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Health Care Uncertainty Stresses North State Providers, Hospitals, Patients

You would have to be pretty dedicated to keep up with the national healthcare debate. While repeal and replace efforts seem to have stalled for now, proposals that may go nowhere are nevertheless having impacts across the North State. 

Covered California released their premium rates for next year, and the numbers for 2018 don’t look great for the North State. This is a concern frequently raised by North State Congressman Doug LaMalfa, usually mentioned to gather support for an Affordable Care Act repeal. He brought up the issue at a Town Hall meeting in Chico last week, reminding constituents that premium rates are slated to increase by 33 percent in the North State, or as Covered California calls it, district one.

Thirty-three percent is a pretty intimidating number, but it doesn’t apply to everyone. Joy Melnikow is the director for the Center of Health and Policy Research at the University of California Davis. She says that few people will actually see the increase in their monthly bill, “Even though the rates are slated to go up for premiums, if people are eligible for subsidized premiums, then those subsidies will compensate for the those increased rates”

The 33 percent rate hike applies to those enrolled in Covered California, who do not qualify for a subsidy and make over 400 percent of the poverty line. North of the Sacramento suburbs, that’s roughly less than five percent of the population. You can use the chart below to determine whether or not you fall into that category. If you make more money annually than is listed in the column on the far right, you do.

Credit Covered California

But why are rates going up in the first place? A recent study by the Kaiser Family Foundation found that many insurers are hiking their rates because they don’t know what’s going to happen to the Affordable Care Act.

Dr. Melnikow says that insurance companies are charging more in part, because of Washington’s continuing threat to withdraw federal subsidies. The government currently provides Cost Sharing Reduction (CSR) payments to insurance companies to help keep costs down for low income patients. President Trump has agreed to make these payments for the time being, but has continually threatened to stop doing so.

“If you are an insurance company and you are deciding whether to participate in the exchange and you’re not sure you’re going to get that support, you may decide to continue with higher premiums or to drop out.” Dr. Melnikow says.

Mike Wiltermood, the CEO of Enloe Medical Center, is worried about several other potential cuts to the healthcare industry. If there were to be any cuts to Medicaid, Enloe would take a big hit, right now as many as 70 to 85 percent of their patients have some form of government insurance.

He says that the threats to cut funding make it extremely difficult to budget for the future, “It’s very frustrating because if the government is going to cut it would be nice if they would just make the decision and deal with it so we could adjust. At  present we have no idea what to do. We’re not going to start cutting costs before we know what the impact is going to be.”

The Disproportionate Share Hospitals program also stands to to lose federal funding. The program provides subsidies to hospitals that serve a high number of a patients on Medicare or Medicaid. Wiltermoods says that these government plans pay significantly less than private insurers do and the hospital needs these subsidies to compensate for their losses.

When hospital struggle to make ends meet, the costs are often passed down to patients, “Traditionally how hospitals make up for the uninsured or cuts to Medi-Cal is by increasing the rates for their insured patients. So health care costs may be pushed up.” Dr. Melnikow says.

If you’re worried about rising health-care costs, you should take matters into your own hands. One option is to talk to an insurance agent to make sure that your plan is actually the best for your needs. You can get in touch with an agent from Covered California. If you have a high deductible, make sure you have enough on hand to pay it should you ever need to. If you can’t pay for the healthcare you need, call your local representative.