OTTUMWA — Some professionals are wondering why Obamacare demands a single 21-year-old male buy a pricier plan that will cover him in case he gets pregnant.
"New plans must [have] all of those 'essential' requirements," said Heather Gerths, the employee benefit agent at McCune & Reed Insurance.
Those requirements tend to be things people may have had trouble getting covered in the past. For example, some Iowa plans limited the mental health benefits. Some of those requirements are gender specific, some are better for older Americans ... yet all must be contained in approved plans.
"The more benefits you have, the more expensive the plan is," Gerths said.
As an agent, she would find the best plan for her clients purchasing individual insurance. There were things some clients just didn't need, allowing her to find them a better value.
Now, it appears, not only must the single 20-something male pay a higher rate so he can have maternity coverage, his plan must also include pediatric care.
In fact, younger people looking for individual private health plans (as opposed to group plans) will pay more. And older people, in general, will pay less. That's because everyone who applies must be accepted without regard to their health. Healthy people pay the same as chronically ill people. So the sick people pay less than they would otherwise. The healthy pay more, she said. There are no more medical questionnaires.
Gerths has been plugging in some real and hypothetical numbers to get estimates to share with clients. And it looks like in general, prices next year will rise. In fact, they'd rise in the next few weeks in other states.
Luckily, said Iowa Insurance Commissioner Nick Gerhart, this year won't be as bad as predicted. His staff asked the insurance industry, like Blue Cross Blue Shield of Iowa, what they needed in order to give their best effort toward making this program work. Their request: more time.