Why Are Deductibles So High?
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I figured out with our family of 5, we make under 50,000 a year, it would cost 500.00 a month and the deductible was like 10,000. I am confused on how we can afford it.
I figured out with our family of 5, we make under 50,000 a year, it would cost 500.00 a month and the deductible was like 10,000. I am confused on how we can afford it.
Christine Gilli
I had to make the decision to go without health insurance and self-pay for everything, even though I have three health conditions. 1- there is no point in paying an 8000 or more deductible, and a 500 monthly premium. Even with my health conditions, I don’t spend that much money on my own. 2- I took time to research where I can pay less for lab work, I use drug savings cards and I plan for my MD visits.
I do admit that I know several people on disability, who see doctors of every kind, every week with a referral in hand for any possible concern without paying a penny. Meanwhile I am searching how to pay for a mammogram, the same way someone might search for a new car. The biggest mistake I made was looking at ACA on line and providing my information. Unless you want to get 25 calls per day and more on email — Don’t do it!
Michael Russo
Who are we kidding? Silver plans have high monthly out of pocket costs.
ObamaCareFacts.com
They don’t, in general bronze plans do. Also silver plans are the only plans that qualify for cost sharing reduction subsidies, so if you make between 100% – 250% they are usually the cheapest and best option in terms of cost sharing.
Brandon Watson
What about the independent small business person? As a Realtor and business broker for 17 years I experienced the worst 8 years of my career during the Obama administration. My cost went through the roof. During Obamas term I struggled to gross $70k annually. I found myself in a 42% tax bracket which left me $40k, then Obama forced me by law to pay for health insurance of which cost annually $12,420 with a $6000 deductible. So this means that I have to pay $17,420 before I can use my insurance. Now my annual income is down to $22,580. How can I save for retirement, Mortgage payment, groceries, auto expenses exceed this amount. Why should I have to pay for a lazy person that will never put into the system. Better question yet, how is their vote equal to mine? Its criminal I tell ya!
ObamaCareFacts.com
In terms of high cost health insurance in past years, that is a legitimate problem for those years. Every reason to be frustrated.
In terms of taxes, they aren’t much lower today, and they weren’t much lower before Obama. So while there is a very valid debate there, its hard to pin it on Obama.
In terms of current health insurance costs, your lower income qualifies you for assistance which should bring your costs down. That is the tax system working in your favor in years like this.
In terms of low income people, they pay a ton of taxes like excise taxes, sales tax, and the payroll tax.
In terms of votes, we live in a democratic republic in which citizens all equally have a vote regardless of class, color, creed, income, etc. That is a pillar of our representative democracy.
Thanks for sharing your frustration, it can all be very frustrating for sure. Hopefully that answered some of your questions.
cid
I want to know why I can’t buy the same plan as a friend. We both are everything the same but income. Her income is 30,000, mine is 45,000. I see the same plan number as hers, but her deductible is 1900 and min is 7000…for the same plan. I can see paying more premium because of the income difference, but why is the deductible on hers so low?
ObamaCareFacts.com
I would assume this is because her’s is reflecting cost assistance based on her lower income and your’s is reflecting cost assistance based on your higher income.
She is get cost assistance toward her premium and deductible, you are getting less and just toward your premium (most likely, based on what you’ve said).
Jude
I find when people ask questions about this high cost Obamacare they get a lot of double talk it’s to high plain and simple some of the people that have taken out this so called affordable insurance can’t use it because the deductible is so high . Now try giving me an answer by double talking ,then again don’t bother answering .
ObamaCareFacts.com
Insurance is high because:
1. For profit healthcare.
2. Protecting preexisting conditions.
3. 7 year long campaign by the GOP to break ObamaCare so they could pass a fix… which now they can’t seem to pass. https://obamacarefacts.com/2017/05/30/the-ongoing-republican-strategy-to-break-obamacare/
There is no more accurate and straight forward answer than that.
