Obamacare costs up, choices down in Missouri and Kansas

Insurance companies have left both markets

KANSAS CITY, Mo. -
It's helped tens of thousands of Missouri and Kansas residents get health insurance.
 
But records the 41 Action News Investigators have obtained from those states show the Affordable Care Act or Obamacare is getting less affordable as options dwindle.
 
 
The first day of November marks the beginning of open enrollment for both Missouri and Kansas.
 
Months ago, the nation's biggest health insurer, UnitedHealthcare, announced it was dropping out of the ADA due to nearly a billion dollars in losses in the last two years.
 
 
 
 
Those decisions are having an impact on both Missouri and Kansas. 
 
When Mark Goodman retired from his job, he was able to get COBRA health insurance.
 
Under that plan, you pay all the cost of your former employer's coverage.
 
But when the time frame allowed on that plan ran out, Goodman realized the Affordable Care Act was his only option.
 
"I found out that the Affordable Care Act was so much more expensive than what I previously had been on," he said.
 
 
 
Here's how the costs compared in Goodman's case.
 
Cobra's monthly premium was $1,566.
 
The ACA's monthly premium was $1,247, but only covered three of his four family members.
 
COBRA's network deductible was $2,600 versus $12,000 for the ACA.
 
After that deductible is met, Goodman would pay 10 percent of any claims with COBRA and 30 percent with the ACA.
 
"COBRA used to be the expensive form of insurance which everyone told me for years. Now it's something you want to do," Goodman said.
 
"Well there's no easy answer to this," said Joseph Jefferson of the Good Samaritan Project.
 
That organization helps people with HIV.
 
Jefferson says the ACA has helped Good Samaritan Project clients and other people with chronic health issues get quality health care.
 
But he also says it's far from perfect.
 
"There's a number of places we can look to I think do some course correction with Obamacare, but Congress is going to have to make some tweaks," said Jefferson.
 
One problem is insurance carriers are dropping out of the exchanges.
 
Both UnitedHealthcare and Aetna have left the ACA market in Missouri.
 
It leaves four insurance carriers for the state for 2017 coverage with only one carrier available in most counties.
 
There are two carriers for the Kansas City area, Blue Cross and Blue Shield of Kansas City and Humana.
 
According to healthinsurance.org, Blue Cross is proposing a 29 percent rate increase while Humana is proposing a just under 35 percent increase.
 
 
"I think that anyone who fairly looked at this law when it was passed would realize that that would happen," said Clark Schultz of the Kansas Insurance Department.
 
Schultz says that state is facing similar issues.
 
Blue Cross and Blue Shield was going to be the only ACA option in Kansas.
 
But the insurance commissioner recruited a new provider, Medica out of Minnesota.
 
Blue Cross for the Kansas side of the metro is proposing a more than 28 percent rate increase and a more than 47 percent increase for the rest of the state.
 
Schultz says despite increasing penalties for people who don't sign up, young and healthy people aren't buying ACA insurance.
 
The result is the ACA is covering mostly the elderly and sick people with pre-existing conditions.
 
"It's a little bit like somebody wrecking their car on a Monday then buying insurance to cover their wreck on Tuesday," Schultz said.
 
"I certainly am not one who is interested in wanting to rip apart Obamacare because we have a risk pool problem," said Jefferson. "We definitely have a risk pool problem," he said.
 
The federal government is paying part of the costs or subsidies for more than 80 percent of ACA members in both Kansas and Missouri.
 
Enrollment is up in 2016 compared to 2015 in both states.
 
And according to a recent Bloomberg report, 77 percent of enrollees will still be able to find a plan for under $100 a month.
 
But Schultz fears if costs keep rising and the number of providers keeps dropping, the ACA could collapse.
 
"I think that it could," he said. "I'm very concerned about that."
 
"I'm a sickness away or my wife is a sickness away from going to the poor house I guess because the cost of the insurance is so great," said Goodman.
 
Goodman took his concerns to Missouri Senator Claire McCaskill's office.
 
Goodman says after months of trying to get action from that office, he says one of the senator’s representatives from her Kansas City office told him nothing could be done to help him.
 
Sarah Feldman, a spokeswoman for McCaskill, provided this statement:
“Our office had been in regular communication with Mr. Goodman to address his specific concerns with his premiums and the Affordable Care Act—and we take very seriously our work serving Missourians. While the law has brought health insurance to millions who would never have had it before, it is not perfect, and Claire has worked hard to improve it. She believes we’ve got to make commonsense reforms to the law to make it work better for folks like Mr. Goodman who are unable to find a good option—but those reforms can only happen with the cooperation of her colleagues in Congress who only want to repeal the ACA with no plans to replace it.”
Since Goodman spoke to 41 Action News, his wife found a solution to their family's problem.
 
She took a new job and put the whole family on that company's health insurance plan.
 
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Andy Alcock can be reached at anderson.alcock@kshb.com.

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