Under the health-reform proposals in Congress, if you can’t get insurance from an employer, you’ll be able to buy a policy through an insurance exchange. But how good will those policies be? We’ve heard from many consumers who bought their own health insurance and wound up with bad policies that were full of holes.
We asked Nancy DeParle, the director of the White House Office of Health Reform, about this problem. Nancy Metcalf, from Consumer Reports Health, told her about Gary Clausen from Atlantic, Iowa, who bought what he thought was a decent health insurance policy. But when Gary got sick with colon cancer, he discovered that his policy wouldn’t cover his chemotherapy, leaving him with a bill of more than $200,000. We asked DeParle how health reform would protect people from this kind of financial disaster.
“Those kind of policies won’t be offered anymore in this new market,” DeParle said. “They’re called ‘Mini Med’ policies, where it looks like it’s a good insurance policy, but when you actually read the fine print, a lot of things aren’t covered.”
And what about people who do have job-based insurance, but the policy costs them too much money? A man named Dudley, who wrote to us from North Dakota, said his family plan costs him $1,200 a month out of pocket in premiums, while his employer only chips in $200. With premiums, copays and deductibles, Dudley estimates that more than 25 percent of his income goes toward health care. We asked the health policy czar if reform would give people in this situation another option.
DeParle pointed to a provision in the reform bill approved by the Senate Finance Committee that takes aim at this problem. People like Dudley with employer-based insurance that’s too expensive or inadequate would be allowed to buy a policy through the insurance exchange, and might qualify for subsidies.
Tomorrow: Small business and the unemployed, the third in this four-part series. (And see our previous post, Health reform: Cutting costs, not benefits.)
--David Butler, communications director, Consumers Union’s Washington, D.C., office
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