understanding that insurers could not go up more than 10%. A fable evidently. Very disappointed to say the least.

Richard Nahat on

I paid out more than Humana paid out. What helps Humana and other insurance companies are the “AGREED DISCOUNTS” that they receive on physician, pharmaceutical, labs and hospital charges that the consumer is not privy to. I imagine consumers would rather pay out of pocket if they were entitled to these discounts and use health insurance for just major medical. IE: surgery, rehabilitation, radiation, chemotherapy etc.
If you can’t afford the premium increase for 2016 and elect a higher deductible and less coverage your hurting yourself physically, mentally and your credit because you refuse need treatment because of economics. This is a double edged sword for the financially disadvantaged. on

It’s almost life if we had Medicare-for-all (basic and catastrophic coverage from taxes, supplemental optional) and rules that favored transparency for consumers over corporation’s profits we would be in a better place in regards to our healthcare.

Paul on

Hogwash. Socialist healthcare has been in effect for decades now, not just with ACA. All ACA did was provide a way to force individuals to have to pay for the ever expanding largess. The reason the system costs so much is because of decades of failed government policies that are put into effect so that politicians on both sides of the isle can receive large campaign donations. So go ahead and keep crowing about how we can’t figure out what’s wrong so we need more government. Tell me, with all this new openness, do you know what the agreed price is for “In Network” service? Most of these service providers do business with several insurance providers and if the rates the insurers were made public as well as those billed to individuals without insurance, we would all see where the rip-off is. But alas, that remains invisible so the politicians can keep the campaign donations flowing.

Dave Bellovary on

My plan for my 19 yr old daughter and myself went from $301 in 2015 to $564 in 2016 (80+% increase). My wife is disabled and on Medicare. Daughter is a full time student, and works a part-time job. In order for her to get a refund of some of her withholding monies, she has to file an individual tax return. However, when shopping for better rates on the Marketplace, I am told that if I claim her as a dependent (she lives with us and we pay for all her meals and other costs), she cannot be one my plan as a family, and must apply for coverage as an individual. I’m sure that will cost more. Does this make any sense? on

Tax families can be coverage families. If you don’t file together than you can’t be a coverage family. Tax credits are based on tax family. So if she files alone she’ll likely get great cost assistance (unless you live in a state that rejected Medicaid expansion and her income is low). Keep in mind your projected income counts all the members in your tax family. So you need to get the tax family / coverage family sorted out ahead of time and get the right plan accordingly.

joe on

one way to play the obamacare subsidy system is to live off your non-taxable Roth investments. Since it is non-taxable, it is not included in the MAGI, Modified Adjusted Gross Income which is what is used to determine subsidy level. So basically, I could live off my Roth for a few years, show MAGI close to 0 for a family of 2 and get almost all my health insurance subsidized….The forms don’t ask how much you have in the bank, just MAGI as far as I know on

Right. If you have a lot of assets, but little income then you can go on Medicaid for free (depending on your state). This is meant to protect people who lose income and have assets and not cash stashed away. But, it can be used to “game” the system. To be fair you paid your dues working hard to funding your Roth. It’s arguably not even immoral to take advantage of the fruits of your efforts as an average person.

Tom Pokopec on

How can I get temporary out of plan coverage? I have a new plan, (second this year) that covers me in a 100 mile radius. I travel outside that several times a year. Is there a way to buy extra coverage for those situations? on

You should be looking into a PPO that allows you to travel so you don’t have to get “traveler’s insurance” when traveling. Most major providers will sell short-term or travelers, which could both work.

