The Other Shoe Is About to Drop

Betsy McCaughey is an expert on health care issues who has been highly critical of Obamacare. In a column in the New York Post she warns that the worst is yet to come. Insurance companies will be rolling out their new policies in June and McCaughey predicts that it will not be pretty. She highlights four big problems that will emerge over the coming year: Premium defaults, premium increases, loss of on-the-job coverage, and loss of cancer care coverage. Here's a summary of each of her points:

Premium Defaults: Twenty percent of the alleged 7.5 million people who have signed up in the exchanges have not paid their first premium and aren't covered, but that's not the worst of it:

The bigger question is how many will keep paying premiums. That’s got the American Medical Association, a chief ObamaCare booster, so worried that it’s sending warnings to its members.

Why the concern? First-time insurance purchasers, especially those living paycheck to paycheck, will be shocked by ObamaCare’s high deductibles, about $3,000 for the silver plan (the most commonly selected) and $5,000 for the bronze plan (the most affordable).

Basically, you’ll have to pay thousands out of pocket for appointments, tests and prescriptions until you reach your deductible.

Rather than pay thousands out of pocket for care while also paying premiums, some will quit paying premiums.

That’s why the AMA is worried. Section 1412 of the health law gives consumers a 90-day “grace period” before their subsidized plan is canceled for nonpayment. But insurers only have to keep paying doctors and hospitals for 30 days. The next 60 days of care are on the care provider. The AMA says “it could pose a significant financial risk for medical practices.”

Not only will the deductibles be a shock to consumers, so will the premium hikes which come out in June:

Overall, consumers had to pay far more for individual plans this year. In some states (Delaware and New Hampshire), rates went up 90 percent or even 100 percent, according to a newly released Morgan Stanley analysis.

And insurance executives already are warning about double- or triple-digit hikes for next year. “I do think it’s likely premium-rate shocks are coming,” said Chet Burrell, CEO of Care First BlueCross BlueShield. Aetna CEO Mark Bertolini, one of the first to raise the alarm, said increases “could go as high as 100 percent.”

Meanwhile, 25 million to 30 million Americans could lose coverage in the coming months:

For the same reasons that millions of policies in the individual market were canceled last year, employers who buy plans in the small-group market will have a hard time renewing their old plans this year. Many will have to choose between providing the more costly ObamaCare benefit package or dropping coverage altogether.

Count on employers with low-wage work forces (such as retailers, hoteliers and restaurateurs) to push employees and their families into the exchanges.

And if you have cancer your access to good treatment will be restricted:

Cancer is the leading cause of death in America and our No. 1 health fear. But access to the nation’s top cancer centers is becoming a hot-button issue, as ObamaCare enrollees are finding how few choices of hospitals and doctors they have.

Many plans exclude all specialty cancer hospitals, even though research shows that women with ovarian cancer, for example, live a year longer when they are treated at high-volume cancer hospitals instead of local facilities. But insurers say they’d have to raise premiums for exchange plans even higher if this growing outrage over access to cancer centers forces them to broaden their networks.

If McCaughey's analysis turns out to be correct, it's hard to see how Mr. Obama's signature achievement, Obamacare, will not go down in history as a national calamity.