Health Care Reform: Questions and Answers
WebMD's Health Insurance Navigator Answers Your Questions
What if I Still Don't Want to Buy Insurance? continued...
The good news for people who already buy their own health insurance -- an estimated 18 million Americans -- is that they will be able to get better coverage, and it may cost less, says Sara Collins, PhD, vice president for Affordable Health Insurance at the Commonwealth Fund, a private foundation and health research group.
"That is something to look forward to, a big difference for people who are buying on their own," Collins says.
Other experts agree.
"There are many wonderful effects of this law that standardize what the product of health insurance is," says Andrew Bindman, MD, a professor of medicine, health policy, epidemiology, and biostatistics at the University of California, San Francisco.
The law will "create a mechanism, akin to a farmers market" to allow individuals to more easily compare prices and products, "and having that competition, the price of the product will come down."
For example, most insurance companies don't offer maternity coverage to women who buy their own health insurance. Starting in 2014, the ACA makes maternity coverage standard on all plans.
It also mandates that insurance companies offer benefit packages that cover treatment for mental health concerns, such as depression, and for substance abuse. That means your plan will pay at least part of the cost if you want to see a psychologist or psychiatrist.
Will my costs go up as a result of the law?
That’s a point up for debate, and the answer you get will likely depend on who you ask and what your current situation is.
The Congressional Budget Office (CBO) projects that by the year 2016, the average health plan premium would be around $5,800, as compared with $5,500 had the law been overturned. And there will be health plans available for sale on the exchanges that will cost less.
However, the CBO said that more than half (57%) of people who buy health insurance on their own will qualify for federal subsidies to help pay for coverage, which will lower actual costs for many people.
Young healthy people may find their insurance will cost more. An Urban Institute study found, for example, that by eliminating insurers' ability to charge people more on the basis of age, small-group markets and individuals will see their premiums rise by as much as $1,400 for people between the ages of 18 and 34 and $800 for people ages 35 to 44.
People with preexisting medical conditions who currently pay high rates for their insurance coverage are likely to see their costs go down because insurers will no longer be able to charge them more for their medical condition.
And, Kofman points out that the law requires insurers to spend at least 80% of the premiums they collect on medical care. This summer, insurers will be returning money to nearly 13 million people who were overcharged for their coverage. "That alone has constrained premiums in many states," Kofman says.
There are other aspects of the law as well, according to Kofman, designed to keep premiums stable so consumers don't experience a huge jump in prices.