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ObamaCare’s Essential Health Benefits are No Free Lunch for Texans

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November 13, 2013 | 2,510 views | Post a comment

By Penny Nance and Michelle Smith

Don’t mess with Texas women. Not kidding. While visiting three cities in West and Central Texas this month, it became abundantly clear that they were less than pleased with ObamaCare. They were specifically steamed about the increased premiums as a result of the government’s mandated “free” preventive services that almost all health plans must provide as part of the “10 Essential Health Benefits.” But if it’s free, what gives?

The website explains, “All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider.” The list includes tobacco use screening, abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked, alcohol abuse screening and counseling and obesity screening and counseling to name just four.

The dirty little secret of ObamaCare is that insurance companies cannot charge specifically for these services, but that does not mean they cannot raise premiums overall. And guess what they are doing because they have been forced by the government to offer these services? They are raising premiums. Who could have seen that coming? In fact, according to Forbes Magazine the average healthy Texas woman age 27-40 will see her premiums increase 27 to 28 percent, and the average healthy man age 27-40 will watch his go up 77 to 88 percent. So what about the skinny Texas Southern Baptist gal who never smokes or drinks, does she want to pay for these so called “essentials”? She wouldn’t, but under ObamaCare she must.

The administration claims they are free, so what difference does it make? Well, anyone with a basic understanding of economics knows that there really is no such thing as a free lunch. the question should be, if one doesn’t need these services, why would one buy them? Of course, they wouldn’t, but under ObamaCare, all plans are required to include them. And you are forced to have health insurance or be penalized with a fee. So then, how could a doctor offer these services for free? She would lose money if her practice did this because tests and her time cost money. If a doctor could not offer these services for free, how can an insurance company?

The short answer is they cannot -- they are passing the costs onto Texas consumers.Whitney Johnson of Texas tells CWA that ObamaCare leaves her worse off even though she has pre-existing conditions, which ObamaCare promised to ignore. Her insurance which she found to be “a blessing from God” has been canceled because herplan “doesn’t conform to the Affordable Care Act.” The termination letter directed her to to find a new plan. Being a strong Texas woman, Whitney quickly looked for a solution only to discover that under ObamaCare she will go from paying $325 per month to over $1000.
Whitney notes that under ObamaCare, “I cannot be turned down by any insurancecompany but what does it matter if I cannot afford to pay the new premiums?” Good question!

She will have these “essential health benefits:” ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and pediatric services but not the plan she liked and on which shedepended.

The point of the government’s power grab for healthcare was supposedly to help women like Whitney and the thirty million uninsured in this country. Unfortunately, the Congressional Budget Office estimates that even with ObamaCare, 26 to 27 million Americans will remain uninsured and many of the rest will be less satisfied with their health insurance.

Many Texans will be paying more money for less usable health care. “Free” health care benefits sure are expensive.

Penny Nance is President and CEO of Concerned Women for America Legislative Action Committee. Michelle Smith is State Director for Concerned Women for America of Texas Legislative Action Committee.
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