Kaylee Rains-Saucedo relies on the federal insurance marketplace to insure her family.
Rains-Saucedo, who is wife and mother of two, is a small business owner. She has worked for three years to build her political consulting business. It’s something she doesn’t want to abandon for other employment because she believes in the American dream of owning her own business. Her husband stays at home to care for their children because child care costs are too high, she said.
Her family pays $750 a month for health insurance through the Affordable Care Act marketplace, she said.
But Rains-Saucedo has found herself among thousands of Oklahomans facing sticker shock as they navigate the re-enrollment process. Most are facing soaring costs due to a combination of higher premiums and the end of some federal tax credits that have helped make their health insurance affordable.
The Oklahoma City resident said her monthly premium will rise to about $1,350 to $1,550. She gets a credit of about $400 a month to offset the premium cost.
“Right now, it means I am going to have to choose between having health insurance or being able to put food on the table,” she said.
The Rains-Saucedo said is trying to pick up more business, which will mean more time away from her family.
“It’s just a really big problem for us,” she said. “I honestly don’t know what we are going to do financially yet, until I can find more work.”
More than 300,000 Oklahomans rely on the Affordable Care Act marketplace for health insurance, said Insurance Commissioner Glen Mulready.
And of those, 97% are receiving some level of subsidy to offset their premiums, Mulready said.
Most consumers will see their average insurance premiums increase by 29%, he said.
The loss of subsidies coupled with premium increases represent a “double whammy for the consumer,” Mulready said.
He said he fears the cost increases will deter young healthy people from enrolling. They’ll opt instead to go without health insurance, Mulready said.
“That is not a good situation,” Mulready said. “You need young, healthy people to participate.”
About 289,000 Oklahoman receive the enhanced tax credit of $559 a month, said Rich Rasmussen, president and CEO of the Oklahoma Hospital Association.
Oklahoma consumers receive about $1.9 billion in premium assistance, which is set to end Jan. 1, unless Congress acts, he said.
The U.S. Senate is set to vote on extending those enhanced tax credits Thursday, but the plan may not have the bipartisan support needed to advance.
Jennifer Eastwood, of Norman, buys her insurance through the federal insurance marketplace and receives a subsidy. She said she has several medical conditions, including Lupus, a chronic autoimmune disease where the immune system attacks healthy tissue.
“I am going to lose my insurance and go off all my treatments unless something changes at the last minute,” Eastwood said.
Broader implicationsThe increase in premiums and reduction in subsidies has broader implications for Oklahoma.
According to the Cicero Institute, Oklahoma ranks in the bottom for primary care and physician availability.
The state ranks 48th nationally in physician supply, 46th in primary care doctors and 47th in general surgeons, according to the Cicero Institute, a nonpartisan policy organization.
Of the state’s 77 counties, 75 are health care professional shortage areas.
The problem is particularly acute in rural Oklahoma, where patients have longer waits and spend more time on the road to access care.
Oklahoma already has the second highest rate of uninsured in the country, said Zack Stoycoff, executive director of Healthy Minds, a nonprofit, nonpartisan think tank that tries to improve mental health outcomes in Oklahoma.
For the uninsured, the options are to seek health care through charities, whose services are often overwhelmed and underfunded, Stoycoff said.
The other option is to seek treatment that costs more, such as through a hospital emergency room, resulting in uncompensated care and more costs to the facility, he said.
“Hospitals are already strapped, especially rural hospitals,” he said.
Rasmussen said the changes will hit rural hospitals and providers hard and will impact the health care professional shortage.
The ability to have health care correlates to a person’s ability to be employed and contribute to society, Stoycoff said.
“We want people to be healthy and have insurance, because it is ultimately more cost effective,” he said.
Up at nightThe rising premiums and reduction in subsidies has caused “intense anxiety” for Rains-Saucedo, the Oklahoma City mother and business owner.
She worries about being hit with a large medical bill that will take years to pay off.
“It has just made me stay up at night,” she said.
