on not buying obamacare

I signed into the website. I looked.

I’m in the odd little demographic of people who were already buying their independent health insurance. Before I quit to go back to school full time, the office-subsidized insurance got REALLY expensive. It was a small office, and a lot of the young and healthy individuals were married to people in the military; when I checked, it turned out that going off on my own, I could get a similar plan through the same company without subsidization for about half the price to me. I hated to make our small pool even worse by leaving it, but I couldn’t afford to stay in it on that salary. The independent plan is a little heavy on teaching assistant salary, but I kept that plan when I dropped the old job since ODU doesn’t offer grad students health insurance.

When I looked at the plans available on the Exchange here, a plan similar to mine — AND AGAIN THROUGH THE SAME COMPANY — slightly higher deductible ($4250 instead of $3500), HMO instead of PPO (so broader choice of doctors) but with a lower coinsurance rate (so 80% after deductible instead of 100% on most things) was $235/month… before subsidies. After, my income’s low enough that it would be $44 a month instead of the $90 that I pay, but that’s a lot to ask the taxpayers to help out for a plan that actually seems a little worse unless I get in a situation where I can’t control where I go. So far, I’ve been profitable to insure — my biggest medical expense the last several years was walking into a glass door and breaking my nose, which earned me a $300 band-aid (tetanus shot included) covered entirely by me. (Add a sinus infection, I think I hit $400 toward the $3500 deductible that year? The insurance is routinely more expensive than the healthcare, but a bike wreck or health issue could easily fix that…)

I do have to compliment the healthcare.gov website. The plan comparison is one of the clearest I’ve seen — I love that each plan has an estimate of what the consumer costs of a pregnancy or managing diabetes would be on the plan… but even with that our system is still so complicated and anticipating healthcare needs is so uncertain that the choices (including tax penalty or shop elsewhere!) are a bit overwhelming.

So I’m not buying into the Exchange because it seems silly to me to let the same insurance company collect more than double the money for no added benefit, even though it’d be cheaper to me until my income goes up. But these systems being what they are and needing the big pools to make them work, I don’t know if staying out on my own is actually better or worse for the American taxpayers as a whole. Would one more heavily subsidized but (usually) healthy sign-up improve or hurt the system’s chances of being viable?

I feel like I have a pretty high level of policy literacy, and I still have no idea. Good luck to the whole crazy endeavor.


3 Responses to “on not buying obamacare”

  1. Carlos Says:

    at the end, I’m not sure if you agree or disagree with ACA. i only conclude that you didn’t buy a new insurance with ACA.
    Health Insurance business is a mad, weird, complicated world… more than quantum mechanics :-P

  2. kait Says:

    Pretty much right. Politically, I like the idea of more socialized healthcare… I’m rooting for the ACA to accomplish its goals, and I think that it’s a bit silly that so many people are gleeful over any evidence that it’s not — the money will be spent whether it works or not at this point, the political horse race is over. But the bill that passed has so many moving parts and compromises cooked in that I don’t necessarily expect great transformations. (The best academic book title ever is in implementation studies: “Implementation: How Great Expectations in Washington are Dashed in Oakland; Or, Why It’s Amazing that Federal Programs Work at All, this Being a Saga of Economic Development Administration as Told by Two Sympathetic Observers Who Seek to Build Morals on a Foundation of Ruined Hopes” — but it expresses the attitude in my field a lot of the time… getting public programs to work well is hard even if they’re relatively well-designed, and it would be hard to even get an answer on THAT part for the ACA so far.)

  3. Carlos Says:

    well, I remember an article (I’m sorry, I’m not able to find it) saying that, long time ago, conservatives Think Tank (I think was the Heritage Foundation), claimed for the mandatory and universal acquisition of a Health insurance. And simple as, by law all hospital are obligated to give medical assistance in case of an emergency, and probably includes major surgery. In case the patient is insolvent, the bill is payed by… states, i.e. taxpayers.
    I’m not aware about all details of ACA, but my feeling is that it should be implemented at all costs and later will be improved, otherwise USA will never have an universal healthcare. I’m pretty sure Medicaid had the same problem, and inclusive Reagan make use of it.

    From other point of view (now I’m speculating). For a country as USA, what you want is people consuming goods (mainly) and services. With the people, more or less, covered by healthcare, they can continue spending money in goods, paying taxes, etc. But somebody, who must ‘work’ to pay the hospital’s bill will start to ask state’s aid, will be a burden on the state (is correct this expression?), and who pay that aid? Taxpayers… Sure, you can claim… no more public aid, but this is something learned during the Great Depression.

    Interesting topic

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