Monday morning news often leaves a bit to be desired. I usually scan several newspapers or websites to see what’s out there. I was surprised to see that the Wall Street Journal had a very interesting front page article on the upcoming insurance mandates for the uninsured population of the US. This article contends that insurance premiums for a healthy, currently uninsured, forty year old male in Virginia could more than double from the current rates to the suggested rates for the new Health Insurance Exchanges (HIX) for the January, 2014, deadline. This is incredible, particularly since this is the exact population the insurers WANT to insure to fund the exchanges.
Why is this happening? As I understand it, new insurance regulations mandate insurers to offer more benefits and require them to spend more money on health expenses. The law also allows for subsidies, which in turn, provides incentives for consumers to purchase more robust insurance packages. Invariably, these costs will get passed down 
to consumers. Also, according to a recent Gallup Poll, 43% of uninsured Americans said they were unaware of the 2010 Affordable Care Act’s (ACA’s) requirement that most Americans must carry health insurance or pay a fine. In addition, premium rates could also increase if not enough consumers sign up for coverage. This may definitely be the case given the results of a recent survey, conducted by Princeton Survey Research Associates International, which revealed that 64 percent of the uninsured (who are aware of the requirement) say they haven’t decided whether they will buy health insurance by Jan. 1, 2014. Since the fines are relatively low the first year, many people may opt to wait and just pay the penalty.
So does anyone win in this situation? Perhaps the uninsured, unemployed or low income families who qualify for a subsidy may benefit. They’ll receive lower premiums and have health coverage. However, for the majority of healthy, hard-working individuals, who are currently uninsured, is the benefit of insurance worth the price of the premiums? For many, it might just be a crap shoot. As a physician, I look forward to the day when all Americans are insured, but at what price? What are your thoughts?
