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.