Skip to main content.

Perspective: Why Obamacare isn’t working and must be repealed

Perspective: Why Obamacare isn’t working and must be repealed

Picture of Mike Pirner
rally against universal health care

In the fall of 2011, I purchased a health insurance plan through Coventry at the cost of less than $100 a month. This plan had a deductible of $2,500, which was also the out-of-pocket maximum. This low rate was affordable, and in good months, it allowed me to build a safety net in our health savings account (HSA), which at the time, I could also use to purchase over the counter medications.

The benefits of this plan were realized immediately in 2012, as that year I was hospitalized in August. That hospitalization immediately tapped my deductible, but the good news was that I also hit my out-of-pocket maximum, which means at the time I was hospitalized, I had comfort in knowing anything beyond that point was completely covered by insurance. Needless to say, I loved this plan.

The point I’m trying to make is that in 2012 and prior, I had a fixed cost of $3,700 on medical care — that’s premium plus deductible. Any expenses beyond that amount were purely voluntary contributions to go into my HSA. It provided financial certainty heading into every year.

Fast-forward to 2015 when I had a $240 a month plan with a deductible of about $4,500, and an out-of-pocket maximum of roughly $6,500. I had double eye surgery that year and I ended up spending around $5,500, for a total combined cost (premium plus deductible) of over $8,360. Had my 2012 plan still been in effect, I would have $4,600 still in my pocket! Instead, I had a pile of bills, thanks to the added costs imposed by Obamacare.

It gets worse, and this is where the awful choice comes in. The best plan available to me in 2016, which I purchased, carries a $243 a month premium with a $6,500 deductible. Which means I wouldn’t get a dime of coverage until I spent $6,500, creating a total possible burden of $9,380. My wife and I are middle income, but well over any threshold for a subsidy.

I have a long list of medical issues that need attention, some chronic in nature. But, entering this year, I was still paying off last year’s medical bills. So, I made the financial decision to shut down all my medical care, only spending money if I absolutely had to, so I could pay off those bills. Which basically meant, I made the choice to let my health get worse, which it has, because I couldn’t afford both to pay off my old bills while also incurring new ones.

Yet, I’m still paying the $243 a month, basically rendering that policy as very expensive “catastrophic coverage,” meaning I basically would only trigger it if I couldn’t bear the agony of a medical condition I ran into.

And, now that has happened. I have two bad shoulders that cause ongoing pain, enough to feel like I should seek treatment, and the tests and doctor appointments alone will cost $2,000. Throw in a potential surgery and you’re looking at a “blow the doors off the deductible” kind of year in 2017. The problem is that the plans now available for next year are much worse than the one I currently have.

So, which do I choose, my health or my pocketbook? Do I spend the $10,000 and hopefully erase the pain, or do I live with the agony, and save the money? It’s a horrible choice. Can I get an Obama Loan? (Just kidding.)

Had Obamacare never been passed, I would have never incurred the bills and thus could seek the ongoing treatment I need to seek.

I don’t want a subsidy, and I don’t need mandates. I just want my old plan back. Millions of Americans are facing similar, or worse, choices than I am facing. That’s why we must seize the opportunity to repeal Obamacare fully and completely. 

**

Other posts in this series:

Perspective: How Obamacare allowed me to become my real self

Perspective: Obamacare isn't working for middle-class American families like mine

Perspective: The Affordable Care Act allows family to return to work and better health

Comments

Picture of

There is a level of income that, in my own opinion, that is the "get screwed" level. You are probably living there. We had so little income that we rarely took summer vacations. However, My children did not qualify for any help with college tuition, we always paid whatever my husband's company demanded for our health-care policy. In all instances where some folks where grazing through free or at low cost, we got stung for the full cost. The only new auto that we every bought was a 1992 GEO that actually cost $7,200 out the door. (We got a loan for this amount.) There must be a name for this state of middle income where you never have enough money for any extras or luxuries, but get stuck with paying full-fair for every government service. We did qualify for the earned-income credit in 1978. Of course, my husband was in school and our total income was $3,800 for the year. Oh yes, he did get $422 a month from the GI Education Bill. All he had to do to get it was spend 12 months in Viet Nam during the war.

Leave A Comment

Announcements

U.S. children and teens have struggled with increasing rates of depression, anxiety and suicidal behavior for much of the past decade. Join us as we explore the systemic causes and policy failures that have accelerated the crisis and its inequitable impact, as well as promising community-driven approaches and evidence-based practices. The webinar will provide fresh ideas for reporting on the mental health of youth and investigating the systems and services. Sign-up here!

The USC Center for Health Journalism at the Annenberg School for Communication and Journalism is seeking two Engagement Editors and a social media consultant to join its team. Learn more about the positions and apply.

CONNECT WITH THE COMMUNITY

Follow Us

Facebook


Twitter

CHJ Icon
ReportingHealth