Sticker Shock, Affordability, and Who Really Counts

When we became self-employed, we searched for a health insurance policy that fit our lifestyle. We found one that had a very high deductible and only covered catastrophic illness and accidents. Although the monthly premiums were high, they were manageable. We are also told that as part of the Affordable Care Act ("ACA"), we would be able to keep the our insurance coverage. As many Americans have learned, that is not the case.  

Despite removing both of our grown children from our policy, our premiums have continued to rise and we expected a hike for 2015, especially with the details of the ACA kicking in. However, nothing prepared us for the shock when we opened the envelope from our heath insurance company, laying out the *new plan details* for our 2015 coverage. Not only had our deductible gone up 30 percent, our monthly premium will almost double.

So over the weekend I went on the government's health insurance *marketplace.* After filling out a new application, the site revealed - ta da! - which plans we were eligible for. A *bright* note was that there was a catastrophic plan that, although had the same deductible as our new 30 percent higher insurance plan, has a monthly premium that is *only* about 17 percent more than our current plan. 

As part of the application process, an *Eligibility Notice* was generated. This notice informed us that our 

household's yearly income is too low for a tax credit [meaning no government subsidy to help with the out-of-reach-for-our-income-level premiums]. Generally, individuals and families whose household income for the year is between 100 percent and 400 percent of the federal poverty level for their family size may be eligible for the tax credit. [If you're below the federal poverty level, you don't qualify for assistance.]

Then we were told that, 

You are not required to pay a penalty for not having health insurance because of your income and because the state of VA declined to expand Medicaid to cover individuals in your situation. [Despite the fact that the purpose of the Affordable Care Act is to make sure everyone has heath insurance, you still can go without if you're too poor to afford it.]

So it boils down to this:

We know the premiums are too high for you to afford, you aren't required to have health insurance, and you don't count.

Now I'm not necessarily whining for us because we're on our second career. We chose to become farmers as we feel we are providing a very important service and setting an example and we were able to prepare a safety net before making the jump. My complaint is for the thousands of people who are self-employed or work for small businesses, especially young adults, who are in the same position and will not have health insurance because they cannot afford it. This segment of the population has no voice. There's nothing affordable about the Affordable Care Act for this group. Since most Americans either have employer-provided insurance or live in states where Medicaid was expanded, they don't understand that there are low income families and individuals who have been entirely excluded from the dance. When it comes to healthcare, everyone should count.