He interviewed some Chicago-area insurers and brokers who were pretty blunt about what consumers will face. Said Dave Stumm, executive vice president at Stumm Insurance, a Chicago-based brokerage: “Yes, rates are really low, but that’s like saying ‘Here’s a free car,’ but if it costs you $500 a month to run, it’s not really a free car.” Frost also reported on the problem of narrow networks—at least a problem for some consumers who want a broad choice of providers. Narrow networks may be the price shoppers pay for lower premiums. So where does all this leave consumers?
For that answer, Frost consulted Karen Pollitz now of the Kaiser Family Foundation. Pollitz once worked in the Office of Consumer Information and Oversight at the Department of Health and Human Services and knows the insurance business well. Frost noted that people who don’t qualify for subsidies or very large ones and have little savings might suffer if illness strikes. “They could get slammed,” said Pollitz. “They just won’t have the money. They just won’t.” That won’t be much different than things are now for people who can’t afford the cost sharing their policies demand.
Tip for doing shopping and trade-off stories. Remind audiences of a disclosure statement that might help them understand the deductibles and other cost sharing required by policies. It’s called the Summary of Benefits and Coverage. Insurers are not required to provide it, but shoppers have a right to see it if they ask. Given how confusing the whole task is, it’s a good idea to ask.
Looking ahead. I was speaking at a grand rounds lecture at a Toronto hospital last week, and a man asked about what Obamacare does for prevention. That question prompted me to think about what happened to the prevention fund called for by the Affordable Care Act. Health and Human Service Secretary Kathleen Sebelius borrowed $13 million from a fund set aside for disease prevention and is using the money for grants to organizations that will train navigators. This is a good one for eager-beaver reporters to explore. What prevention programs will lose funding, at least in the short term? What effect might that have on patients? When will the loan be repaid and how will the navigator program be funded in the future given the emphasis on budget cutting? Was enough money allocated for both programs in the first place?
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