Peter V. Lee: Don’t be misled by bogus claims of rapidly rising deductibles

More than five years after the Patient Protection and Affordable Care Act became the law of the land and launched a new era of health care in this country, the law and Covered California remain the target of misleading and inaccurate political attacks.

The op-ed “California health insurance deductibles going up” (Page 3I, March 10) is the latest attempt to confuse consumers with a smokescreen of outrageous claims. Fortunately, it is easy to clear the air and find the truth.

The author, Nathan Nascimento of Freedom Partners Chamber of Commerce, mistakenly claims that Covered California consumers need to pay thousands of dollars in deductibles before their health insurance coverage kicks in.

That’s simply not true, and it is irresponsible to make such a misleading claim.

Covered California requires its insurance companies to adopt a system of patient-centered health plan designs that put the consumer first and remove financial barriers to accessing care.

For example, the author does not seem to know that every outpatient service in our Silver, Gold and Platinum plans can be accessed without being subject to the consumer’s deductible. That includes primary care visits, specialist visits, lab tests, X-rays and imaging.

Even our most affordable plans in the Bronze tier promote care, allowing consumers to see their doctor or a specialist three times before being subject to the deductible.

In a historic move, Covered California also put the consumer first when it became the first health insurance exchange in the nation to establish a cap to protect consumers from the high cost of specialty drugs.

All of these benefits are designed to bring health care within reach and to make sure that a Covered California plan is not just an insurance card, but something that opens the door to health care and helps consumers get the services they need and deserve.

In a recent article I coauthored with a leading physician, we urged state-based marketplaces, the employer-sponsored insurance market and health insurance companies to take action and move toward these patient-centered plan designs to help us reach the next level of health reform. We’re pleased the federal exchange is adopting our recommendation for 2017. This will help consumers more easily make apples-to-apples comparisons of plans and make it easier for them to see what services are subject to a deductible and which ones are not.

In addition to promoting health care through our plan designs, Covered California has kept rate changes at historically low levels for two consecutive years, and at a fraction of the rate changes that consumers saw before the Affordable Care Act was implemented.

Consumers can also shop around for the best deal that fits their needs, and in many cases they can actually lower their premiums.

While the author tries to raise the specter of financial doom, noting that some health insurance companies have lost money on a national level, the fact is that nearly all of Covered California’s plans made a profit in 2014. Two new insurance companies joined our exchange in 2016, because it made good business sense for them and it gives consumers even more choices.

California has put the politics behind us, and thousands across the state – Democrats, Republicans and independents – have worked to implement the law in a way that puts patients first. Millions of people have gained health care coverage, cost increases have slowed, consumers have more choices and life-changing care is being delivered.

Those are the facts, and we are all better served by focusing on them instead of misleading hyperbole.

This story was originally published March 16, 2016 at 1:28 PM with the headline "Peter V. Lee: Don’t be misled by bogus claims of rapidly rising deductibles."