I have been reading the declarations of how things will be so much better for everyone after the Affordable Care Act plans kick in next year. I am an advocate of quality universal health care, and glad for all of those who are finding health coverage who never would have gotten it before, whose rates are going down, and whose coverage is improving. HOWEVER, I would like to add a voice from the ranks of those losing their excellent, low-cost coverage (I got one of those famous cancellation letters) who will now be paying higher rates for less. My monthly premiums, at minimum, will go up by 38% for a Bronze plan that has a far higher deductible than my soon-to-be-obsolete one. A couple of disclaimers – I am 62, hence at the high end of the cost chart; and have the good fortune not to qualify for a subsidy. Also, I live in a blue state (Washington) with a multitude of choices; I cannot speak for other states.
After initial sticker shock, and even a feeling of betrayal (as an activist for universal health care), and after studying the different “metal” categories' plans, and the plans within the plans, and thinking about where this all fits in the big picture of universal health care, here are my impressions of the bad and the good.
First, the bad:
1. Yes, it IS true, some of us will lose our current coverage which is not at all junk – and will pay far higher premiums. A high deductible ($5000-6000-range plan) will cost me 38% more than my current low-deductible ($2000) plan. Plans with that low of a deductible - so-called "Silver Plans" - would double my premiums.
2. Understanding the plans is beyond my education level and I have a Ph.D. :) Once you sort through the basics, there are the nuances. Within each of the “metal levels” there are several different choices, which have perplexed me to the point where I still have not made a decision about which plan I will apply for. You still have to figure out things like, “Will I need Tier 3 drugs but not so much Tier 1?” and “Am I likely to need an MRI but not a lab test, or vice versa?” And I have done due diligence in researching all available information - checked with individual insurers, with Washington State’s health care plan info line, with sites like “ehealthinsurance,” etc.
After a month of these efforts, I can see why the Administration would be faulted for this mess – technical glitches aside, even with smoothly-functioning sites it is difficult to sort through it. Yet I am not sure the Administration should be faulted as I am guessing this was forced upon us by the need to keep insurance companies in the loop (to mollify Republicans – a lot of good that did).
I am glad for the success stories of people managing to sign up in their various states, but I can understand, also, if some people out there felt dazed and confused.
Now, to the good -
1. Here is the advantage which should be shouted from the rooftops, yet which somehow gets lost in the shuffle: all plans have relatively low yearly out-of-pocket maximum and no lifetime limits. (Okay, Bronze plans’ $5000-6000 range caps aren’t exactly low – I said “relatively.”) That is extremely significant because it means that major illness will not force people to lose all assets and go into bankruptcy paying medical bills. I believe this point has not been stressed enough by Administration officials as a selling point; Tea Party and Libertarian types aside, I think most rational people who seek to protect themselves, family members, and assets would recognize that the low out-of-pocket maximums offer an amazing amount of security. I would expect the benefit of this to be apparent even to younger people who have something to protect, so I believe you don’t have to be 50+ to see the advantage of this level of coverage. Even if I have to pay more in the short run – I get it, that serious illness doesn’t mean losing everything, as it easily might have prior to the ACA. That’s great news for me, and for everyone in the country as well.
2. Having to contemplate becoming uninsured is now a thing of the past. I have my own mini-horror story about being on the verge of joining the uninsured when I lived in California 4 years ago. My insurer at the time had been socked with “recision” lawsuits, as well as failure to demonstrate that it needed the rate increases (as it was extremely profitable) so apparently it turned to other means to purge the old folks. So after being with this company for more than two decades, I now found myself facing rate increases of 20-25% every other month, then every month as I approached 60 even though I had never filed a major illness claim. When rates hovered at $1000 a month I sought other coverage and in California the options at the time, at my age, were “catastrophic only” – say, $410/mo for the privilege of having $18,000 deductibles - in other words, high-cost junk coverage. (I was saved from this fate by moving to another state).
3. Almost all plans (at least among the dozens in Washington State) cover prevention and have co-pays so even high deductibles might be manageable. This makes a tremendous positive difference, unless there is a major illness (in which case, see point #1). I’d like to think that this is an improvement over my current plan, which lacks co-pays, but if there is a major illness, frankly, I will pay more out-of-pocket than I would have with my soon-to-be-obsolete plan.
I mention this, again, not as a “negative” but to point out that not everyone is going to literally save on the plan – some will pay more – and this from an Obamacare supporter.
So, the bottom line is this: not everyone who reports that they are losing good plans, and facing much higher premiums, is a Fox News propagandist. Yet as believer in good quality universal health care as a right, not a privilege, I “get it.”
On the one hand, I am going to lose the fine plan I had; on the other hand, in exchange I will have the security of knowing that whatever health conditions I may face in the future, I cannot be denied coverage. And above all, I appreciate the fact that we are taking the first major step toward a universal health care system even if it still needs to have some of the kinks ironed out. Now, if we can just keep the Republicans from gutting Medicare…..