We’re a few weeks into the enrollment period for the Affordable Care Act (commonly known as Obamacare) and some disconcerting facts are beginning to emerge.
Of course, the most obvious is the unbelievable increase in the cost of coverage, something the Obama administration vowed would not happen because so many more people would be paying into the massive government program, helping to distribute cost among the populace.
The horror stories are all over the news: A Bay Area woman seeing an $1,800 a year jump; another Bay Area man who will be forced to pay $10,000 more a year for his family. The Charlotte Observer reports that thousands of health plans are being canceled in North Carolina, replaced by more expensive plans – one jumping up nearly $1,000 a month.
Many remember President Obama promising at a 2009 town hall meeting that “if you like your health plan, you can keep your health plan.” What he meant to say is anyone changing plans after 2009 would be required by law to enter into the new Affordable Care Act-approved plans with all the caveats the law includes.
We fall into that unfortunate category since I retired in 2010 and my health benefits no longer carried into my retirement years. But I’m an older gentleman and eligible for Medicare. I enrolled into the program and added a supplemental insurance plan that will not change much once the Affordable Care Act is fully implemented.
My wife, however, needed to secure new health insurance, which she did as soon as we moved to Idaho. Realizing her health was exceptionally good, we opted for a high-deductible plan that fit our needs with Blue Cross of Idaho. Initially, her monthly premium was slightly more than $200 a month. Last year it jumped to $267 a month.
Enter Obamacare. A few weeks ago, she received the news from Blue Cross of Idaho that she can keep her plan one more year at a cost of $319 a month, but at renewal time (November 2014), she will be rolled over into a “Bronze qualified health plan that most closely matches your current plan.” Or she can opt to enter into the world of Obamacare this enrollment period.
At first glance, that looks like a choice between death by firing squad or hanging.
We were happy with the existing plan, although the 19 percent increase in the premium for the coming year was obviously stiffer than expected or desired.
But under the new Affordable Care Act, we will be paying for maternity care, dental care for our children under the age of 19, prescriptions, newborn and pediatric care. Give me a break. My wife will soon be 59, still six years from Medicare eligibility, but many years past maternity and pediatric care needs.
Then the bad news. That $319 a month price tag will jump to $529 under the silver O-bomb-a-care plan offered by Blue Cross of Idaho. That’s about a 66 percent jump in premiums. She could opt for the bronze plan that has a higher deductible and is inferior to her current plan.
But wait. There could be a silver lining – perhaps. Written into the law is a pain killer. It’s called a subsidy, and we just might qualify. This is the carrot that could sway millions into believing Obamacare is just what the doctor ordered.
Anyone within 400 percent of the poverty level can collect a subsidy. It caps at $45,960 earnings for an individual and $94,200 for a family of four. The Kaiser Family Foundation estimates that 48 percent of Americans could qualify.
My calculations tell me it includes the James family of two.
Using the Kaiser Foundation calculator, it appears our meager retirement income might qualify us for a handsome subsidy that could lower that $529 payment to anywhere between $181 and $275 a month.
The process of getting the subsidy is rather substantial. The Wall Street Journal reports that myriad agencies are involved in scanning your request, including Medicaid, the IRS, Homeland (to determine citizenship), Veterans Affairs, the Office of Personnel Management and Children’s Health Insurance Program. There are a few others, but I think I made the point. It takes time for all to approve the request.
Our poor insurance agent is on suicide watch. Within two weeks after enrollment started he still hadn’t received information from the Idaho Health Exchange on complete rates and available plans. No wonder fewer than 100 entered the plan during the first couple of weeks of October.
We were happy to pay for our $267 per month plan. Obamacare made that null and void. It now appears some other unlucky American is going to help pay for a program to cover my wife’s insurance that far exceeds her needs, that is if we can crawl through the government maze that will get us from here to there.
Bill James is a former Daily Republic editor and publisher now living in Meridian, Idaho, a suburb of Boise.