Thomas
It’s funny how I swapped to a gold family plan in preparation for the birth of my new baby girl.
$1,000 premium each month. That’s $12,000 a year coming out of my check. I don’t think my child will cost $12,000 in medical alone in a year.
Turns out that if anything ‘tragic’ were to happen, my deductible goes from $1,000 to $5,000.
Who defines ‘tragic?’
I will be swapping back over to Bronze, saving my money, and trusting the Lord.
Michael Ellender
Our focus is on the wrong industry! In this country only the rich could afford medical cost if insurance was not available. I am talking about millionaires and above. Just one catastrophic illness could cost over a million dollars. To think that we need a third party to help us pay our basic needs is absurd. Of course there should be a product on the market such as insurance to cover our risk with health care if so desired. But it should be a risk that we could pay for if we had to. Unfortunately, that does not exist for medical needs. Cost continually go up at a rate greater than we can afford. What will we do now? The insurance that use to be affordable many years ago is out of hand. Insurance rates go up faster than our earning capacity can keep up with. Why do we pay so much? Capitalism assures us that we are getting a good buy for the money! Why are the cost so high? The medical profession and all cost associated with that profession do not compete against one another. Until we get a handle on this segment we will continually be paying too much. There is little capitalism in the medical industry…..no competition. Why don’t we address this?……. possible reasons…big political donors, huge lobby and nothing else! We are erroneously attacking the insurance companies for the mess we are in along with the politicians who try to come up with a plan that is suitable for all. Our focus should be on our politicians for letting the medical industry get away with their non-competing industry! Think about it…wouldn’t it be nice as a businessman you could get whatever you wanted for a product. You can’t blame them we would probably do the same thing. This was not talked about enough in the original answer (root cost).
mac
So glad Ovimit is GONE~~~~ – over 68% of Americans did NOT want OBamacare, yet this clown shoved it down our throats by executive action… my ded went from $500 to 12,600 and my monthly premium went from $90 to $312.. Affordable?.. YEA RIGHT
Lisa LeDoux
I wish I could say I had a full understanding of how health coverage systems work, but I find it a bit confusing. One thing I do know is that I’ve worked hard all my adult life (I’m 51), and made sure I had jobs where I had health insurance. I’ve been doing fine, but now that Obamacare is in place, although I’m still paying for health insurance, I can’t actually afford to be treated because the deductibles are so high! I’ve got a terrible case of carpal tunnel in one hand that keeps me up at night and a kidney stone that’s been lodged in my left kidney for over 10 years that causes me pain, yet I can’t have these things taken care of. I can get them diagnosed. I just can’t get them fixed. I’m already making payments on one round of lithotripsy to try to break up the kidney stone, but it wasn’t enough and I can’t take on any more debt right now, so I continue to suffer with it and hope it doesn’t cause other issues. So am I screwed over so others can have insurance??? Is that why I’ve worked for the ability to have healthcare all my life and now I can’t have it?
Steve
Sad that the commentator works for obama
Erin
Not even a little. This website is a completely run by an independent private business and is trying to provide people with information and resources about the law commonly referred to as Obamacare. We’ll do the same for any future healthcare reform laws regardless of who is the President when they are made law.
SDW
I understand the premise behind ACA and certainly agree Americans should not be excluded for preexisting conditions. But here’s my problem – I’m single, healthy, self-employed. So I’ve always 100% of my premiums. But now there is only one insurer in my area, and the coverage is only 50%. Long gone are the days of 80/20 coverage. I do not qualify for subsidy. For 2016 I rolled the dice and said the heck with it and went without coverage. First time in my life I’ve been without coverage. But here on the brink of 2017, I’m facing premiums close to $1,000 per month, $10,000 deductible, and 50% coverage after meeting deductible. I “love” it that so many insurance companies are actually non-profit organizations who have us now over a barrel without options. In my humble opinion, any health insurance company writing policies in any state should be required to offer it in all states. Now that would be true competition. I bet we’d see much better plans offered. I’m not sure what the answers are, but this is not working. We can’t go back to the way it was, but those like me are struggling beyond measure.
