Itemizing The Obamacare Fees

Tyler Durden's picture

Obamacare's rollout may be in limbo even though the official deadline has come and gone (despite a much touted 2 million visitors to on Monday which probably means it should IPO immediately), but the real sticker shock of actual fees awaits. And even as most insurers are opting to keep the full impact of the higher cost hidden, instead adding them to the overhead premiums charged, one company, Blue Cross Blue Shield of Alabama, has itemized the impact of the Unaffordable Care Act by adding a separate line itme for the "Affordable Care Act Fees and Taxes." Here is how these add up according to a breakdown conducted by the Post.

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.


The new taxes and fees include a 2 percent levy on every health plan, which is expected to net about $8 billion for the government in 2014 and increase to $14.3 billion in 2018.


There’s also a $2 fee per policy that goes into a new medical-research trust fund called the Patient Centered Outcomes Research Institute.


Americans also will pay hidden taxes, such as the 2.3 percent medical-device tax that will inflate the cost of items such as pacemakers, stents and prosthetic limbs.


Those with high out-of-pocket medical expenses also will get smaller income-tax deductions.


Americans are currently allowed to deduct expenses that exceed 7.5 percent of their annual income. The threshold jumps to 10 percent under ObamaCare, costing taxpayers about $15 billion over 10 years.

Then there is the new Medicare tax:

Under ObamaCare, individual tax filers earning more than $200,000 and families earning more than $250,000 will pay an added 0.9 percent Medicare surtax on top of the existing 1.45 percent Medicare payroll tax. They’ll also pay an extra 3.8 percent Medicare tax on unearned income, such as investment dividends, rental income and capital gains.

So will a big story for 2014 be Americans taking out student loans, already over $1 trillion and more than all US credit card debt, to pay for their health insurance? We hope to find out soon as the biggest capital misallocation in US history continues.

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VD's picture

so health now is a tax....hahahahaaaaaaa

Crash Overide's picture

Obamacare is the gift that keeps on giving...

This thing is dead in less than 6 months.

hedgeless_horseman's picture company, Blue Cross Blue Shield of Alabama, has itemized the impact
of the Unaffordable Care Act by adding a separate line itme for the
"Affordable Care Act Fees and Taxes."

But the Obamacare website and the health insurance carriers still hide the biggest costs, the deductible and co-insurance!


Do you have any other questions that I can help you with?
[12:42:03 pm]: CALLER
Yes. The Blue Advantage Bronze HMO 006 Plan shows a $6,000 per person per year deductible. What is the co-insurance rate?
[12:42:33 pm]: Diana
i cant pull up that information im sorry


Deductible:  The amount paid by the member before insurance will begin to reimburse services.  It is reset annually, and based on the level of benefits or amount of premium paid.  For example, with a $5,000 deductible the patient must pay medical providers for the first $5,000 of allowable expenses incurred by the patient each year, after which costs may be split according to a coinsurance arrangement, and/or may be limited to the patient’s out of pocket expenses.

Coinsurance:  A cost-sharing requirement of some insurance plans where the patient assumes a percentage of the costs for covered services after the amount of the deductible has been met.  Coinsurance is described as a ratio, for example 30/70, meaning the patient is responsible for paying 30% and the insurance will pay 70% of the allowable.

pods's picture

That is the biggest thing hedge, people are up in arms right now, before they walk through a doctor's office door.

Wait till they actually have to use a doctor.  

They just put sodium silicate into the engine of 1/6th of the economy.  Granted most of that money spent is not actually helping, but this sucker is going down.

Long cash on the barrel medicine.



hedgeless_horseman's picture



So you have been paying your monthly Obamacare premium for 9 months, and now that you broke your ankle, you must come up with the $6,000 deductible and $1,845 co-insurance before you can have the surgery to actually fix it. 

Also, the insurance company is going to end up paying less for this surgery than you are!


A Lunatic's picture

That only applies to those not fortunate enough to have the proper D.C. connections allowing them to opt out.......

hedgeless_horseman's picture



No, it applies to the majority of Americans that believe they are entitled to a free lunch, but are too fucking stupid to understand a premium, deductible and co-insurance.

Thing1Thing2's picture

.... or even a penalty tax as defined by the US supreme court.

I am more equal than others's picture




..... Pelosi 'you gotta vote for it to see what's inside the bill.' 

Hopefully a lot of democrats who voted to see the 'inside' will become lobbyist in the republican run congress. 

Oh that would be sweet justice indeed. 

Pure Evil's picture

I actually saw a libtard with an "I Heart Obamacare" bumber sticker today.

Of course the driver of the vehicle was a white, overweight, middle aged female, uglier than sin, and somewhat on the manish side.