Harold Hall on

It is so inappropriate that Obamacare is called the Affordable Care Act. When I retired in 2011 my wife paid annual premiums of $5,100 for a $10,000 deductible policy. My employer no longer offers health insurance for retirees so I must now go to the exchange and purchase insurance. For 2016 the annual premium has been raised to nearly $18,000 for a health insurance policy with a $11,900 deductible. This would be like the US Government raising the cost of $3.00 gasoline to $10.59 and calling it the Affordable Petroleum Act. Our new policy means my expenses would be almost $30,000 before the insurance company kicks in $1. My legal residence is SD and the insurance company is Wellmark. How can the most ardent supporter of the so called Affordable Care Act think this is appropriate for a family making a bit less than $80,000? 28% of my after-tax income should not have to go to health care costs. We would have to spend 46% of our after tax income before the insurance kicks in $1. Nancy Pelosi was asked “What is in the Affordable Care Act?” She replied “Pass it and we will find out!” Now we know and it sucks. on

I agree. When costs are unaffordable to a person, the name invokes a sense of irony. So in defense of the law for many it made insurance affordable for the first time and for the country it is curbing long term costs. It earns it’s name in some respects, but in your case, I get it.

That said, what you quoting (For 2016 the annual premium has been raised to nearly $18,000 for a health insurance policy with a $11,900 deductible) does not seem right to me. There is no good reason a family or person should be paying this much. Take another look at your states Marketplace, and although it seems your income is over 400% double check that you truly have no cost assistance options with HealthCare.Gov. Some people’s costs are high, but they shouldn’t be that high. If that is the cheapest plan, you may actually be exempt from having to get coverage (again depending on income).

Greg on

I totally Agree…

Jackie Gales on

My husband disabled and I just became disabled. Last year with his medicare qualified y extra help and I also received credits on premium and deductible. Last year I paid 142.00/no 159.00 deductible and 500.00 out of pocket. Husbands meds went from 2000.00 month to 1.20 ea. It was a blessing. NOT SO THIS YEAR. I have recently become disabled. With the extra 980.00 per month caused my premium to go to 304.00/mmonth, 1400.00 copay and 4700.00 out of pocket. No help with scripts for husband even purchasing part d for his scripts will still be devastating to this family every month!! When figuring cost we were far better off last year and that was the worst year financially we ever had. Something needs to be done to keep costs affordable, fair and quality of care to the highest. This is devastating to most of American families who are already struggling financially just to maintain without any expenses that pop up.

Anonymous on

So, can you clarify for me: is ObamaCare a good thing or a bad thing? I’ve been hearing both sides. on

It’s not good or bad. It’s a 1,000 page bill with over 400 provisions in it. Some are amazing, some are boring, a few really helped some and hurt others. ObamaCare is “a good first step” toward solving the healthcare crisis. People who want full repeal or who support the program without question are often missing the bigger picture. That said, it’s confusing and those who are helped a lot or hurt a lot tend to have strong feelings.

darren christensen on

The people that are getting a free ride for the moment loves it! They just sold there soul to the devil which is the government which owns them and will tell them what to do or how they can do it. Oh reminds me of past history oh HITLER! So the people that are paying there way hates everything about this plan including Me! So you and the government and the president can go and go screw yourself for taking are freedoms away. on

It is bad form to compare US politicians to Hitler. Liberal or Conservative, doesn’t matter. Hitler and the NAZI party were a disgrace to the human race in terms of human rights violations. In another world WWII could have ended modern civilization, about 60 million people died. This is just a healthcare law.

Not picking on you, but the aim is to approve 100% of the comments.

Larry Leisenring on

My wife and I are 62. I am self-employed and my wife’s employer can no longer afford to provide group benefits, so we both are on individual medical plans with a $6,500 deductible, and costing us over $13,000/yr, just in premiums.
I had a great plan through Kaiser and was paying thousands of dollars less for far better benefits, before I was forced to go on an ACA plan (remember “you can keep your plan, if you like your plan” being repeated over 30 times by Obama?)
We pray that we don’t need to see a doctor, or, worse, be hospitalized, and are watching our retirement savings dwindle just to pay our premiums.
We were lied to by our President, then had to pay far higher premiums for inferior health coverage.

