You know who is getting screwed by ObamaCare? All the people who live in states where Medicaid wasn’t expanded or where the state didn’t conduct insurance rate reviews. Rural areas have higher rates because they have fewer hospitals and, therefore, less price competition, but Republican lawmakers and governors have made a tough situation much worse. They have actively discouraged insurance companies from bidding for customers, which has resulted in fewer plans, which has driven up prices. Not only are Wisconsinites paying double what Minnesotans are paying for the same plans, but people in rural Georgia are getting shafted when compared to folks in Atlanta.

In rural Baker County, Ga., where there is only one insurer, a 50-year-old shopping for a silver plan would pay at least $644.05 before federal subsidies. (Plans range in price and levels of coverage from bronze to platinum, with silver a middle option.) A 50-year-old in Atlanta, where there are four carriers, could pay $320.06 for a comparable plan. Federal subsidies could significantly reduce monthly premiums for people with low incomes.

The people who are really hurt are folks who make too much money to qualify for subsidies and that live in rural areas of Republican-run states. In other words, the Republicans’ strategy has basically resulted in their strongest supporters paying double what Obama’s strongest supporters have to pay. And, while prices would be somewhat higher for rural folks anyway, at least until more competition is introduced, the bulk of the disparity is not explained by the law, but by bad decisions by Republican officeholders that have screwed their own people.

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