Myth Busting Obamacare - 9 Myths You Need To Know!

Our team is on the phone almost all day long. We speak to so many wonderfully unique Texans that range from health experts to lost searchers needing assistance. We love the diversity of clients that reach out to us and we have made incredible friends with many of them. Interestingly, every conversations we have lately includes some untruth that people have heard or some myth that they've been "sold". To kick off another week of blissful Open Enrollment, we wanted to highlight 9 myths we've heard and try to find some clarity amid all of the noise.

Myth #1 - There Are Obamacare Health Plans

We keeping hearing about "Obamacare Plans". There are no Obamacare Health Insurance Plans. Obamacare or the Affordable Care Act is the law that set up the rules and guidelines for the insurance that companies can offer. The law added 10 essential health benefits that must be included in a policy and it also changed the way insurance companies could price the plans they offer. Most importantly, the ACA makes it law that you buy health insurance from a health insurance company, effectively making you buy a product from a middleman (insurance), there isn't any government plan to buy.

Myth #2 - The ACA Creates Death Panels

The ACA is the law that establishes the minimum coverage that a health insurance company can provide. In fact, the minimum coverage rules forced Texas insurance companies to offer maternity coverage and mental health benefits to the policy holders. The ACA doesn't create some group of federal bureaucrats that decides who gets saved or who doesn't get a medicine. Obamacare does not create a one-payer system as we described above, it makes you do business with health insurance companies.

Myth #3, #4, #5, & #6 - You Can Keep Your Doctor, You'll Keep Your Current Insurance, You Will Save Money, And This Will Save Taxpayers

Ok, I couldn't resist. While I'm highlighting myths and lies associated with the government's Affordable Care Act, I had to highlight the three or four lies our President told us to get support for Obamacare. First, you CAN keep your doctor if your employer doesn't drop the carrier and network coverage you have right now. If you are going to receive a subsidy, you may be forced into a HMO that doesn't have your doctor in-network.

Finally, we are seeing more and more employers dropping health plans. The President misspoke when he said that the impact of the ACA would be that you'd be able to keep your insurance. The Texas High Risk Pool is closing its doors and thus is another example of an insurance plan that clients cannot keep. Surprisingly, some of my clients were on the Risk Pool and had BETTER deals that what they are seeing on new ACA market. While the Risk Pool was expensive, many liked the plan; too bad they cannot keep it. If you are on the Texas High Risk Pool and you want to discuss new options, please contact us and we'll guide you through the search!

Several of us knew that prices would increase, and we are seeing that now. The only winners are going to be the insurance companies as you are buying a product that is more expensive in January 2014 than it is now, and every US citizen must purchase the product. Good for them, bad for you and your pocket-book.

Last, the ACA does nothing about reducing prices and "bending the cost curve". In fact, I believe strongly that the healthy won't apply and the sick will come in droves to the new plans. The insurance products will be priced too low for the amount of claims and so prices will increase again and more healthy people will drop the coverage and pay the penalties. The taxpayer will be on the hook for the fallout related to this mess and taxpayers will pay all the subsidies for the generous benefits the poor receive at inflated prices.

Myth #7 - Prices For A Plan Are $2,000 Or More Per Person

I was driving to an appointment today and was scanning talk radio to see what information I could hear about the healthcare issue. I heard a guy on Sean Hannity today saying he lived in Texas and that he was in the High Risk Pool and that he quoted plans on the exchange that cost him $3,000/month for just him and $3,000 a month for his wife for a total of $6,000 a month. This is a total fabrication! There isn't a plan in Texas that costs more than $1,500 for a person (and I'm really stretching it) and no one in their right mind would buy that plan! Look, I'm not a big fan of these changes, but making up lies isn't good whether it's the President or some joker on talk radio. Clarity is best and lies are horrible. The ACA and its impact on health insurance is bad enough, we don't have to lie to find things that stink about it! If you want real data on the Pricing Impact From Obamacare please click the link for our in-depth article detailing the real facts from our real life price analysis.

Myth #8 - If My Family Doesn't Make Much Money We Can Qualify For A Subsidy

This could be true, it could be false. We're working on another post right now that will provide more details, but simply stated, if your employer offers you health coverage and pays 50% of the premiums for your insurance, you probably don't qualify for subsidies for the rest of your family! Yikes! Its true, if you are a lower-income earner and your employer offers you health insurance, you might find yourself begging your employer to stop offering health insurance as he'll be costing your family serious money in that your spouse an dependents won't be able to obtain financial assistance. We are working with a number of small employers now that were asked by their employees to talk with us because this issue is very real and could cost lower wage earners thousands in subsidies for their whole family. If you own a small business and want help determining if offering a group health plan is hurting your staff and their families, call us, we are happy to help! Our office number is 713-422-2935.  You can also reach us through our Contact Us page on the Texas Health Design website, or request a free quote online.

There is another segment of the population that will get hurt if they earn too little. Folks that qualify for Medicaid here in Texas don't qualify for the new ACA plans and therefore get the Medicaid program, not a subsidy! For some this is quite shocking. Effectively, they may get a poorer quality healthcare because they don't earn enough!

If you are in a lower-income bracket and your child is on the CHIPS program, do not move them off of that plan. You may qualify for a health plan subsidy to obtain health insurance for the adults in the family, but you do not want to remove the children from CHIPS as they have already qualified and need to stay put. Don't let a well-intentioned but uninformed navigator or health agent talk you into moving.

Myth #9 - The ACA Will Foster A Healthy Marketplace With Lots Of Firms To Choose From

Nope! The ACA actually damaged the competitive environment here in Texas in the individual market place. In our state we had as many as 5 major carriers providing insurance and several smaller carriers. We currently have 3 major carriers offering plans (Aetna is coming but had some plan approval problems with the Texas Department of Insurance) for a total of 4 and United Health Care is simply stepping out for at least a year. There isn't any benefit from losing a competitor in the market place. In fact, I was hoping to see UHC compete with some good pricing at levels similar to the other firms for once!

I hope this myth busting post helped. If you need answers to your questions or have a myth we need to address, let us know. You may call us at 713-422-2935, visit our Contact Us page, request a free quote online, or leave a comment in the comments section!

Jason W Bohmann
Texas Health Design