Insurance Companies are Making You Pay More for Less Coverage
The bureaucracy. The hidden costs. The specialty tiers.
It seems like they’ll do anything to find a reason not to help you when you need it most.
It’s time to shine a light on an industry that blames everyone but themselves for our broken healthcare system.
Infographic - A Closer Look
In the news
Insurers are raising the 2017 premiums for a popular and significant group of health plans sold through HealthCare.gov by an average of 25 percent, more than triple the percentage increase of this year’s plans, according to new government figures.
The steep increase in rates serves broadly to confirm what has become evident piecemeal in recent months: Prompted by a burden of unexpectedly sick Affordable Care Act customers, some insurers are dropping out while many remaining companies are struggling to cover their costs.
The figures, announced by federal officials Monday, injected a new round of uncertainty into the future of the insurance exchanges that are a core feature of the 2010 health-care law. Health policy experts said the rising prices and shrinking insurance options add tumult to the coming ACA enrollment season. The data immediately touched off a fresh round of criticism among the ACA’s persistent Republican congressional opponents.
Last week, America’s Health Insurance Plans (AHIP) President Marilyn Tavenner and American Hospital Association President (AHA) Rick Pollack took to The Hill with an op-ed that continued to spread pervasive myths against our industry.
In their op-ed, Tavenner and Pollack claim drug prices are the reason insurance premiums are on the rise: “Unjustified and unaccountable spikes in prescription drug prices are the engine of higher costs.”
That is false.
The truth lies in the insurance industry’s own rate justifications that show prescription drugs are not the cause of rising premiums. According to a study from Avalere, a leading policy consultant to the insurance industry, on premium increases in 2016, “premium growth is primarily driven by inpatient and outpatient hospital spending.” And a more recent Avalere study found that, “outpatient spending is expected to be the largest driver of premium increases in 2017”. Drug costs accounted for merely 14 cents of every dollar increase in premiums.
For years, insurers dropped sick people from their plans or denied coverage due to preexisting conditions like cancer, keeping them from the care and medicines they needed. The Affordable Care Act (ACA) was supposed to make it unlawful for insurers to refuse coverage to such individuals or charge them more for health insurance. But it is still happening.
No longer able to keep patients off their plans outright, insurers have resorted to other ways to discriminate and avoid paying for necessary treatments. Specifically, they have imposed specialty tiers and high copays or coinsurance for prescription drugs that effectively force sick people to delay needed care or to find a different health plan. So much for the end of preexisting conditions.
Covering fewer sick patients translates to bigger profits for Big Insurance, but less health care for those who need it most.
Patient Denials In The News
Morgantown Family Fights for Life-Saving Medication
This is why Bio supports patient access to life saving medications.
Krista Sizemore's brain was crying out for heroin. But she knew she was pregnant. She knew her baby needed her to stay safe. She knew what could happen if she used again.
Melanie kept paying more in premiums, but her insurance company wouldn’t cover all the drugs she needed.