Ricky meyer
obama care is a joke. because i make a little over 40000 dol. a yr. retired. we have to pay for people that won’t work or don’t want a better job and pay for them. affordable i don’t don’t think so mine went from 650 to 950 dollars. with deductibles out of sight. you need to publish the real statistics of people who lost there ins. because of obama care. repeal and replace.
Josh Schroeder
$639 premium with $13,500 deductible!!!????? With all do respect from a US Marine, Get F’d, and go to Hell!
ObamaCareFacts.com
Can’t say I wouldn’t have the same reaction if that was the bill in front of me. I would suggest in these cases looking into HSAs, cost assistance, other insurers, and other ways to save money. That price you quote is very very high for any age group in any region.
Karen Smith
Unless someone can show me different, I think the Obamacare is a joke and should be stopped. Why do I want to pay $500 a month for a policy that has a $6600 deductible and a $12,000 max out of pocket. That is like throwing my money away. I know something could happen but for the past 50 years, I have never had a hospital bill over $1000. Besides Obama himself, what other idiot came up with this mess.
B A S
I can’t afford to use my health insurance with a $10,000.00 deductible. It is unconstitutional, unreasonable and unethical to FORCE the American people to PURCHASE something we can’t afford. Before the ACA came into effect, health insurance costs were on the rise, right beside health care costs. Now, health insurance is a joke.
Jamie Hoefs
It seems like the people on welfare get free healthcare and us who have always carried health insurance have seen our deductibles skyrocket and our premiums triple in cost. It would be better for us to go back to the way it was – welfare recipients still got it free back then, it’s a win win situation for them.
[email protected] Erin
Welfare recipients did not get free healthcare back then and millions of working and poor Americans in states that didn’t expand Medicaid aren’t getting any healthcare coverage now. Before the ACA states didn’t covered low income adults on Medicaid unless they were disabled or pregnant. Now many states have expanded Medicaid under the Affordable Care Act and include all making under 138% of the Federal Poverty Level. Those in states that haven’t expanded Medicaid must make at least 100% of the Federal Poverty Level in order to be able to use the Marketplaces and be eligible for cost assistance. Thing is though, the Federal Poverty Level numbers gets higher for every household member. So the larger your household, the more income have to make to gain access to the Marketplaces and be eligible for cost assistance.
George
I had a surgery a few years ago, it was 78K and I paid zero. I need another and it is a minimum of FOUR THOUSAND DOLLARS. My monthly insurance through work, the best they offer, is $227 a month, the highest I have paid since I started working in the mid – eighties. I HATE YOU OBAMA. I HATE YOU!!!!!!!!!!! I have to suffer without now.
Patty
My deductible went from $4500 to $6000 for a single person, plus now I have to pay 100 percent for doctors visits, etc. I could not afford the $4500 deductible let alone the $6000. Medical insurance is outrageous, it is only good for catastrophe insurance. I have had health issues for years, and my doctor keeps giving me slips to have tests done to find out what is wrong and I can’t have the tests because I cannot afford it because of the LOUSY insurance. Something has to give. What does the government expect of the American people??? These high deductibles are putting money in someone’s pockets and it certainly isn’t mine. My heart breaks for the next generation, what is it going to be like when they get older.
Joe
So youre going to get $80k worth of services but only pay $6k? and this is Obamas fault because before you got it all for free and you feel entitled for free stuff from other people?
People here need to grow up. Healthcare in the USA is expensive, period. Our facilities cost more than in other countries and we pay our medical workers more. Money doesnt grow on trees.
To the people complaining about the skyrocketing deductibles and premiums: Welcome to the Real World. It is so nice that you could finally join the rest of us outside your tiny bubble. Medical Care has always been expensive. I have minor pre-existing conditions yet could not get even catastrophic coverage for less than $1,000 a month before the ACA came into effect. The only difference now is that everyone gets to share in paying for it instead of a few people benefiting at the cost of everyone else.
