Last week I wrote about a friend who has issues with the Affordable Care Act and vented to me in a rather adversarial way. In that post I shared my self-doubt and conflicts about whether I could handle such a political hot potato in this blog with intelligence, objectivity and balance. Afterwards, I was pleasantly surprised to discover that just writing that introduction resolved most of my discomfort. The bit that lingers is just par for the course for this sensitive and scrupulous INFJ!
So now I’ll continue with his story in his own words:
“In 2014 my United Healthcare PPO health insurance policy cost me $213.09 per month with a $2500.00 deductible. My wife paid $250.00 per month with a $3500.00 deductible, also from United Healthcare. We are both in our 50’s and self-employed in the service industry. We pay 25% income tax. There were no savings or other advantages to purchasing a joint health care policy. Together, our effective monthly cost was $450.00 per month with $5000.00 in deductibles.
“In 2015 the Affordable Health Care Act went into effect. My monthly premium went up to $489.39 with a $5200.00 deductible with Humana (HMO). My wife’s plan with United went up to $475.00, also with a $5200.00 deductible. That cost us $965.00 a month with an effective $10,400.00 deductible! The policies included maternity costs; my wife had a hysterectomy in 2004. They also included children’t dental care. We have NO children. By definition, we are a “married couple with no children” and our annual adjusted gross income is above $62,000.000 — the defining line to qualify for the government health care subsidy. Affordable??
“In November of 2014 I had a bout with gastroenteritis. Severe dehydration sent me to the emergency room in a life-threatening condition. After being hooked up to IV’s in the ER for two hours, the finance rep from the hospital came in to secure payment for my $5,200.00 deductible. Awesome. My wife gave him my credit card as I was out of it. Eight hours later the doc told me I needed to be admitted to the hospital because my kidney function numbers were not good. What they never mentioned was that this hospital was no longer in my network. I left the following afternoon. The bills that arrived over the next four months totaled $6,000.00 in addition to the deductible. A friend in the medical industry went to bat for me by reviewing the hospital bills. We found charges for services and tests I never received, so the finance department offered a discount for full cash payment. I took it. My brief visit to the hospital cost me $11,000.00 out of pocket. Affordable??
“My wife and I have a simple lifestyle. We live in a condo, go out to dinner once a month. Both our businesses barely survived the economic crash in ’08. We still haven’t recovered. When she had to relocate her business, costs were high, including three separate licenses to fulfill city, county, and state requirements. At the time of my hospital stay we had not taken a vacation in three years. But we are thankful for what we have and are not complainers.
“In 2016 we received notice that our Humana HMO plans were going up. Our savings are dwindling, yet we now have to pay $1,150.00 per month with $14,400.00 in deductibles. Two years ago we paid $450 per month. Affordable???
“Options. We’ve shopped plans through three agents. We have the cheapest plan, a Bronze HMO. Alternatively, we could choose a catastrophic plan for $380.00 a month with $10,000.00 deductibles, but they cover very little and we’d have to pay a penalty for choosing a plan that is not ACA approved. We think the penalty would be 3% of our adjusted gross income, but our CPA isn’t sure because the law is so convoluted. Our only other option would be to find new entry level jobs with benefits, but our income would be considerably less. And this isn’t an easy thing to do for 55- and 59-year-olds. We’ve worked hard for 25 years to develop our clienteles and reputations.
“Now our health care costs are the biggest expense in our budget. While I understand the overall goal of Obama’s plan to provide health care for everyone, this plan is a total failure. In my mind, the insurance companies responded to the government getting into their business (less piece of the pie) by raising rates to make up for profit loss. Also, the requirements of the Affordable Health Care Act are too inclusive. Why would we pay for maternity care or children’s dental? In the past I was rewarded for being healthy. I only saw doctors three times in the past ten years, and those were at a Centacare and my dermatologist. I don’t drink, smoke, or take any medications. I am not obese. Now I’m treated the same as an overweight, smoking alcoholic on ten different meds. Really?? Furthermore, with such high deductibles we’re less likely to consult a doctor when sick.
“My feelings are that Obama wanted the Affordable Health Care Act to be part of his administrations legacy; because it was an ego thing he pushed it through at any cost to us. The philosophical benefits to society do not justify crucifying the middle class American. There has to be a better plan. It was easy for politicians who receive lifetime health care at taxpayers’ expense to pass this law without even reading it since it was so long. I’m angry. We are honest and hard-working. We make our own money and are trying to be responsible small business participants. But it really is hard to watch the President vacationing in Hawaii while asking us “to tighten our belts” for the “greater good.” I’ve watched this country go off course for too long and I think the system is irreparably flawed, with no solution in my lifetime.”
Jeanie again: I invite you to share your story and perspective. It will surely be interesting and enlightening, especially if anyone can suggest solutions. Knowing how divisive political issues can be, I ask only that you use diplomacy and restraint. (As if any of my amazing regular readers needed to be reminded to behave with civility!)