The main three pre-existing conditions are my age (57), my residence in Monterey County, California, and my 2012 income that was 413% of poverty. While I rejoice for those who are going to have a taste having health insurance after years of anxiety, I am overwhelmed at how Obamacare will be affecting me. I can either go back into that pool of the uninsured (where I have been before) or continue happy crappy coverage and pay significantly more for it than I pay now. My current plan with Blue Cross has been $410 per month (after California went after Blue Cross and made them reduce their premiums) but purchasing an individual plan for 2014 via the exchange will be a minimum of $550 per month, 13.89% of my annual net income. I'll still have a $5000 deductible and 40% co-pays. I'll still be buying my name-brand medication from Canada for $83 per month because the $5000 deductible includes medications. The extra $140 premium per month will have to come out of the amount I am able to put away for retirement, which is already sketchy and continues to get sketchier.
So, I'm riled up with all the reactivity I am seeing in the diaries and comments at Kos about people's complaints about Obamacare--the accusations of lying (I'm sure some people are), of being too ignorant to understand (I'm sure some people are) and of being part of the right-wing nut factory (I'm sure some people are). Yes, it's a better system than what we've had, but it's also completely inadequate, too complex, and doesn't do nearly enough to contain health care costs. I'm a person who doesn't mind paying taxes--who wants to! to support those things that make a livable society for all. I want to see people fed, housed, receiving health care, educated, having access to public utilities (including internet and phone), public recreational spaces, etc. through public/community funding. I know that when I need a plumber, a carpenter, a mechanic, a teacher, a cashier, a good moisturizing product, I am benefitting from public education. I appreciate being able to drive to work on roads that are maintained by county, state and federal funds. I recognize that access to clean water, to electricity (and to the minds that figure out how to store and distribute those things), are available only because we come together to pay for those things. That's a good system.
At the same time, I am angry that I'm going to be subsidizing the health insurance companies, and only secondarily other people's access to less-than-adequate insurance that still will turn over a profit for the insurance companies. I am discouraged at best, outraged at worst. According to Covered California, I am not eligible for any subsidy. I have three options for a Bronze Plan (two are Blue Cross) at monthly premiums of $550, $552, $558. The lowest premium for the two available Silver Plan options is $736, the other is $806 per month. A 30-y-o will pay $256-$343 for Bronze; a 45-y-0 $326 to $436 for Bronze. From what I can find on the Covered California site, I am eligible to have the tax penalty waived if I don't buy insurance. Or I can purchase a "minimum coverage plan," which is nowhere explained and no resources for finding such a plan are to be found on the siute, so I can't see that I have any other option than to do without health insurance if I can't afford the premium. And to think the Bronze Plan on the exchange is going to be a vast improvement over the plan I have now is a false assumption.
In insurance language, a $5000 deductible is not met by paying $5000, but by the insurance company's determination of what they WOULD HAVE PAID HAD THE DEDUCTIBLE ALREADY BEEN MET. So, for instance, with a Bronze Plan and 60% co-pay, only 60% of the charge will be applied to the deductible. So if you have a $5000 deductible, and only 60% of what you actually pay gets applied, then your deductible is really $7000--$5000 plus the 40% that the insurance company doesn't count toward the deductible. After that $7000, you could pay $6350 (the stop-loss amount), which brings you to a total of $13,350 that you'll be liable for. If the $6350 is determined in the same way as the deductible, then it's not $6350 but 40% more, $8890. Add in $6600 of premiums and you come up with $19,950 or $22,240 per year. I make 2.5 times $19950 per year. How many years do you think I can sustain those kinds of costs if I should get seriously ill or injured more than one time? Or have a long-term illness needing long-term treatment? "Affordable" is an egregious misnomer. Though the Covered California site states "It is important to think about how much health care you will need" it is impossible to know, and also useless to know if you can't afford better coverage even if you have the foresight to know you'll need it. If I need a lot, I won't be adequately covered by the Bronze Plan anymore than I'm adequately covered until Dec. 31, 2013 by the plan I currently have, to be discontinued by Blue Cross on Dec. 31. I suppose that all plans that cost less than the plans on the exchanges will be cancelled. After all, the health insurance industry exists for profit. They can blame the government for why they are cancellling all their crappy plans that don't offer the 10 ACA essentials.
An additional painful irony is that if my income was $128.33 less per month in 2012, I'd qualify for a Bronze Plan with a premium of $106, or a Silver Plan with a premium of $291. The plans stays the same, but the premiums would be $421 cheaper for Bronze than my "windfall" of $128.33 a month nets me. Get that? I'd save $421 per month if I didn't make that additional 13.89%. I am expected to pay FIVE HUNDRED PERCENT of the premium that someone who makes 400% of poverty will pay. Who came up with this math? Why can't I pay 113.89% of what their premium will be?
More irony below the fold:
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