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Q.

Are insurance companies sabotaging Obamacare?

 

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16 Answers
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A.

I think that there's no doubt that there are some terrific insurance plans out there and companies that try to do the right thing by their customers, that have good networks and they’re prioritizing, providing good care. There’s some that don't do a great job. One of the things in the Affordable Care Act that we did was put together all these consumer protections that apply to everybody. I mentioned some of them. Making sure that, you know, your child can stay on your plan until they hit their 26thbirthday.Three million young people now benefit because of that provision. Making sure that there aren’t lifetime limits. Making sure that you can't be barred from getting health insurance because of a preexisting condition. Those are all things that were designed to ensure that insurance companies do a little bit better by their customers.

 

One other provision that was in the Affordable Care Act says that insurance companies now have to spend 80% of the premium that you pay on actual health care as opposed to administrative cost and CEO salaries. And if they don't do that, at the end of the year, they send you a rebate. And, in fact, several billion dollars in checks have already been sent out in rebates. People may have gotten those checks and not known that was because of the Affordable Care Act, but it was. But, you know, what is true is, is that, as long as you've got a private insurance plan, then there are going to be some decisions that those insurers make about who's in the network, what their costs are, what their co-pays are, that may not satisfy everybody. There are other countries, like Canada, that have a single payer plan, and by definition, every doctor and every hospital is part of that network. If you're part of Medicare, you have a very broad choice just because it's such a huge program that almost every doctor and hospital has to be part of that network if they want to have a lot of customers.

 

I think that as the Affordable Care Act grows and more and more people are signing up, that you may see insurance companies starting to add more doctors to the networks, putting more options on the table, but keep in mind that, what this is really designed for is not to replace people who have got a good deal through their employers. What it's really designed to do is to deal with the 40 million people or so who don’t have health insurance at all. Or, people who are in the individual marketplace, they’re not getting it through their employer and so don't have a lot of leverage and may not be getting a good deal through their health insurance companies because they really don’t have the ability as part of a group to negotiate a better package. And I think what you'll find is, is that the private insurance that’s available on healthcare.gov is going to be as good or better as what you could get outside of the Affordable Care Act. And, when you add the tax credits or subsidies that you may qualify for, it's going to be a really good deal for a lot of people. And I get a bunch of letters every single day with folks saying, "I saved $200.""I saved $500 a month. “Small businesses who say, "I’m saving tens of thousands of dollars covering my small group of employees. “And what I really want to just urge everybody to do is check it out for yourself. Go to healthcare.gov --the website's working --see what options are available for you.

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