美国国家公共电台 NPR Shopping For Obamacare Opens To Mixed Reviews From Consumers（在线收听）

Shopping For Obamacare Opens To Mixed Reviews From Consumers

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And today is the first day that people can buy insurance through the Affordable Care Act for 2017. Many people who get their insurance through the federal health law are worried after news that premiums would rise an average of 22 percent next year.

As NPR - as Alison Kodjak reports, that average masks a more complex reality, one where prices are going up for some but falling for others.

ALISON KODJAK, BYLINE: Health and Human Services Secretary Sylvia Burwell has her work cut out for her. After a week dominated by news of big price increases for Obamacare insurance plans, it's Burwell's job to convince millions of people that they should go online and shop for a good deal. Her biggest challenge...

SYLVIA BURWELL: Helping people focus on what the consumer pays because that's the most important thing. And that's what consumers actually care about.

KODJAK: But it's not always easy to figure out what the consumer pays. That's because the people who buy policies through the Affordable Care Act can qualify for discounts on premiums and out-of-pocket expenses based on their income.

BURWELL: Eighty-five percent of those folks actually receive tax credits or subsidies. And for them, that insulates them from these changes.

KODJAK: That's what's happening to Darvin Bentlage, a farmer in southwest Missouri. Like many farmers, he's been having a rough time recently. He raises corn, soybeans and beef. And prices for all his products have plummeted in the last two years.

When I talked to him late last week, he was pretty upset because he got a letter from his insurer saying his policy was going up $200 a month. Even after his subsidy, he thought he'd be paying $500 a month just for his premium. On top of that, he spends about $300 a month on medications for diabetes.

DARVIN BENTLAGE: So I'm going to be paying close to $10,000 for my medicine and my insurance on a $20,000 income.

KODJAK: But Bentlage hadn't yet logged on to healthcare.gov to shop for a plan. But he did that over the weekend and called me back. He was much happier.

BENTLAGE: It comes up that I get a $664 tax credit.

KODJAK: Wow, so that's about double what you were getting before.

BENTLAGE: Yes, that's about double.

KODJAK: He says he found a plan that will only cost him about $150 a month, and it has a lower deductible.

BENTLAGE: So that was a pleasant surprise, you know.

KODJAK: Bentlage says he's glad he doesn't have to go without insurance like he did before the Affordable Care Act. At that time, he couldn't find coverage because of his diabetes.

BENTLAGE: No. And I went through those colon surgeries and had to go through and refinance the farm.

KODJAK: If Bentlage is the story Sylvia Burwell wants to hear, Will Denecke is her nightmare.

Denecke is 63, and he's a self-employed urban planning consultant in Portland, Ore. He makes too much money to qualify for financial assistance. He's also pretty healthy and doesn't use much medical care. But his premiums have almost tripled in the last three years. To him, it's just too much.

WILL DENECKE: I am not willing to pay $930 a month for coverage and to pay a $3,000 deductible.

KODJAK: Unless he can find a better deal.

DENECKE: I'm going to hope that if I have a health issue, I can go back during the middle of the year - not during open enrollment - and go on to the marketplace and buy insurance.

KODJAK: Now, people are only supposed to be able to buy insurance through the ACA mid-year if they've had a big change. Maybe they got married, or they lost their job. But Denecke says those rules are easy to get around. He knows from experience.

DENECKE: I've done it before, and my broker helped me. The great thing was we got an answer, like, in two minutes.

KODJAK: Denecke's actually a supporter of Obamacare in theory. And he's aware that what he's thinking of doing could undermine the whole system. That's because insurance only works if sick people and healthy people both buy in. But if lots of people abandon the program, the people who run Obamacare will be spending next fall trying to explain even more price increases.

Alison Kodjak, NPR News.