To the people that somehow think that making people pay for their own health care is socialism while demanding that other people pay for theirs: you’ve somehow got this whole thing completely backward.
Dawn Hatcher
This is as clear as mud. My health insurance is not affordable and I have and HSA. I now pay higher premiums, have a deductible of $4700 for me and my son (was 2200) and our copay has gone away. We would have to visit the doctor forty times in order to meet the deductible. Affordable healthcare my foot. I lose 55% of my check for taxes and insurance and for a single parent this this outrageous.
Peter
My bronze plan costs $1278 per month with a very high deductible and my wife and I healthy. I lost my job and was making more than 100k but my employer insurance was about $550 per month. I could find private insurance but have to pay the penalty. I have lost my choices and lost some freedom to chose. This is creeping socialism.
P
If the father has the nerve to get sick, say have a stroke, he will be financially punished with an unexpected bill for $10,000 plus he must keep paying premiums. He will also spend his recovery on the phone arguing with every provider and his insurance company. This could very well lead to the breakup of his family. However, since he has a plastic card I suppose the President is satisfied that he has adequate protection in an emergency
Di
My premium doubled and deductible tripled when obamacare took effect …
ObamaCareFacts.com
I’m sorry to hear that, you are in no way alone. Those who had drastic increases should remember they were in a limited and lucky group who had cheap healthcare coverage before the law. Sometimes it was just a great plan, otherwise it was a plan that was cutting corners to keep the cost down. We can’t go back to the past to play out things and see what would have happened, but today the ACA protects you from being dropped for no reason. Still more work to do in regards to rights and coverage, and obviously more work to do on costs too!
tiredofthiscrap
Well, that’s not really true. The reason why costs are so high now for people who paid reasonable costs before is because insurance companies have to recuperate the costs associated with the ACA’s mandates. The ACA effectively shifted the burden that the people who couldn’t afford those plans to the middle class. So now we have a class of people who afford extremely cheap, or even free, healthcare (and who are statistically more likely to abuse it) being provided the care on the subsidized dollar of the middle class. A monthly premium of 1200$ for a deductible of 13,000$ for a young family of two who are non-smokers and rarely go to the doctor is just retarded. Beyond stupidity.
Angry
This is a BS Answer from this Government website.
ObamaCareFacts.com
BS is semantics, but we aren’t a government website. Also, this is a list of tips and tricks for avoiding a high deductible. We devote large portions of our site to being critical about high deductibles and explaining how people can leverage everything under the ACA to lower them.
I assume you are looking for an answer to “why” specifically. Simple answer is, “we have a $3 trillion healthcare system, someone needs to pay for it, and some mechanism needs to be rationing care.” (this answer is given politely at the top of the answer, BTW.)
mj
Please avoid using acronyms in explanations. Deductibles must be lowered–a lot.
ObamaCareFacts.com
Good insight.
Angie
Because most of us can’t do math, we have the Unaffordable Care Act. Corruption at it’s finest with no way for us to turn the tide. For example, my premium is $267.00 per month and that pays for zero medical care until I pay $13,000 in deductibles for the family meaning I essentially would pay over $1,083 a month plus the premium should we need catastrophic care for a family member. How are we to afford that? This did not answer the as to how the person can afford this insurance. It we look at the reality of what happened here we can see the Affordable Health Care Act basically is taxpayer subsidization of health insurance companies who will reap billions as people pay premiums for insurance coverage they cannot afford to use due to excessively high deductibles-the extra income to those companies coming from not providing health care while collecting mandatory premiums from us- brilliant. How many hard working Americans will die due to this lousy, corrupt insurance act? I suppose those deaths will cut down on future social security payouts.
lawrence turner
Here you go blaming Republicans, the high cost of healthcare is solely the fault of president Ovomit.
