Individual Market: Patients struggle to keep health care through individual marketplace

Patients struggle to keep their health care policies

Patients that must buy health insurance on the individual market are struggling to keep their health care policies.

Forbes contributor Merrill Matthews describes the situation many individual patients are facing. Since 2014, his wife has been dropped by her health insurance company – not once, not twice, but three times.

“No wonder Politifact awarded President Barack Obama its 2013 “Lie of the Year” award for his Obamacare promise, “If you like your health plan, you can keep it,” writes Merrill Matthews, a resident scholar with the Institute for Policy Innovation in Dallas, Texas. “My wife has been trying to do exactly that for three years, and has failed every time. But at least she was able to keep her doctor—until now.”

“We are paying much more for health insurance than we ever have, and with an almost prohibitively high deductible,” Matthews explains in a piece published at “And yet the only way my wife can see her doctor, or most other doctors in our area, is to pay for it out pocket, just as if she had no health insurance. And now we learn that her current insurer is dropping out of Obamacare exchanges.”

Read Merrill Matthews’s entire piece by clicking here. You can also follow him on Twitter @MerrillMatthews.

In 2017, individual patients can’t avoid rate hikes

Next year, patients shopping on the individual marketplace can’t avoid rate hikes — no matter where they live.

After reviewing data from 18 states plus the District of Columbia, the McKinsey Center for U.S. Health System Reform concluded that patients should anticipate an average premium increase of 11 percent.

“That’s more than double the increase McKinsey measured last year for the same plans in the same group of states,” the New York Times notes. “People who want to stay in their current plan — either because they like the coverage or want to keep a certain group of doctors and hospitals — could face much larger increases.”

Patients could pay more for individual coverage than before the Affordable Care Act

As some patients struggle to find coverage, other patients are finding out they’re been priced out of the individual marketplace.

USA Today reports that insurance commissioners throughout the country are approving big health insurance rate hikes — that, in some cases, exceed the cost prior to the Affordable Care Act.

“Many of next year’s premium rate increases on the Affordable Care Act exchanges threaten to surpass the high and wildly fluctuating rates that characterized the individual insurance market before the health law took effect, interviews with insurance regulators and records show,” USA Today reports. “With dramatic drops in insurance company participation on the exchanges for some states, decreased competition and other factors are leading to often jarring rate hikes. Some of the states that are facing what are likely among the biggest increases this year — Tennessee, Arizona and North Carolina — were among those the Urban Institute reported in May had the biggest increases last year.”

Double-digit rate increases have become normal — with patients in Tennessee facing an “average rate increases of 59%.” It’s not much better in Oklahoma, where patients are bracing for a 42-percent increase in the cost of the state’s lowest-priced silver plan.

“It is quite infuriating to read about how all the insurance companies are losing money, when we rarely, if ever, have utilized our many insurance plans over the years,” Gina Brodie, a patient from Tucson who has chronic arthritis, told USA Today. “Those insurance companies have made nearly 100% profit on us, while we got either zero benefits or zero access to the system.”

Quote of the Day: Individual premiums or the mortgage

“The reality is, these premiums for some families — it’s their family premium or their mortgage. These are becoming very challenging costs from a budget perspective. And some families will have to consider that trade-off.”

— Dannette Coleman, a senior vice president with Minnetonka-based Medica, quoted in the Star-Tribune.

Health and Human Services ignores rate hikes on individual market

About the only person unconcerned with the rate hikes on the individual market: Secretary of Health and Human Services Sylvia Burwell.

On Thursday, Secretary Burwell said that the marketplaces could survive even if Congress takes no action to reform the broken system and struggling health care law.

“The answer is yes,” Burwell said when asked about the viability of the individual market, according to The Hill. “Stability exists even using the administrative tools that we have. We understand premiums going up is a difficult issue, it’s an important issue.”

Could an official be more out-of-touch with the harsh realities facing millions of patients that purchase insurance on the individual marketplace?

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