Just pointing out the obvious here: when people don’t seek health care because their deductible is too high, they are effectively blocked from getting the care they need. And also, the economy suffers.
Looking forward to hearing more about the new way we will pay for health care in Rhode Island. There is lots of room for improvement. I also hope there is going to be something done about high deductible health plans which are leading to more uncompensated care at hospitals, clinics, and private practices.
RI Seniors: Help! We’ve fallen into the Doughnut Hole and We Can’t Get Out! Please, Senator Whitehouse, come to our aid!
Senator Whitehouse responds below.
Over 13,000 Rhode Islanders Benefitted from Medicare “Doughnut Hole” Fix in 2012
New Interactive Map Highlights Savings for Each Zip Code in State
Cranston, RI – During a visit with Cranston seniors today to commemorate the three-year anniversary of the Affordable Care Act, U.S. Senator Sheldon Whitehouse and Lieutenant Governor Elizabeth Roberts discussed how the health care law is saving money for Medicare recipients in Rhode Island. According to new data, 13,834 Rhode Island seniors saved over $8 million dollars through prescription drug discounts in 2012.
Prior to the passage of the Affordable Care Act, thousands of Rhode Island seniors fell into the so-called Medicare “doughnut hole” and were forced to pay the full cost of their prescription drugs. In 2010, Senator Whitehouse successfully fought to eliminate the doughnut hole as part of the Affordable Care Act.
“Over the years, I’ve heard from hundreds of Rhode Island seniors who were hurt by the doughnut hole,” said U.S. Senator Sheldon Whitehouse. “Seniors should never have to choose between putting food on the table and paying for the medication they need to stay healthy. Fixing the doughnut hole was one of my top priorities when I was elected to the Senate, so I’m proud to see the Affordable Care Act saving Rhode Island seniors millions of dollars every year.”
“While much of the country is still trying to figure out the Affordable Care Act, here in Rhode Island we have been fully committed to ensuring that Rhode Island is a national leader in implementing health reform since the law’s passage in 2010,” said Lt. Governor Elizabeth H. Roberts, chair of the RI Healthcare Reform Commission. “And for Rhode Island seniors who are already benefiting from provisions in the law, such as closing the prescription coverage gap or ‘donut hole’, health reform has improved their lives.”
The doughnut hole exposes seniors to the full cost of prescription drugs after they and their plan spend a certain amount of money ($2,970) for covered drugs in a year, but before they hit catastrophic coverage ($4,750). The Affordable Care Act closes the doughnut hole in phases over a ten-year period.
Because of the Affordable Care Act, in 2011 and 2012 seniors in the doughnut hole received a 50% discount from the drug manufacturers on all brand name drugs. Starting this year, the federal government will subsidize an additional 2.5% of brand-name drug costs for seniors in the doughnut hole. These subsidies will increase each year until the coverage gap is closed in 2020.
In 2012, Rhode Island seniors in the doughnut hole saved $579 each on average.
When’s the last time you called up your local doctor and asked for a price schedule?
From what I understand, Obamacare is supposed to make it impossible to have a health care deductible of more than $2500. Which is high, but I guess it could always be higher.
Out of curiosity, I went to Healthcare.gov to find out what my insurance options would be if I were a 44 year old healthy female looking for coverage. I was prompted to do so by an email from Lt. Governor Elizabeth Roberts, reminding me that we are in the countdown to 2014, where everyone will need to be enrolled for insurance.
The only options that came up for me were provided by Blue Cross Blue Shield and they gave me a range of plans with deductibles from $3,000 to $7,000 a year and premiums with a range of $275 to $400 a month. I had checked the box saying it would be difficult for me to afford care, but fat lot of good that did.
Forgive me, Dear Reader, but this does not sound like Affordable Health Care. This sounds like how to potentially lose a good chunk of my savings as well as pay a hefty monthly premium, all so I can’t have any really meaningful access to care such as mental health benefits and emergency room access without having to go broke. If this is really all the Affordable Health Care Act is doing, I’m not sure it will be an improvement over what we have and may just lead to more medical bankruptcies for the middle class and the poor.
I am withholding judgement for now, as I assume that more options will be listed soon in the directory, such as some more affordable plans from United Health Care or Neighborhood Health Plan. That’s my hope at least. If you want to check it out for yourself, give the Healthcare.gov Finder a try.
…And don’t accidentally use that HSA debit card for something else, or you’ll be sorry. Read on.
How will the new health care system work? By expecting middle class and poor people to spend money out of a health savings account or out of pocket to pay for medical services? Is this part of the “it gets worse before it gets better” scene of American healthcare?
This study has a good graph showing how people in high deductible health plans forego or delay care. It also notes that the incidence of foregoing and delaying care goes up as the poverty of the individual increases. Conclusion: HDHP’s are making access to care even more challenging for the poor. I would like to see how the Affordable Health Care act plans to remedy this.
When low income people end up skipping preventive care and maintenance care for ongoing conditions, their health suffers.