Terry Brennan on

Before I was a human being and now I’m treated like a car. If I just want to check my overall heath I have to pay , get a new paint job so to say. Before it was a $20.00 co pay.Evil is what it is

Mirza Tarique Beg on

I was paying $1300/month in CA for Cobra after leaving my last company, which I thought was high. Since my wife had a pre-existing condition, I got fooled by the rhetoric and I voted for Obama. Boy was that a mistake!!!. Now as a contract worker, I am quoted almost $2000/month for my wife and I. That’s as much as I pay for mortgage. Perhaps, I’m to blame for being a gullible idiot, but my wife and I had only two votes. There were millions of us gullible idiots that voted for this thing. The real way to handle this mess is to investigate and restrict hospitals and pharmaceuticals from setting their own prices. This is simply gouging the public.

darren christensen on

i hate the whole dang thing. i hope they die a long painful and poor death like 95 % of america is. i will not support it and i’m at end of my leash. i’m about to not file taxes they can kiss my a$$ and ill rot in jail or be shoot its better than live in this controling country

Art Kazar on

I am a retired Federal Employee. I carried my Humana into retirement. In 2014 I enrolled in Medicare which became my Primary and Human became the Secondary insurer.
In 2015 my Humana premiums increased by $130.00 a month. In 2016 the Premiums increased another $201.00 per month. That’s $331.00 in two years! Why, when Humana doesn’t even have to cover all the costs as they did before I got Medicare?
I’ve had no illnesses and just go for regular check-ups 4 times a year and get blood tests twice a year.

Josh G on

Art Kazar, this is part of socialism.

Imagine, you, me, and Mr fact all go to a restaurant and order our food and drink.

You ordered water and an appetizer.
I ordered a beer, hamburger, french fries, and pie for dessert.
Mr. fact orders a steak with onion straws and a coke to drink.

The bill is all together and we each pay 1/3rd of the bill..
Somebody always get the short end of the stick unless we all order the same thing…
welcome to socialism, great on paper, bullcrap when emotions and “fairness” get pushed into play.
Lots of ignorance exists in the United States in the differences in the words equality and fairness, But I digress…
Isn’t it interesting there is an entire website devoted to the facts.
The REAL kicker is, since this is part of the tax system; anybody who is a u.s. citizen does NOT actually have to pay for the tax or even get “obamacare” Shocking as that may sound it’s true.(Under law).

I don’t get how people are for a system where u.s. citizens pay money(when they don’t have to) and lots of that money will go to the administrative agencies, “spread the wealth” by giving those below the poverty level lower premiums and then very possibly, if there is some money left over, that left over money will be used for “non-health” reasons just because it exists. I for one will be a “bad citizen” and decide not to participate in such corrupt (non)voluntary systems.
Be like me, study law and don’t feed the beast.

jerri on

we are living in a communist society. we are a big socialist countryl i worked all my life and get a few dollars for retirement. now a lot of it has to goto those who do not work, did not work, and illegal aliens.

Sultaun Abdulshahid on

I echo much of the sentiment of the readers that have taken time to post their comments. FULL DISCLOSURE I am a licensed life and health insurance Agent. The first year of Obamacare allowed me to help many of my clients get premiums for less than $60.00 per month. However, this last Open Enrollment period premiums were much more. This year I had to look for an alternative for my clients and fortunately I did find an alternative that is actually AFFORDABLE. However, it does not meet the requirement of meeting the 10 Essential Benefits of being a Qualified Health Plan. Instead, it is a plan that offers premiums that are typically 30 to 60% less than Obamacare. These plans have four choices of deductibles ranging from $1,000 to $10,000. A typical premium for a male non smoker age 35 with a $2500 deductible is only $96.22 per month. I would encourage the readers here to look into our plans if they are interested in saving hundreds or even thousands over the Obamacare option.
As far as the “Penalty” is concerned, our plans do not satisfy the “Qualified Health Plan” provision of the law. But let me ask this question. If the cost difference between the private plan and the Obamacare plan is more than the $695 Individual Responsibility Payment aka Penalty, which is preferred?

