My story about navigating the minefield that is the American health insurance industry

Obamacare is importantNext Tuesday, October 1, 2013 is an important day for my family. In order to understand why, we need to go back in time a little bit.

For the first 20 years of our marriage, my husband Reed and I each had health insurance through our employers. When Reed left his job at a major San Francisco law firm in 1997 to pursue a career in Architecture, I added him to the policy I had through my job because my employer provided domestic partner coverage.

When I lost my job in 2011, we had the option of continuing the coverage under COBRA, but the premium was more than $850 per month. Each! So, we looked for individual policies. I found three that worked for me, but I was declined by all of them because of a pre-existing condition. (I was taking blood pressure medication and I was honest about that on my applications.) Reed applied to the same companies, and in spite of being in excellent health and not taking any prescription meds, he was declined because he had not had a physical within the last 18 months.

I apologize for getting all wonky here, but there’s really no way to discuss this issue without running the numbers. Reed is self-employed, and I was still unemployed, so we decided to formalize his company into an LLC and become employees. We retained an insurance broker to secure a health insurance plan for our company. Most employer-based plans provide what they call “guarantee issue”, which means we would not be excluded because of pre-existing conditions, etc. Our policy cost us about $433 each per month.

In November 2012, the premium increased to $522, an increase of  more than 20%. We were recently notified by our broker that on November 1st of this year the premium will increase by a little over 12% to $585 each.

Two things to keep in mind here. First, this policy is not even remotely a good one. Basically, we look at it as “catastrophic coverage” in case some really serious medical issue arises that could otherwise wipe us out. In our opinion, it’s just reckless for anyone not to have health insurance, particularly two guys in their 50’s who are a decade away from Medicare eligibility. The other thing to keep in mind is that very few people can sustain annual double-digit increases in health insurance premiums. We certainly can’t. Any logical person can see that spending $1,170 per month on insurance for a family of two is ridiculous. That’s more than our mortgage!

This morning, Reed and I did some research. Insurance companies are finally starting to release information about policies and premiums as a result of the ongoing implementation of the Affordable Care Act, aka “Obamacare.” We found three policies from major carriers that mirror the coverage we have now and in one case the plan is a lot better. The least expensive is $243 and the most expensive is $393. That represents a 58% and 33% reduction, respectively. That’s why Obamacare is important to us.

Obamacare is importantSince we live in the backward state of Georgia, we will not have a state-run insurance exchange like we would have if we still lived in California, but we will have access to www.healthcare.gov. This is the Federal Government’s program for people like us who are being victimized by our state politicians. Next Tuesday, October 1st, we will be able to use that site to research additional plans and choose which plans are right for us. The good news is that on January 1, 2014, our health insurance premiums are going to be much lower.

Some people will read about our journey through the modern American health insurance maze and relate to it, but will be bored by it. I share it because I want to make this point: We are just two of the 50 MILLION people (as of 2011) who are either struggling to get/keep health insurance or who don’t have it at all. Consequently, we have a certain perspective when we watch the 2012 Republican Presidential nominee vow to repeal Obamacare on his first day in office.

We seethe when the House of Representatives votes over and over and over again to repeal Obamacare and never once debates or votes on legislation that would improve the economy and reduce unemployment. We are pissed off when Ralph Hudgens, Georgia’s Insurance Commissioner, vows to obstruct, delay and ignore laws and rules related to Obamacare.

Our heads nearly exploded when we watched the House Republicans cheer and slap each other on the back after passing a budget bill that would defund Obamacare and thereby deny us and the other 49,999,998 people who need affordable health insurance.

Obamacare is important

President Obama signed the Affordable Care Act into law on March 23, 2010 and for 2 ½ years we have listened to Republicans lie to us about it. They say they want to delay it. They say they want to replace it. They believe that Americans hate it. They say they are genuinely concerned about the uninsured. None of that is true of course, especially the part about wanting to replace it. Make no mistake; they want to kill it.

I follow politics very closely and I have never once heard a Republican politician describe what specific things about Obamacare they don’t like and what plan they support in its place. Not once. The truth is they don’t have a plan and they don’t want one. They hate Obamacare because they hate Obama. They do not care about the uninsured or people like us who are a hair’s-breadth from losing our insurance.

Look, I know Obamacare isn’t perfect, but it’s so much better than this unfair and unsustainable system we have now. We need to allow Obamacare to become fully implemented. After it’s been up and running for at least a year or two, inevitable weaknesses will be exposed. Then we can tweak it where necessary. That will take leadership, compromise and a commitment to governing. I haven’t seen much of that coming out of Washington since November 2010.

15 COMMENTS

  1. Gordy, that was a great view into the reality of why our national healthcare plan is so important. One thing I’ve noticed that is consistent, all the people doing the most complaining are already insured. They completely lack the ability to put themselves in the shoes of the uninsured. That total lack of empathy or compassion, is astonishing to me. Americans have become incredibly callous and greedy. I also wish everybody hadn’t co-opted the name Obamacare. It’s our national healthcare plan! It’s not Obamacare! Why do we insist on calling it something that it’s not really going to be known as in the long term? We are such a “10 second Tom” culture anymore. We have no ability to look beyond the most immediate thing in front of our faces. What happened to serious thought? I am appalled at how much misinformation is out there, and how many willing candidates there are who propose these bunk theories. America seriously needs to pull her head out of her ass, or we’re going to be known for being stupid, mean, and greedy. Now there’s a legacy.

