The last time, Cheryl TSUTSUMI visiting his doctor Kaiser Permanente, costs $ 8. A few years ago, when she had the surgery, it pays nothing for his hospital.
But since Jan 1, TSUTSUMI and others as they are independent, payment for a greater proportion of their medical care. For TSUTSUMI the change represents an increase of up to $ 15 for doctor visits, $ 200 per day, when the hospital and the loss of their dental plan.
TSUTSUMI is one of more than 4500 people recently, a letter from the emperor informed of the change. She said she had not paid extra money and held their usefulness.
Sole Proprietor have found increasingly difficult in recent years, accessible and comprehensive health insurance, given that the state insurers, or the removal of plans or benefits reduced gradually.
The emperor is the younger than the insurer for the elimination of remaining proposed plan, the self-employed. Instead, he proposed the members concerned an individual level, costs about $ 15 less per month, but has much less benefits.
Under the new plan, TSUTSUMI lose their dental benefits, which were introduced by an agreement with the United States, dental.
TSUTSUMI, independent writers, bears a travel ban column with the Star-Bulletin, said he found the health status of their plan premiums edges over the years, but was willing to pay for services as an integral part of maintaining a healthy lifestyle.
But she fears the most recent cuts in benefits and increase Out-of-sac to guess the cost of final disposal of health plan option for people like him.
“I was happy with Kaiser’s care and have been with them for 15 years and I love my doctors. I am disappointed and discouraged, however. At some point, I am very concerned, I’ll give up. ”
In recent years, it became a challenge for the emperor, for the sole owner of affordable plan, “said Claudia Schmidt, Director of Business Development. The only possibility was a few advantages, she said.
“Typically in each health plan market, it is absolutely crucial for the premium low, and in this case, the pool of prospects for the various projects is relatively low, given that the Pre-Paid Health Care Act. We have a real struggle they offer forever, “she said.
Because individuals as TSUTSUMI are not subject to compulsory insurance requires the State employer, it is a small group of less stable and secure, “said Schmidt. It expresses premiums over time.
She compares the reduction of benefits of health care for the adaptation of pro-rata rate to reduce automobile insurance premiums.
“The reason for reducing payments for the same reason, adjust your share in motor insurance for the premium down and make the choice, Pay as you go,” she says.
Schmidt said the emperor hopes to continue to offer at least some people like on the cover TSUTSUMI, but there are no guarantees.
“One thing we try very hard to do is maintain the health of some plans on the shelf beyond what the law requires,” she said.
HMSA has adapted to similar plans in recent years, Vice President Cliff Cisco.
“Our advantage is not unlike what the emperor. A few years ago, we co-pay per visit and things. At a certain point, nobody will participate, you have to keep it accessible, and that it would be to reduce benefits, “he said.
Milton Kwock, director of the Business Action Center, said he observed, plans and benefits disappear over the years and is part of complaints from workers.
“It is always a problem with small entrepreneurs, as occupied or not,” he said. “Many sole owner, or to a spouse or a second job, if they have, they cover health care.”
Lack of political sole owner, and have no protection under the Pre-Paid Health Care Act, and insurers have no incentive for them, “said Kwock.
“There is no industry group for entrepreneurs. … The lawmakers are not lobbyists, and that is how the change,” he said.
State Senator Saturday SLOM, President of Small Business Hawaii, provides more benefit reductions and less choice in the future, both for small businesses and individual entrepreneurs, partly because of a lack of competition in the health-Arena.
“Insurers say she has lost a lot of money, but I think the truth lies somewhere in between. I think we can expect more of this,” he said.
Furthermore, with large groups, are protected by the Pre-Paid Health Care Act, nobody is concerned that in the various contractors’s Not, he says.
But there may be some relief on the horizon for the sole owner, Tom Paul, President of Benefit Plan Consulting. His company health benefits of big business and unions-Trust-Fund.
A few years ago, HMSA Foundation, states covered by the project and, finally, to identify the needs of the insured and not underinsured in Hawaii. Now, the project includes stakeholders from different parts of the town and adopted several research projects to fund. The program has already self-employed as a target groups, could finally enjoy the creation of some sort of plan for health unversichert.