Sep 27, 2013 by

by Donna Garner



Texas Public Policy Foundation has produced a report today that verifies how bad the “train wreck” of Obamacare would be for Texans.  I have posted excerpts from this report below.


This TPPF report should give us just that much more motivation to call every U. S. Senator and plead with him/her not to vote for cloture which would cut off debate on the House’s CR and allow Harry Reid to strip out the defunding of Obamacare.


Senator Cornyn should be ashamed of himself because he has indicated he will vote for cloture. His phone lines have been shut down with so many calls, but he can still be reached on his Facebook pages.


A few additional points on the health exchanges that I believe are important for the public to know:  Many of the people on the health exchanges have never had health insurance before.  Even though some of these people will qualify for federal tax credits, they think since they will be paying premiums that their healthcare expenses will all be covered.  Not so.


The four health exchange plans are Bronze, Silver, Gold, and Platinum.  All four cover the same benefits and have the same out-of-pocket cap on expenses for a year – $6,350 for an individual, $12,700 for families. It is the amount of the monthly premiums among the four plans that varies.


What these “newbies” do not realize is that if they decide on the Bronze plan with the lowest premium, only 60% of the person’s medical costs on the average will be covered; and they will have to pay out of their pockets for the difference up to the annual out-of-pocket cap  ($6,350 a year in out-of-pocket expenses for an individual, $12,700 for families).


The Platinum plan has the highest premiums, but it still covers only 90 % of the costs – still leaving 10% (up to the yearly cap) to be paid by the patient.


This will be a huge shock to the “newbies” who think that once they pay their monthly premiums, everything else will be covered.


It will be possible for a few of these “newbies” to get tax credits along with the out-of-pocket costs, but only people who choose at least a Silver plan will be able to apply for cost-sharing subsidies.  Those who choose the lowest monthly premium plan (Bronze) will not be able to apply for cost-sharing subsidies.


(9.11.13 – “Applying for health insurance? Homework involved” – by Ricardo Alonso-Zaldivar – Associated Press:



Please go to this link to read the entire 9.26.13 Texas Public Policy Foundation article (with charts):


TPPF Policy Review

ObamaCare to Increase Average Individual Premiums in Texas

By John Davidson, Health Care Policy Analyst

The release this week of data about the 36 federal health insurance exchanges by the federal government confirms what the Texas Public Policy Foundation and others have long argued about the plans offered on the federal exchange: premiums on the exchange are significantly higher than pre-ObamaCare premiums.

According to HHS’s data, the average cost of a catastrophic plan for a 27-year-old in Texas will be $153 a month on the federal exchange. Compare that to an average of the three cheapest catastrophic plans currently available to that same 27-year-old in Austin, which is $59 a month. That’s a 158 percent increase.

The HHS press release doesn’t point this out, but instead insists that “premiums nationwide will also be around 16 percent lower than originally expected.” But that’s only compared to what the Congressional Budget Office estimated rates might be in 2016, not what rates are right now in the individual market.

That’s an important distinction that HHS intentionally is at pains to avoid because it undermines the administration’s narrative that the Affordable Care Act will lower premiums for most Americans. In fact, the opposite is true. Even for a 40-year-old man, the average “bronze” plan on the exchange in Texas will be 88 percent more expensive than it was prior to ObamaCare.


Although premiums won’t go up for everyone seeking insurance on the exchange, they will go up for most people. The reason for this is simple: the ObamaCare exchanges are designed to work only if large numbers of young, healthy people purchase more expensive coverage and offset the cost of insuring older and sicker people.

Another thing to keep in mind is that premiums are not everything. Also important is the network of providers these exchange plans will offer. Because insurance carriers had to include a standardized set of government-mandated benefits for all exchange plans, the only option they had to control cost was to restrict provider networks. The result is that many of the exchange plans will severely restrict access to doctors and hospitals relative to typical private health insurance plans.

The bottom line is that ObamaCare makes health insurance less affordable. This should not come as a surprise to close observers of the “train wreck” that is the Affordable Care Act, and in fact we have been saying this for months. Now, finally, we have the data to prove it.


Donna Garner

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