Gambling with our health in 2016

by Rachelle Chang, Better Hawaii, December 9, 2015

Last month, I received a renewal letter for our 2016 health insurance coverage, and I was shocked to read that our monthly premium is going up over $200 – an increase of 34%. To be able to afford health insurance, we are downgrading our health care plan even more, with a very high deductible.

We are gambling with our wallets, hoping that we will be healthy in the coming year.

This is not the first time that our health insurance premiums have skyrocketed. In 2010, under the Hawaii Prepaid Health Care Act, we had a very good health care plan with our employer. Over the years, premiums slowly increased for our family of three, but we had time to adjust. Four years later, we felt the jarring impact of the Affordable Care Act: our monthly premium went up over $200 – an over 30% increase. Then, as now, we switched to a lower-benefit plan in order to afford our health insurance.

I know that health care is expensive. I know that the costs of providing health care increase every year. I know that we have access to good health care in Hawaii. And I just learned that Hawaii’s health care premiums are among the lowest in the nation, according to the Centers for Medicare and Medicaid Services.

Now I am apprehensive that next year when premiums increase, there is no other “basic” plan that we can downgrade to in order to keep our premiums affordable.

I thought that adding more people to health insurance plans would result in some economies of scale and cost savings in the long run. But in the case of health care, more demand results in higher costs.

Based on my experiences with health insurance in Hawaii, I have three suggestions:

Suggestion #1: We need to make health care premium increases more gradual. The Hawaii Department of Commerce and Consumer Affairs Insurance Division approved a 2016 rate hike because health care providers say it is necessary. A 20% or 30% increase isn’t affordable for most of us. I’d like to be able to limit the percent increase of health care premiums (and state taxes too). It all comes down to figuring out how we can make drastic rate hikes unnecessary.

What if we could limit annual health care premium increases to a set percentage or dollar amount? This would help us budget our money for the coming year.

Suggestion #2: We need access to up-front, published rates for medical and dental services. I would like to see doctors, dentists, optometrists, specialty-care physicians, clinics, and hospitals tell us the costs for services, labs, and procedures without insurance. This would help us compare rates and levels of service among health care providers, and figure out which level of health insurance works for us.

What if doctors decided to accept “cash only” (cash, checks, and credit cards) for services, and individuals were responsible for getting reimbursed from health care insurers? Would this lower the cost of health care, because doctors could focus on serving patients, instead of billing? Would this make individuals more proactive about preventative care and more cost-conscious about health care?

Suggestion #3: We need to move away from health care through employers. By linking health care with individuals, there’s no loss of coverage if we change jobs and we don’t need to rely on employers to make health care plan decisions for us.

What if we received a Health Care Card in addition to a Social Security Card upon birth or naturalization? We could automatically sign up children for pediatric medical and dental plans at the same time that parents fill out birth certificate forms.

Do you think that the Affordable Care Act has been good for Hawaii? How has the Affordable Care Act affected you?