Affordable Care Act driving some premiums up


In looking into this, we talked to health insurance companies, and representatives of Covered California, agency implementing the Affordable Care Act in California. What they told us may be a bitter pill to swallow, for those who will pay more.

Cynthia Jaynes thought her family would benefit from the Affordable Care Act.

The author of several young adult books says her family will see a minimum 11 percent increase in her premiums with Blue Shield but that's not what bothers her the most.

"We would have to pay, out of pocket, for all of our prescriptions until we reached that $9,000 family deductible," said Jaynes.

The plan includes three doctor visits, with a $60 co-pay and a free wellness check. But prescription drugs are not covered until Jaynes pays a big deductible.

That's a critical issue for Jaynes because she suffers from migraines but it will cost her another $330 a month to upgrade. She makes too much money to qualify for subsidies.

"I wanted the Affordable Health Care Act. The problem is, is it's not affordable," she said.

"You have to understand that health insurance is not cheap. We are really trying to make it affordable, but it's not going to be inexpensive," said Dana Howard of Covered California.

Howard emphasizes that 2.6 million people qualify for assistance in the state. And another 2.7 million people will be able to take advantage of enhanced benefits, such as an elimination of the current cap on benefits, or guaranteed maternity care.

"The fact is over a million people are going to get subsidized coverage. Some people don't get subsidies. Those are the people who make more money," said Patrick Johnston of the California Association of Health Plans.

That's of little consolation to a Novato woman who sent us her notice from Kaiser showing a premium increase of 106 percent. She too does not qualify for subsidies.

Johnston says under the law anyone who has to pay more than 9.5 percent of their income for health insurance is exempt from having to purchase it.

"This is a good system to make sure that those that need help get it, and no one pays such a high amount that they could be bankrupt," said Johnston.

There's no estimate of how many will have to pay more for their coverage. But California says it's a much smaller percentage than those who see enhanced benefits.

"People are guaranteed that they're going to be able to get insurance and on top of it, being guaranteed, meaning pre-existing conditions are now out the windows," said Howard.

Jaynes sees the benefits of the Affordable Care Act, but she thinks it needs to be tweaked.

"I do want to emphasize that I don't want the Affordable Care Act repealed. There's too much good in it. It's a fabulous first step," she said.

We should stress that the policy holders in our story don't have employer-sponsored health plans; they pay the full cost of their benefits.

Ninety percent of those who have health insurance are covered by employers, and should not see these types of increases.

Copyright © 2024 KGO-TV. All Rights Reserved.