Perspective: Why Obamacare isn’t working and must be repealed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