Monday, December 30, 2013

Affordable Care?

I'm not a happy camper right now.  Why?  Because I finally took the plunge and decided to see how the Affordable Care Act would save me money.  It was a given, right?  This program was designed to save low-income families money.  Since we're a self-employed family, we've had to purchase our own health insurance for the past 2 years.  Of course, the premium is high, despite having only a catastrophic policy with a very high deductible.  Which was fine with us as we didn't want a lot of the "bells and whistles" that comes with health insurance.  But today I decided to look into the government's health insurance "marketplace."  I really, really expected to be happy with the results.  However, I. WAS. STUNNED.  

Below is information that I copied from the actual website.  I included the lowest and highest "bronze" levels and the lowest and highest "gold" levels available in our state.  The lowest of all is still much higher than what we currently have.  So I ask individuals who have employer-provided insurance, who do not have to purchase plans through the government "marketplace," and who believe the studies that say this program is good for everyone, especially low income individuals:  Do you think these premiums and deductibles are fair and affordable?  Please remember, despite all the studies you read that say this program is good, this is not an academic exercise.  People like us are actually going to have to pay these premiums - low income people like us.  And please don't assume that anyone who is upset about this program is an opponent of the president because that's not true.  

Lowest Bronze:

Monthly premium

$645.65/mo.

Deductible

$12,600

Out–of–pocket maximum

$12,600

Copayments / Coinsurance

Highest Bronze:

Monthly premium

$4,024.19/mo.

Deductible

$12,600

Out–of–pocket maximum

$12,600

Copayments / Coinsurance

Lowest Gold:

Monthly premium

$975.56/mo.

Deductible

$2,500

Out–of–pocket maximum

$10,000

Copayments / Coinsurance

Highest Gold:  

Monthly premium

$5,864.26/mo.

Deductible

$2,500

Out–of–pocket maximum

$10,000

Copayments / Coinsurance

I tried to use the live chat option but immediately got a message that they were busy.  And since they keep making up changing the rules as they go along, I don't really understand all the details (and I have a master's degree).  I found a web site that said we "might" be eligible for cost-sharing.  What that means is we might get some kind of tax credit that is sent directly to the insurance company.  How nice for the insurance company to instantly have access to taxpayer dollars - more than what I'm currently sending them.  What a nice bonus for them.  I've said it before and I'll say it again:  why on earth do we not have single-payer health insurance - like Vermont has chosen - instead of this nightmare?  Do I sound upset? You betcha.  

4 comments:

Laura said...

Glad to see someone else upset. We have two people on disability in this household yet only one qualifies for Medicaid. In Virginia there was no Medicaid expansion and there is no way that we could afford the premiums out there. Crazy. So, we can't afford affordable health care or the fine.

WB said...

I am saving money by shopping the 'market' rather than staying on my husband's policy at work. I'm going from a $2500 deductible at $550 a month, to $0 deductible at $380 a month. I probably should have gone with the same deductible and saved even more (another $80).

I did find the process frustrating...there were several times when I just had no idea how to proceed but I finally figured it out. At least I hope I did!

Cherie said...

Laura, my husband looked into the website and, instead of going directly to "apply," he tried the "learn" button and it gave him different results than what I got. If you can believe it, going that route reduced our premium to $0. Even though we both put in pretty much the same income, the results were vastly different.

Cherie said...

WB, my son is trying to navigate the system (lives in different state) and is frustrated because he was told the marketplace wasn't yet fully optional. Hearing how difficult the system is to navigate really annoys me. If educated people are having a hard time, what are the people this system was supposed to help faring?