Health Team

Insurance changes force some into health exchange for coverage

Posted October 1, 2013

— Enrollment for health insurance under the Affordable Care Act began Tuesday, and some people complained that the federal law was driving up the price of coverage.

Blue Cross Blue Shield of North Carolina, the state's largest insurer, expects two-thirds of its individual customers will see rate increases next year similar to those of recent years. The remaining third will see larger increases because of changes associated with the Affordable Care Act, spokesman Lew Borman said.

Under the law, most health plans must cover so-called "essential health benefits," such as maternity coverage and pediatric dental coverage. Some of these items were previously optional, and Borman said more than 200,000 individual and small-group customers must upgrade their coverage to meet the new requirements.

"Some of these essential health benefits, I wasn't paying for those because I didn't need them. But now, I'm required to pay for them in this new plan. I'm never going to use them," Amy Williamson said Tuesday.

Williamson, the controller for a small Web design company, has purchased her own insurance. She said her monthly premiums have been $192, but Blue Cross recently told her she would have to start paying $314 a month for coverage in January.

"I, honestly, was absolutely shocked. I wanted to go on all social media sites and post how mad I was about it," she said.

Borman said the health care law also required various taxes and fees, such as for pharmaceuticals and medical devices, that Blue Cross is passing on to consumers.

Blue Cross Blue Shield of North Carolina (16x9) Blue Cross says new coverage requirements drive up costs

Company health plans in place before the law was enacted in March 2010 can be grandfathered in and provide less than the "essential health benefits" as long as no changes are made to benefits or the percentage of premiums paid for by employees.

Because of the premium increase, Williamson turned to North Carolina's online marketplace to shop for insurance.

"I'm keeping my fingers and toes crossed that I'll be able to find something on the marketplace or maybe with another provider besides Blue Cross Blue Shield," she said.

The Affordable Care Act requires each state to have an online "health exchange" where people can compare coverage and cost options from various plans and sign up for coverage.

Angela Caraway, who has a lung condition that has meant expensive premiums, was enthusiastic about being able to shop for insurance through the exchange.

"I've been uninsured for four years," Caraway said. "(The exchange) means an opportunity to feel like I'm part of everyone else who is receiving health care coverage."


This story is closed for comments.

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  • pedsrndad Oct 11, 2013

    Welcome to Obamaworld Healthcare. Hate to say it but we told you so if the plan was passed. Listen next time. If the government tries to sell you on some plan or other, double their estimate of costs and cut in half the estimate of benefits to even come close to reality.

  • Combat MP Oct 3, 2013

    junkmail15 doesn't live in the real world. My company health care cost has risen 10% (company used to pay 85% of cost now pays 75%). My wife now has to file a claim on her insurance before filing a claim on mine. This is called coordination of benefits... part of ACA. Diagnostic services are now billed as Outpatient services... part of ACA. My daughter's vist to have an x-ray was a $35.00 copay. Now the cost $345.00. Her visit to Wake Forest-Bowman Grey diagnostic visit should have been a $35.00 copay. That one cost me $978.00 (73% of the total cost). This is part of the ACA requirement that all brick and mortar facilities charge Outpatient rates for all services that had been previously deemed diagnostic services (x-ray, cultures, general and specific lab test). This came straight from the Accounts Receivables offices of WFBG Hospital and CFV Hospital.
    Tell me again junkmail15 that my cost haven't gone up and will continue to rise.

  • skeeter II Oct 2, 2013

    I do not understand why many people are surprise about the "Health Plan". The then head of the US House said "vote for the bill and then read it to see what is in it"! There was not a printed copy of the plan for anyone to read until days later! Many of the "changes" were made administratively and not specifically in the bill that was passed! Many more changes will be implemented administratively soon to exempt labor unions and others from the effects of this law.

    There are probably more surprises that will not be known until after January 1, 2014 when the law goes into effect! Stay turned for later updates.

  • souljp1 Oct 2, 2013

    I already had insurance and I should not be forced at GUNPOINT to pay for other people to buy insurance- whatelseisnew... With this type of mentality and plenty on here have it, Who do you all think pays for now for uninsured when they go to the Dr. or ER and dont pay the bill? DUHH

  • Wake1 Oct 2, 2013

    C'mon! Is anybody really surprised??? BCBS is a cash generating machine! They have several billion $'s in their reserves & they do not want to refund any of this back to the policy holders! Their CEO makes around $2.5 million!

  • junkmail5 Oct 2, 2013

    The annual cost increases slowing had to do with the economy and nothing to do with ObamaCare- whatelseisnew

    citation needed

    I already had insurance and I should not be forced at GUNPOINT to pay for other people to buy insurance- whatelseisnew

    No guns at all are involved.

    But you already are 'forced' to pay for schools you might never use... and roads you might never use.... and a military that hasn't had to defend our actual country directly in your lifetime... and a wide variety of other things FAR less vital than peoples basic health.

    The cost increases are much greater than what you and the media are pretending.- whatelseisnew

    citation needed

  • AConservativePerson Oct 2, 2013

    The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

  • whatelseisnew Oct 2, 2013

    "And annual cost increases have slowed dramatically starting in the year the first elements kicked in."

    The cost increases are much greater than what you and the media are pretending. Billions in new taxes were not counted as part of the cost. I really wish there was a way for taxing only those foolish people that think this legislation is helpful.

  • whatelseisnew Oct 2, 2013

    "There'll be some grumbling and griping, and before you know it, 97% of the population will have insurance without the economy collapsing."

    I already had insurance and I should not be forced at GUNPOINT to pay for other people to buy insurance, nor should anyone else be forced to do that. As to the economy, much damage has already occurred and continues. Government is going to HAVE to seize ever more money to pay for this insane program. Every tax they put in place that involves businesses is getting passed directly to the consumers either in their insurance premium or in their bill from a medical provider. The damage being done to seniors is especially despicable and that is only going to get worse. BUt hey you go right ahead and enjoy the damage and continue pretending it is not happening.

  • whatelseisnew Oct 2, 2013

    "And annual cost increases have slowed dramatically starting in the year the first elements kicked in."

    The annual cost increases slowing had to do with the economy and nothing to do with ObamaCare. ObamaCare ADDED billions upon billions of taxes to the cost side of the ledger. Anyone thinking this insanity reduces health care costs or the ACTUAL health insurance costs is just simply ignoring the facts.
    NOw MY insurance was inexpensive and met my needs. Now the best I can do is obtain a different policy at more than DOUBLE my current cost. As to what will happen next, premiums AND health care costs AND the taxes will increase substantially. I am absolutely amazed that people support the damage that is being done to far more millions of Americans that the tiny number of Americans it helps. The Dems that voted for this should ALL apologize and immediately resign from Congress. John Roberts should resign from the court along with the other four imbeciles that ruled this to be consti