Joanna j on

I am a “healthy” Type I diabetic. 33 years diagnosed, 45 years old, no family history. Skinny, eat perfectly,great eyes and teeth, on Dexcom and insulin pump. Started 2015 with UHC. $437 per month, good coverage. Received letter in nov 2015 that my coverage would continue with nothing needing to be on my part and going down monthly by $7. Yay! Never have received one piece of documentation regarding coverage changes. Previous had $250 script deductible, $1500 max OOP. GROCERY store pharmacy. Logged 43rd call today since November to finally reach a human. New monthly us $427, $500 script deductible, $6,850 OOP, Walgreens or Walmart almost only, oh and my test strips that MUST be used with insulin pump? Went from free after deductible to a minimum MINIMUM of $285 per month REGARDLESS OF DEDUCTIBLES OR OOP MET!!!! What was Obama trying to accomplish? Having HEALTHY “sick” People say “screw coverage”. I do not want to pay for those working yet not paying in. I would rather move to Canada or Europe. This is RIDICULOUS and I will cancel coverage and live “outside the Obama law” if it means I pay out the ass and cannot even afford my children’s college or braces as a single mom working 7 days a week….

James Windham on

I think trying to cover everyone with insurance is as stupid as trying to elect everyone as President at the same time. Be real the people nor the economy can afford Obamacare. There is no such thing as a perfect healthcare system and a majority of people with preexisting health problems are still uninsured because of cost under Obamacare. The people who can afford it the least still have to pay the most to be covered. on

Disagree, we can’t do it in our current system. But we can keep the ideal and do what it takes to make it happen over time.

There is no can’t, only try.

J.W. on

Why is it that when individuals use a coupon to purchase something they expect no more than is printed on the coupon for value and pay the balance.

Yet with health insurance everyone expects the insurance company to have an unlimited value and for individuals to share very little or no expense and then blame the insurance company because they want to run up a bill with no limitations or consequences?

Why is it there is no common sense when it comes to healthcare, healthcare costs and insurance companies. Insurance companies don’t determine the price for care or prescriptions they simply help defray whatever cost there is. Let’s start demanding answers from the source(s) drug manufacturers and healthcare providers; not the middle man.

Andrae on

I started a new job and I will not have insurance for 90 days…and I definitely won’t be insured on day 90 so I have to find temporary coverage so I don’t get the penalty. I live in NY and I can’t find any temporary coverage…It doesn’t seem to exist..any suggestions? I make to much to get any financial help but i don’t make so much that I can afford a hundreds of dollars for a month or two of coverage(assuming I can find temporary coverage in NYC). I am single and only have to cover myself on

Yeah if it is less than 90 a short term plan works, this is because you get less than 3 months each year (even if only by one day) where you don’t have to have coverage or pay the fee. If it is more you can use a marketplace plan in-between by calling and enrolling in special enrollment.

You can also just pay the per-month fee if need be.

It sort of a matter of preference, but this is the sort of situation a short term plan is designed for (it won’t protect you from the fee, but in a case of a short gap, it doesn’t need to due to the exemption).

TJ on

Obamacare does not work and is killing the middle class. In 2015, I had, what I would consider, excellent health care coverage through my employer. In 2016, all of that went right out the window. I now have a crappier plan, higher out of pocket minimums, higher co-pays, and far less coverage. Why did my company opt for a bare bones plan? Because they can’t afford to provide awesome insurance anymore thanks to Obamacare and the lack of gov’t regulation in the health insurance arena. How come gov’t can regulate utilities and refuse utilities’ requests for rate hikes, but the health insurance industry can do whatever it wants and charge people astronomical prices? Because lobbyists own the government, that’s why. Obamacare and the current state of the health insurance industry are a disgrace. Republicans, you HAVE to get rid of this nonsense and start regulating! on

You have lots of valid points that resonate with millions. However, you can’t dismiss the tens of millions who have coverage under the law and couldn’t before due to cost (sometimes as a result of preexisting conditions). There are vital protections in the ACA that should never be repealed. Now for the revenue and subsidies part of the law, I think we have room to flip that into single payer… or if you want to be very conservative a voucher-like system. I won’t even argue specifics of funding and spending, but I will always step in and point out the vital protections and cost curbing measures contained on the other 990 pages and advocate for those who couldn’t afford the uber-cheap plans of the past.