StychoKiller's picture

May be the only lovin' "she" can find...

El Oregonian's picture

Hey Hedge, why all the downer news on this holiday season? Barry's Obots believe all he has to do is wave his magic wang and everything will get better!

FL_Conservative's picture

I've long been a staunch advocate of a direct pay medical system, similar to what exists for lasik and cosmetic services, to rein in the cost of medical care through a free market approach to service pricing.  In essence, ObamaCare is accomplishing this but with the HUGE negative of making you pay through the nose for an annual medical insurance premium on top of the direct pay cost.  Maybe by the time we put a fork into ObamaCare, people will be more open to a direct pay system, funded through health savings accounts, and supplemented by only a catastrophic insurance plan.  I know....wishful thinking.

Boris Alatovkrap's picture

Obamacare by definition is not Catastrophic Plan?

hedgeless_horseman's picture



I've long been a staunch advocate of a direct pay medical system...funded through health savings accounts, and supplemented by only a catastrophic insurance plan. 

The insurance companies would hate that.  How could they keep up their quarter-on-quarter growth to justify the appreciation of their stock price?

Also, our government clearly believes that the people cannot be trusted to negotiate a fee for a service without assistance.

Boris Alatovkrap's picture

Citizenry is obvious to be too stupid, so must elect academic elite for making decision. Of course, but is require extract wealth of citizenry to pay for brilliant "advisor" and "consultant" to masses. All is so happy happy joy joy in utopian dream.

John_Coltrane's picture

Indeed, this is the reason conceirge (direct pay to a private clinic doctor) medical care is growing so rapidly and bringing in the best doctors as well as the smartest, health savvy customers.  Its the clinics advantage to keep you as healthy as possible since you pay a fixed fee (typically $300-500)/month, for unlimited care and immediate access (often including house calls).  Thus, no unncecessary proceedures, drugs etc.  The clinic meanwhile has no insurance reimbursement hassles, can predict both its income and expenses and even the doctors have more free time (since each doc has at most 200-300 families).  People are surprised when they call and the doctor answers the phone since there is almost no overhead for billing etc.  I encourage readers to read the reviews by patientis of these clinics-they are the highest rated care experience you will find.

If you shop around you can find a clinic that will also  provide tests and diagnostics at their cost.  Since these are run by the most competent physicians they also have the best contacts with the best private specialists.  This is the future.  Free markets, price transparency and no "free lunch".  Competition is the lifeblood of an economy.  Insurance, like banking is a parasitic profession.

hedgeless_horseman's picture



Its the clinics advantage to keep you as healthy as possible since you pay a fixed fee (typically $300-500)/month, for unlimited care and immediate access (often including house calls).

The "unlimited" aspect of your statement is simply not true. 

Generally, the annual concierge membership fee only covers a single annual visit, whether you attend it or not.  Additional visits and treatments are billed under your regular insurance, or you can pay cash.

Boris Alatovkrap's picture

In Russia, is much more simple, break leg and get hack saw from shed. Later, when bleeding is stop, same hack saw is can use to cut table leg for manufacture of prosthetic. Deductible and co-insurance is negligent, but you are want purchase some vodka to keep in hand.

F em all but 6's picture

Is also simple in Amerika. Hacksaw blades will be reclassified as a medical device and taxed as such.

Boris Alatovkrap's picture

This is medical device tax? Maybe is consider tax on torch and rope noose? Soon is only cure for Obamacare.

Atomizer's picture


We can only ponder over the slanted MuppetCare MSM results when free condoms were used to sign-up before ACA deadline expired.

Angry Samoans




Colonel Klink's picture

You have to pass it first to find out how hard you're going to be bent over!

-Nancy Piglosi

Atomizer's picture

They have penetrated every ethnic culture to racially divide people to join a mandatory taxed based healthcare system. This is known as a Ponzi scheme. Watch the class action business asset freezing go up the ladder. Thanks to NSA, we have contacted your phone call & burnt phone to people like Nancy. The snap shot of her 2003 phone activity. All her network government terrorist cell are already compiled. Collapsing the US Dollar is what you’ll hear Nancy Pelosi talking about in past audio recordings. Future breaking wind news media excusive. winks

Boris Alatovkrap's picture

New name for crime of century is not Ponzi Scheme, but is Pelosi Scheme - crime so insidious must be screw first to know how painful is.

Snoopy the Economist's picture


The PELOSI SCHEME - that's beautiful - unlike pelosi 'IT'self.


Merry Christmas

Boris Alatovkrap's picture

You are Merry Christmas too! Happy New Year, is not so much in AmeriKa new eKonomy, but keep children close in bosom and those you are love.