ObamaCareFacts.com
Well the commenter was blaming Republicans for union busting. That makes a lot of sense actually, that is 100% exactly the platform of Republicans (and specifically libertarian conservatives in this day and age). Just Google for example “Scott Walker Union Busting”. Anyway, what impact does union busting have on insurance? Some arguably, but truly the blame lies in many many different places. Healthcare in America is a collective problem that defies one party or part of the industry and instead lies on all of our shoulders (although some do deserve more blame than others).
Unbelievable
I worked for the insurance companies for over 30 years processing medical claims and collecting premiums. You know, back in the day when you actually paid a reasonable premium for decent healthcare coverage? Of course most of those years were for Union Insurance plans and they actually had the power to negotiate good benefits for working families. Then the Republicans came along and began union busting and convinced people that there was no need for unions in the workplace.Todays deductibles are ridiculous and the insurance companies are lying to you all. The deductibles are high because the insurance companies know you won’t use their plans because you can’t afford to after paying your high premiums. Everything involved in insurance and medical care is to make some people extremely wealthy. Monthly Insurance premiums are now as much as some peoples mortgage payments but with a mortgage payment you at least get something to live in and shelter you. With your insurance premium and high deductibles you pretty much get nothing.
ObamaCareFacts.com
Good insight. I think the best way to get value out of the current market is: 1) For 100% – 250% FPL Get cost assistance on a silver plan, thereby reducing out-of-pocket costs via subsidies. 2) Those with incomes above 250% get a High Deductible Plan and use an HSA, thereby reducing taxable income and using tax free dollars to pay for out-of-pocket care and deductibles. 3) For those with higher incomes and more medical needs, simply face the fact that a premium that will buy you low cost sharing is going to be high.
Kevin Ballenger
“…face the fact that a premium that will buy you low cost sharing is going to be high.”
Wow.
F that.
Richard Gassen
Putting profits before people is why private insurance plans are bankrupting people. And the do-nothing Republicans, only in the interest of reducing the size of government, blame Obamacare. They’d rather see people suffer and die than confront the greedy insurance companies that have absolutely no sense for the common good. Pathetic!
Robin
It’s referred to as Obama care, but do your home work. It’s the healthcare reform act that has been in the making, being revised repeatedly, for decades. No, I don’t care for Obama or any of the other greedy politicians that are used as pawns, so I don’t want to receive feedback about my comment. All politicians are greedy liars that work together. Their hearts are filled with filth and greed, and their sole purpose is to stay rich while the poor stay poor and struggle to thrive. I have been searching for healthcare plans and the deductibles are ridiculous and not affordable. I be glad when Jesus return and all these shenanigans stop.
Rob
Before this obamacare crap came about my family and I had good insurance and a $500.00 deductible , Now I pay more than double and have a deductible of $6500 . That’s the Republicans fault , Um No it’s Obama’s fault.
ObamaCareFacts.com
Well, lets be honest it is the underlying healthcare industry. Not that we can remove Obama from the picture, but I argue he is one of the forces trying to make a change. Either way, those costs you are paying would make anyone frustrated. Frustration noted for sure.
Fitzgerald Kennedy
It’s the Republican ‘s fault. This plan, of fining people was brought to the house by senator Chafee- Repubs.
Enacted by Romney- Republican.
And all of the terms were agreed to by the house at the time-REPUBLICANS.
They call it Obama are so you will continue to believe that this was his fault, when in actuality the price of these plans is the fault of the repubs.
Obama took the calculated risk and strive to get coverage for those with pre – existing and terminal conditions with the hopes to repair, through legislation, the fines and steep cost.
But as usual, if some one is making money off of the poor, you better believe there is a Republican laughing all the way to the bank.
Wake up, America. You have been fooled, yet again.
Stewart till
Actually yes it is the Republicans fault. You see the Republicans took away the provision that set limits on co-pays and deductibles so that’s why your premiums your payments and your deductibles are so high if you have a problem with that talk to the GOP