concerned american on

There are always people in need. The question is how do we solve the problem without putting the burden on the middle class. Most of the laws and changes in our system opens up more people to be irresponsible and I believe this is the root cause of all the anger from people. They are working and doing the right things to be secure in their future and the law makers are a) not on the systems that they vote on and b) putting the responsibility on those that consistently work hard there whole lives and still being penalized. The facts are real simple… The law makers changed the law. A lot of people that could get help care because of preexisting conditions, no limits, or health care cost put the pressure on insurance to cover and then need to raise all the rates and low the coverage to meet this new law… If you want all productive american’s to give up and look for the easy route just keep doing what your doing and the end result will be Bernie Socialist and nobody will be around to cover the cost. These people on here don’t have the luxury of a Federal or State funded(OPPs mean tax funded) insurance… Here in Iowa they pay nothing for their health care for their family. on

There are always people in need. The question is how do we solve the problem without putting the burden on the middle class….. Amen! Couldn’t agree more with that. We obviously err on the side of favoring healthcare reform, even when its lack-luster in places, with the goal of getting it right over time. But this is largely a result of the mentality of the opposition, who want to “break” the program and reject Medicaid, and less about the underlying core conservative principles of fairness and not overburdening taxpayers. Think we can find middle ground as people, the question is can we get representation for that middle ground in the house, senate, and business world.

Cindy on

Obamacare is not affordable for anyone. I work for a small business that use to offer insurance but now can not because of the cost. So I guess I am suppose to leave a job that I love so I can get insurance that will be affordable. Its all a big joke. Only thing about Obamacare is does not hold preexisting against you. Why shouldn’t this be the same for all insurance carriers not just the Marketplace? I need surgery or I will be in a wheelchair so I have to use Obamacare to get what I need. It sucks. on

Well I understand the frustration, but it isn’t true. ObamaCare is very affordable for millions, very good benefit and protection wise for all, and at the same time price hikes are hurting those without access to tax breaks or credits. So good points, but the first part isn’t fully right.

andre spearman on

I think no one wants to deal with the powerful lobbyist who are well funded, Citizens United has allowed corporate profits over people health. Anyone who say health care for all will be drowned in negative hit pieces. We must ban for profit corporations or corporate non profits from unlimited political funding. It is a threat to democracy and every citizen suffers. We should allow medicare and other big purchasers to buy from Canada or other cheaper drugs and medical supplies

Greg on

The Idea was sound but at what cost. OUR SANITY!!! Covering everyone is a good idea, but there is a statistic that no one bothered to consider. A study I heard about said that 75% of America has some kind of health problem and half of those have pre existing conditions. Now I’m not prejudice against sick people, but why should 25% of America pay for the other 75%. does that seem fair to you. I like health savings accounts because then the consumer can control their own healthcare decisions. People say that isn’t fair for those who cant afford to start one…or for those who are sick already. Well it is not fair for us healthy people to be paying for the sick people either……JUST SAYING.

Helena on

I am 53 years old and for the 1st time since I was six years old, I will not have health insurance. I decided not to sign up for ObamaScare, for 2017, because of the high premium. For me and my son (age 21), both nonsmokers, the ObamaScare Bronze Plan, H.S.A. H.M.O. was $$682.56 with an $11,000 Family Deductible, $13,100 Out-of-pocket and high copays/coinsurance. We do not qualify for the subsidy.

Instead, I signed my son and I up for a health sharing ministry. We each pay $150 per month, for the Gold plan, for $125,000 coverage per medical incident with a $500 “deductible” and $40 per quarter for additional unlimited medical cost sharing. Under ObamaScare, H.R. 3590: U.S. Patient Protection and Affordable Care Act [26 U.S.C. §5000A(d)(2)(B)(ii); p. 128], members of a health care sharing ministry are exempt from ObamaScare. There is no tax penalty. See the link for exemptions allowed under ObamaScare.

I will be able to go to any doctor, hospital or facility I choose. I will try to negotiate a better rate since I am, in essence, self-pay. It is a bit more work since I will also have to submit my bills to the ministry for payment or reimbursement but I am willing to do it to save thousands of dollars.


In the past, only Government Workers could get GEICO. Then it was opened up to everyone. I would like to know what Health Insurance companies cover Federal or Government workers and be able to access those plans. I heard that those on those plans were able to keep the plans they had and that they were pretty policies at a reasonable cost.