With most of today's Americans insured through the employee benefits they get through their workplace, business owners are largely interested in what plans cover. However, there is also the issue of what services aren't provided for, or those that must be paid out of pocket by consumers. After examining the variety of metal plans offered through the health exchanges and set up by the Affordable Care Act, the answer to this question depends on the one being talked about.
According to insurance information firm HealthPocket, of the four metal plans analyzed in nine states, expenses for deductibles and other out-of-pocket costs are in a state of flux for 2015. For example, among bronze plans, a decrease in deductibles is on tap, but specialist copayments will be more expensive and there will be a higher maximum for annual out-of-pocket costs. Meanwhile, for silver plans, deductibles will be lower, as will doctor and specialist copayments, not to mention maximum annual out-of-pocket expenses.
Similarly, for gold plans, HealthPocket found decreases across the board, except for maximum annual out-of-pocket costs, which will increase. It's just the opposite for platinum plans, though, evidenced by an increase to deductibles, doctor and specialist copayments, but a decrease to the max amount of out-of-pocket costs on a yearly basis.
Kev Coleman, head of research and data at HealthPocket, indicated that this analysis was done to cast a light on the expenses that are often forgotten about until medical bills are received.
"Early media attention of the 2015 ObamaCare plans has focused on premiums," said Coleman. "But out-of-pocket costs are just as important, inasmuch as they can represent thousands of dollars in annual expenses for a consumer who uses health care services regularly."
Uninsured rate continues to decline
Though a majority of Americans say that the health care law hasn't had an impact on them for good or bad, based on a recent poll performed by Gallup in May, more people are insured since the Affordable Care Act was signed into law, based on several different analyses. For example, between April and June, the uninsured rate dropped by more than two percentage points to 13.4 percent, Gallup revealed in its most recent health care survey. That's down from nearly 16.5 percent in 2010, prior to the ACA being signed into law and from 18 percent approximately 12 months ago.
More specifically, since the first open enrollment period started in October, approximately 9.5 million fewer adults are uninsured, based on analysis from the Commonwealth Fund. The uninsured rate among young adults dropped the most, falling from 28 percent to 18 percent.
The improvement may have been due, in part, to the expansion of Medicaid. Among people below the federal poverty line, the rate of uninsured dropped from 28 percent to 17 percent, according to the Commonwealth Fund's findings.
