Tuesday, November 05, 2013

winners and losers in the ACA

No doubt you have heard reports of folk  who have lost health insurance or had it increase in price because of the Affordable Care Act.  I know that in some of those instances, the reporting has been less than 100% accurate.  In some cases, such as with Trader Joe's, the employer discontinued their employee insurance because they calculated that their employees could get coverage through the exchanges for less than their portion of the coverage they were getting at work.  Dropping them actually got them equivalent insurance for less money.  In other instances, people with woefully inadequate insurance found themselves having to pay more but also receiving significantly better coverage.  All that said, I know there are folk who have seen increases in the cost of their insurance and I've heard some reports for which I have no data to question, that the reason is Obamacare.  And finally there are those young adults who "don't need" health insurance until of course, they do.  For them, any cost is an increase.

My experience has been different.  As I said in an earlier post, moving to the exchange will save significantly money for my employer.  I had no idea how much.  To recap, my insurance is ridiculously high for a number of reasons.  Clergy are a high risk group to begin with.  They tend not to take good care of themselves so heart disease, stroke, and diabetes are rampant.  Clergy also tend to be older which just increases the risk pool.  Finally, the health insurance we get through our denomination is an even higher risk pool as it tends to include only those who cannot get insurance elsewhere.  Until the ACA, I was part of that group.   I also happen to live in an area where healthcare and insurance are very expensive.  We received word that for next year, our denominational healthcare plan would increase by 11.5% and the increase has nothing to do with the ACA.  Additionally, the co-pays all increase as does the out of pocket limit and fewer medications are covered.  Add the fact that I move into another age category and insurance for my spouse and I would cost $4251 a month.  Simply, that is beyond what the church could possibly afford and minus housing allowance, is more than my salary.  Looking at the exchange, it seems that a platinum plan in our area at our age would be under $1900 a month for a savings of about $2,350 a month or over a 55% savings.  It is still a lot of money but the church can afford to keep me covered.

My son-in-law, daughter, and grandson will experience an even larger savings.  My son has been without health insurance for 3 years because as a single male he was not eligible for any government help and could not begin to afford coverage on the open market.  He will have insurance beginning January 1 and I will breathe much easier every time he plays basketball or flag football.

I guess there are losers in all of this.  I still agree that the overall shape of the ACA is not the best we could have done.  Given the current situation and the political climate in which we live, I am more thankful than I could say for the ACA.

3 comments:

Michael Mahoney said...

I'm glad things are working out for you, I really am. I'll be honest and say I wish I didn't have to pay for it, not because I'm cheap, but because we live paycheck to paycheck as it is. Another $140/month is really pushing us over the edge, and for less coverage is just salt in the wound.

I wish that they would have dealt with this in a better way, attacking the cost structure fixing a broken healthcare system instead of slapping a band-aid on it.

roy said...

I understand your frustrations Michael. Every year over the past 11, I've faced the brokenness of the system and felt over a barrel. I have tried every year to find other options for insurance and every year been told simply there are none at any price and certainly not at a lower one and the costs of what has been offered have become higher every year until they are prohibitive. I could say we were blessed that there was any option but it sure didn't feel like a blessing. The system is clearly still broken. I'm sorry that things are not working out for you and your family.

roy said...

the other piece I should add is that I am in no way typical of the savings folk would have via the ACA. Our current insurance is a terrible aberration in the system reflective of the worst aspects of the pre-ACA system and the savings are reflective of that I'm sure. I don't know how someone with a more typical situation than ours would fare. As for my children, they likewise are reflective of the worst aspects as neither has health insurance through their work.