So I just got off the phone with Blue Cross and Blue Shield of North Carolina to find out if my insurance from last year had rolled over into this year. I was getting emails and phone calls from Healthcare.gov that my insurance hadn't rolled over and that my subsidies might be at risk. So I called healthcare.gov first and found out that they didn't have the required paperwork forwarded to them to see if my health insurance from last year rolled over into this year and if there were any changes. So I proceeded to call BCBS and found out that the health plan I had from last year had gone up. I asked the lady what the new price was and she told me $106. I about lost my shit. Last year with this same plan I was paying $45. Thats actually more than 100%. Follow me below the squigly for the rest of the story
So my plan has gone from $45 to $106 in just one year. I started asking the lady did she realize that was over a 100% increase in my premium. She said yeah and that BCBS's rates go up every year. Now I am starting to get furious. I tell her I can understand rates going up 5-15% with 15% being really high, but that !00% increase was just unacceptable. She gave me some excuse about it being the State that sets the rates. So I asked her, so you are telling me your company doesn't set its own rates for its plans, the State does. And she said yes. I really find it hard to believe that BCBS doesn't set it own rates. BCBS basically has monopoly here in NC and have some of the highest rates in the country. But then she decided to tell me that I needed to go back to Healthcare.gov and reapply because since the health plan I had went up in price I would need to have my subsidy reevaluated. So I called healthcare.gov back and they told me that yeah I needed to reapply so that they could adjust my subsidy accordingly. After the 30 min question and answer I was again approved for a subsidy and it brought my health plan down to $86. Which is around 100% of what I was currently paying for my plan.
As you can imagine I have a few problems with what seems to be an unsustainable market here in North Carolina. I don't think the lady from BCBS understood when I was arguing with her over the fact that I realize I got a subsidy and that my plan would be cheaper because of it. What she didn't seem to grasp was that yes it was cheaper for me, but the federal gov't ie all of us, was being reamed by BCBS. Now let me make this perfectly clear. The actual cost of my plan last year if I didn't get a subsidy would have been $320. With my subsidy and cost sharing I was paying the $45. That same plan this year if I didn't get subsidies would have been $460. So thats roughly I think a 32% increase. So if I didn't get any subsidy my rate would still have gone up 32%. So basically BCBS gets a nice check from Uncle Sam and 100% more out of my pocket.
My question is what protections are in place to stop Insurers from screwing over both the Federal Government and the lowly citizen? If BCBS raises its rates the exact same next year then I will be back to paying the exact same amount I was paying out of pocket each month on this plan I was back before ACA was started. Yet not only will BCBS be getting the same from me but will be getting extra money in my name because of the actual total price of the plan from the Federal Government. If they raise the rates the following year I won't be able to afford health insurance even with the subsidy. It will then be over $150 a month even with my subsidy if I keep using the same values. How is this sustainable to me personally and the Federal Government in totality? Add to the fact that BCBS says they raise rates every year and because they do that, everyone has to then go back every year to Healthcare.gov to have their subsidies reeveluated. While thats not a problem and am willing to do it, I don't think that was how this was supposed to work. My only hope is that other folks get just as pissed as I have and can't wait for the day to vote for single payer. At this rate its the only viable health structure I can see, because while ACA has helped out immensely the last year and this year, at this rate it looks like that will be its only reprieve. Hope like the dickens I am wrong.
New Update Thu Feb 05, 2015 at 12:56 PM PT: Just got off the phone with a lady at North Carolina Department of Insurance and she told me that the rate hikes were approved by the Insurance Commission and that if I didn't like the rate increase I had other options than BCBS like United Health and Coventry. I told her Coventry didn't cover my area and that wasn't an option. United Healthcare is offered but their rates are even higher and don't have as broad a network as BCBS and they are strictly HMO as opposed to a PPO. I asked her if this was the agency that regulated the rates the Insurance companies could charge and she said yes. I then asked if they had ever not allowed a rate change and she said of course they have, and then SHE F-ING HUNG UP ON ME!!!!!!!!!!! Unbelievable. Honestly I think I knew more about what Insurance options I had than she did as she had no idea what I was talking about when I told her Coventry didn't cover my area or how the United Healthcare plans differed so much from my original plan. I am at a loss for words at this point.