How The Minnesota Affordable Care Act Crisis Proves We Need Single Payer
Update 11–2–16: I believe these rate hikes were planned by insurance companies to influence the 2016 election. Up until 2014, MNSure was affordable and Obamacare was working in the states that actually tried to implement it. Then boom, they have 59% increases in some cases in premiums.
There are people across the country complaining about health insurance hikes that live in red states where exchanges were never set up. In other words, they are complaining about something they never had. Obamacare. This is the sleeper issue of this election. I think insurance companies are trying to manipulate the election.
Republicans are licking their lips in Minnesota. They get to point to the Affordable Care Act (Obamacare) and declare, “It’s not working!” They are absolutely right. It is not. It started out a rocky love affair. Much like the federal website, the state website was not initially working. Once it did, the rates for insurance were pretty darn affordable. Things were looking up.
There were many insurance companies to choose from. Medica, Blue Cross/Blue Shield, HealthPartners, PreferredOne, UCare. They each had four levels of care: Platinum, Gold, Silver, and Bronze. Each level had different variations of plans with different deductibles, copays, etc. Given what you paid for, and what people with employers pay for their insurance, the insurance was a bargain. It cost anywhere from $200 to $900 a month depending on your plan.
For example, my husband and I had to buy our insurance privately on the MNSure exchange in both 2014 and 2015. Due to my high medical expenses, we wanted a premium plan with a low deductible. We paid just under $800 a month for a Platinum Blue Cross/Blue Shield plan the first year. It went up to about $950 a month the next year.
Is this amount cheap? Affordable? For what we were getting it was. We got far more in health care than we paid in. That was the problem. A lot of private insurance customers were paying in less than they used. It might still have seemed like too much money for us to afford, but it was worth it for what we got.
Then another problem occurred, not enough people enrolled. The MNSure program were aiming for 100,000, and got less than half of that. In the insurance game, more people is critical, because you have to distribute risk. Healthy people weren’t signing up for insurance. Only sick people seemed to be.
Companies started to complain they were losing money on MNSure customers until Preferred One and Blue Cross/Blue Shield pulled themselves completely out of the MNSure exchange by 2016. So now, as private insurance customers are signing up for 2017 open enrollment next month, the prices of insurance have been announced, and they are up to 67% higher. Wow. So, next year my husband and I would be expecting to pay $1500 for our monthly insurance payment.
The cost of insurance is offset by tax breaks for people with salaries up to just under $50,000. The premiums in Minnesota were so low, many people didn’t even qualify for the tax credit. That will obviously change.
Here’s what all of this proved. There were a lot of uninsured people who did want insurance, and they were motivated to get it, because they needed to use it. The large numbers of people who didn’t enroll voluntarily were no doubt healthy and willing to pay the fine for going without insurance. Insurance companies have no interest in offering insurance to a group of people with actual health expenses. It is the flaw of the private insurance model.
There is no solution that will allow for these sick customers to get health care at an affordable rate WHILE still allowing a private company to skim a profit from them. No equation allows for that. The only way to address this is a single payer, non-profit system. So while Republicans in Minnesota may be excited about their chance to replace Obamacare, they should be aware that the ONLY logical way out, the ONLY solution left is single payer. Other countries have tried other ways. They always come back to single payer. Nothing else works.
We’ve tried tweaking private insurance. That’s what Obamacare was. A conservative’s answer to healthcare reform. It has failed. If Minnesota couldn’t do it, it shows the Massachusetts model doesn’t generalize. It is now time to implement Medicare for All.
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