Open enrollment provides dose of reality on health costs
Big, heady discussions are unfolding on Capitol Hill over revamping the nation's health care system, but smaller, personal debates are playing out in living rooms and workplaces across the land as many Americans go through the annual ritual of open enrollment.
Michelle Enriquez, a program analyst for the city of Sacramento, said Friday that she agonized over her confusing options to see if she could save money.
"I don't have the option of not taking health insurance," said Enriquez, a single mother with a daughter in college.
Next year, she estimates that her share of the premiums for medical, vision and dental will jump about $75 a month to $536, although she's eligible for a monthly $200 credit that can be applied toward health-related paycheck deductions. "These premiums are outrageous," she said.
The outrage over health care's rising costs is shared across the country as Congress tackles overhaul legislation.
Nationwide, next year's premiums are expected to rise by an average of 6 percent, according to Hewitt Associates, a human resources consulting firm in Lincolnshire, Ill., that tracks the yearly data.
Certainly, there is heated debate about whether the legislative changes being proposed would help contain costs.
Nevertheless, the open-enrollment ritual serves as a dose of reality, according to Anthony Wright, executive director of the advocacy group Health Access California.
"Having people go through open enrollment gives a boost to health care reform," Wright said. "It's a time when people start seeing the problems with the current system. Open enrollment is when they face the increases in the cost of health care and face the limits of what they have."
In many cases, he said, folks face confusion over whether their health coverage is truly adequate to protect them against the financial stresses from medical bills.
Enriquez said she will have to cut back on other expenses to afford the premium increase.
"I suppose we should be grateful we have a job," Enriquez said, "but at this rate, how can we continue to afford to live?"
It certainly could be worse. She could have no health insurance at all, or have to pay the entire cost of premiums herself.
The Kaiser Family Foundation this week estimated that 1.5 million working-age adults became uninsured in 2007 because they lost their jobs.
But for many of the 162 million people still covered by employer-based health insurance in the United States, important deadlines loom. Decisions made in these days of reckoning are crucial, because they usually can't be undone until the next open enrollment period.
Year after year, health premiums continue to rise – more than doubling over the past decade.
Employers expect workers to carry more of the burden – forcing some employees into a quandary during open enrollment. Should they attempt to save money now and opt for a cheaper plan with higher deductibles and out-of-pocket costs, or should they spend more money for a comprehensive plan that offers more benefits?
Dawn Deason, a communications managers for BloodSource, a Northern California blood bank, hasn't worried much about health insurance. She's happy with the coverage she has and plans few changes. She's sticking with her current coverage.
Her premiums, however, have gone up a third for virtually the same coverage. She'll be paying $60 a month, which she calls a bargain for the coverage she gets.
The cost of providing Deason health coverage is heavily subsidized by BloodSource, which employs 550 people from Merced to the Oregon border.
For the past two years, the company has absorbed the increased cost of providing health insurance to its 550 employees, but BloodSource decided to pass on some of the increase next year, said Jennifer Griffith, the director of human resources. "Our employees are seeing a small increase and a few plan design changes, but the impact is relatively minimal."
"All in all, we're not thrilled about the increases, but at least it's manageable," Griffith said.
Recent studies, however, show an acceleration in the rising cost of premiums.
In 2009, the annual cost to provide health coverage for a typical family was $13,375, up from $5,791 a decade ago – an increase of 131 percent, according to the Kaiser foundation.
What's more, employees are being expected to carry more of the load. The typical family will pay $3,515 this year in health premiums, a 128 percent increase over 10 years ago.
"This is really a signal that the problems of rising cost affect everybody, that the increasing cost of health care is not just a theoretical phenomena," said Marge Ginsburg, executive director for the Center for Healthcare Decisions, a nonpartisan policy group based in Rancho Cordova.
"For those with health insurance, this is real," Ginsburg said. "And I hope they're making the connection."
The connection, she said, is that rising premiums and other health care costs are at the heart of the debate in Washington.
"If there's one consistent message we've been hearing about health care, it's that it has to be affordable."
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