    • I suppose you’re right about the use of the “Obamacare” label. I was surprised that poll numbers were higher for the Affordable Care Act than for Obamacare. They are the same thing, but I guess names and labels matter.

      One thing I didn’t write about was that our current insurance carrier has reached out to us because we are in open enrollment right now. While they originally promised a 12% increase, they are now offering to keep our rates the same if we promise to keep the policy in force for a year. That’s because they aren’t stupid. They know we can get the same coverage at a lower rate. What is even stranger is that one of the three plans we got quotes on is from them! The right hand doesn’t know what the left hand is doing, I guess.

  2. “A new survey of chief financial officers finds that American companies expect to increase the number of full-time employees by 1.8 percent over the next 12 months as key parts of the Affordable Care Act go into effect, undermining conservative critics who’ve argued that the health care law would hamper business growth and expansion.”

    “How is this tax more fair than the current system?” Your taxes currently include compensation to hospitals, clinics and doctors for their care of the uninsured (whether or not these people could afford to pay for it themselves). The ACA requires everyone to be responsible for their own healthcare via premiums. Those that truly cannot afford to pay receive subsidies or are put on Medicaid or a similar program. (Read my previous comment to Elena.)

    As to jobs, “Wal-Mart, the nation’s largest employer, announced Monday that 35,000 part-time employees will soon be moved to full-time status, entitling them to the full healthcare benefits that were scheduled to be denied them as a result of Wal-Mart’s efforts to avoid the requirements of Obamacare.” Also, new jobs have been and will be opening up directly relating to the healthcare industry. This will all put new money into the economy that will be spent to pay bills, buy food, clothes, etc…. stimulating further growth.

    Tell me Park, HOW is Obama suppose to be creating jobs? WHAT jobs “are literally there and he just as to give an approval.”?

  3. President Obama introduced the American Jobs Act in 2011. The House of Representatives refused to vote on it and it was blocked in the Senate by Republicans. It is just sitting there waiting for Congressional action. So don’t be blaming President Obama or Democrats for the unemployment rate.

    It’s pretty naïve to assume the President, ANY President, can just create “…as many new jobs as possible.” And what are these jobs “…that are literally there” that he just needs to approve?

    Finally, I certainly don’t think we’re rushing into anything with respect to health insurance reform. First, this has been a critical issue needing governmental attention since the early 90’s. And second, the ACA was passed over three years ago! For my part, I’ve been extremely impatient about the pace of its implementation! But, regardless of all that, we’re in the home stretch now.

  4. wonderfully written! couldn’t have said it better! thanks for sharing your story with us! It is disgraceful what people will do to block the good work of others for no good reason, other than to be petty – and sacrifice the health and welfare of the rest of us in the meantime! I hope everyone remembers this kind of petty crap next November.

  5. You didn’t really listen to any Republicans. Please!!! Every said has valid points. Don’t be so richous. How is America to pay for all this. We are Trillions of dollars in debt as we speak. Aren’t you being taxed enough already? I’m a single mom & i have no insurance as we speak & i am against this. I grew up where you pay your debt before creating more debt. When everyone is insured by Obamacare who will see all these patients? Are there enough doctors? Hospitals are overcrowded now. My insurance will be worth nothing if i can’t use it. Did you read obamacare?? The Senators & Congress have still to read it.

    • You are against Obamacare because there might not be enough doctors? There’s an objection I hadn’t heard before! But never fear! One of the amazing things about the free enterprise system is supply and demand. There may be more demand than supply for a while, but the supply will catch up with it soon enough. As far as you and your family going without insurance because you oppose Obamacare, all I can say is wow. Just wow.

      Oh, and I don’t know what “richous” means. I don’t see how I could be something when I don’t even know what it is.

    • Elena, you need to turn off Fox and your conservative radio, they lie to you. The Senators & Congress HAVE read the bill, they know exactly what is in it. Have YOU read it? Do you know how coops work? Do you know how the unions were able to get low cost excellent health insurance for their members? Pretty much the same way that Obamacare will work. The first thing it does is get rid of all the inflated costs (ever look at a hospital bill? How much for an aspirin). One of the reasons that doctors and hospitals inflate their bills is to cover all the uninsured that they have to take care of. With Obamacare, that cost will go away. WE are already using taxes to cover this in tax write offs to the hospitals, clinics and doctors. As a single mother the ACA should be a godsend. The idea of paying your debt is what it’s all about, this is why we pay premiums. Being a benevolent country WE care for those that are struggling and know that if we all help together, we all benefit. There has been a shortage of doctors for years (I’ve heard various reasons as to why) and these have sufficiently been filled with physician’s assistants in the past. More recently Nurse Practitioners have stepped in. These individuals often have more med training and practical experience than most doctors. They work under a consulting doctor that can be called on for difficult cases. With preventative care hospital admissions should drop significantly. Please do some research, it will benefit you greatly.

    • Elena WOW you need to get FACTS before you speak like a mouthpiece for Fox, Beck, Limbaugh and all the other lying trouble makers who are causing our Country SERIOUS HARM! WAKE UP!

Leave a Comment