Around 31 million people from 19 to 64 years old remain ‘underinsured’ due to the high insurance cost relative to their income. This is the lowest rate in history, according to the survey conducted by Commonwealth Fund.
The main goal of Obamacare is to provide “more secure, reliable, and more affordable” healthcare to all Americans. However obtaining an insurance plan under Obamacare can give consumer’s healthcare coverage, but only at an optimal amount.
Despite the main goal of Obamacare, also known as the “Affordable healthcare act,” 44 percent of the 31 million underinsured Americans are undergoing medical treatment without healthcare insurance.
In order to standardize Obamacare, the law established an “actuarial value,” to categorize in four plans, Bronze, Silver, Gold and Platinum. These plans must cover consumers 60 to 90 percent, and the insured party would be responsible for paying the remaining costs.
The higher actuarial value, the greater the premium cost.
The premium cost calculation are based on a couple of factors like, how often a consumer would probably claim the plan, where the consumer lives or operates a business, and the number of competitors the consumer has in the marketplace.
Policy holders are also subject to a deductible. This is the amount a consumer or co-payer needs to pay up-front before the insurance begins to cover.
The Affordable Healthcare Act needed an insurance deductible to lower the risk a consumer can make, as they are responsible for covering a substantial portion of costs from an emergency injury or from a catastrophic event.
“The steady growth in the proliferation and size of deductibles threatens to increase underinsurance in the years ahead,” according to Commonwealth Fund.
Once consumers pay their premium and deductible, they would need to shoulder a ‘co-pay fee’, that can range from $20 to $100 for every emergency room visit.
All policy plans under Obamacare have a maximum out-of-pocket clause. After paying all required deductibles, co-pay, and more, for their policy to cover them 100 percent, they would need to pay a remaining cost depending on their plan.
Millions of Americans are now suffering a high out-of-pocket cost which leads to less coverage than what they expected under their health plan.
President-elect Donald Trump vows to “repeal and replace” Obamacare, but failed to give specific plans to reduce consumers’ out-of-pocket costs. Some propose to change the structure of the insurance industry to lower the deductible cost. Others say a law needs to be passed to address the loopholes in the currents system that burdens the policy holder with high unexpected out-of-pocket costs.
According to a Tennessee Health Commissioner, healthcare exchanges in the state are “very near collapse.” While some insurance companies in North Carolina are now suffering from a “financial sinkhole.”