RobD's picture

Sure glad I broke my ankle pre-obamacare. Blew may ankle up 10 weeks ago that took two surgery to repair and the bills/insurance statements have mostly come in. My insurance through work is pretty good, $500 deductible 20/80 split and $3000 max out of pocket not counting deductibles and co-pays. Throw in a out of network ambulance ride and that was a $1000 deductible and I'm out over 4K.

Colonel Klink's picture

Still less than Obamacrap.

Boris Alatovkrap's picture

You are pay $4K AND keep leg? When Obamacare is implosion manifest, you are pay $40K and lose leg.

lostintheflood's picture

Also, the insurance company is going to end up paying less for this surgery than you are!


well...yeah...right...what else would anyone expect, since the insurance companies WROTE the ACA!

StychoKiller's picture

Bwahahahahaha!  You're "assuming" that there's gonna be Doctors willing to work under those conditions!

NoDebt's picture

You forgot the caps that are supposed to exist but don't currently.  There is no cap on the coinsurance, although there's supposed to be one according to the orginal legislation.  You're paying that 30% from your example to infinity.

MachoMan's picture

Picked up a BXBS gold policy outside the exchange a few weeks ago...  and it came with an out of pocket maximum...

hedgeless_horseman's picture



NoDebt is probably thinking of the maximum co-insurance rate for a plan to qualify under the ACA, not the maximum OOP expense.

Out of pocket expense:  The total of covered health care expenses that are paid for by the member or patient, not including any premium.  This is typically the total of the deductible and any coinsurance paid during a year.

MachoMan's picture

To continue with my anecdotal example, the policy we picked up has a co-insurance of 20% across the board...  I think the highest I saw of the obamacare plans were 40%...  once you inquire about the plan, you'll get a summary of benefits...  so, I'm not sure where this discussion is going, unless there's some evidence that the insurance companies' obamacare plans routinely have co-insurance rates larger than that allowed by obamacare...

NoDebt's picture

I'm talking about out of pocket cap (maximum) which is comprised of both decutibles and co-pays (also called co-insurance) plus the elimination of lifetime coverage limits.  It's part of the reason you're seeing such high deductibles and co-pays that would not have been allowed under the law as written.  You push down on one area, the other costs go up.  A giant game of whack-a-mole.

This was done by the president back in August, unilaterally, to try to keep monthy premium payments (the "headline number" most focus on) lower.  Obviously, it didn't prevent premiums from rising, dramatically in some cases, even though the OOP maximums, no longer limited, naturally shot to the moon in the form of both co-pays and deductibles (potentially to infinity depending on how the insurer writes the policy).  In any case, a lose, lose, lose situation.

And this is the mild stuff.  Wait till next year when the insurers find they've been handed a giant bag of adverse selection by the exchanges and really start to sharpen their claws.

MachoMan's picture

Co-insurance is not the same as a co-pay, nor is it typically treated the same for purposes of out of pocket maximums...  how a policy treats co-insurance for purposes of out of pocket maximums is policy specific...

TheRedScourge's picture

When it's all said and done, the Obama admin will just claim they didn't build that.

divide_by_zero's picture

Coinsurance is the reason AARP supported this POS, they make tons o $ on co insurance.

pods's picture

Well it is a good thing that the economy is moving ahead so briskly with wages rising so rapidly, otherwise people might have trouble affording all of these "cost saving" measures.


knukles's picture

Well of course, stocks are rallying because of the future expected massive pop in earnings!
Stocks are telling us everything's OK

Right (Prior Nobel Dwarf Winner and Objective Essayist for the Middle of the Road All the News That Fits Water Carrier.) Paul?
Just think of all the broken necks that'll spur economic activity

knukles's picture

Taxing our way to prosperity.
Redistribution from the worker bees to the Potentates in the New Versailles.

It has always worked so well in the past...

Uh huh....


Say, isn't there a new tax on big butts, too?
Or has that been waived for government employees and their families?

Oldwood's picture

That's why they ask for your race on the application. For some races, a big ass is considered genetically superior and therefore not applicable to surcharges. Unfortunately white folks don't fit in that category.

Is it appropriate to now say....fuck me!!?

NoDebt's picture

I'll take the over on that bet, Crash.  Zero is still in the WH for 3 more years and he's NEVER going to allow "his" signature legislation to be rolled back, or even significantly scaled back.  His Majesty will keep throwing out delays to different parts (employer health plans is the likely candidate this year) but that's it.  It's going nowhere, no matter the pain it inflicts financially, or to the millions more who just LOST coverage because of it over those who gained coverage.

El Vaquero's picture

That is his MO, but I don't think that he can keep it going no matter how much he stamps his feet.  He's going to have to start looking for somebody else to blame and quick. 

NoDebt's picture

I hope you're right.  I really do.