I imagine most of you who read allie123's diary (and if you haven't, read it!) had a similar reaction to mine: some combination of moved, inspired, saddened and infuriated.
The decency, humility, intellect, strength, tenacity, stoicism and sheer heart of the diarist are moving and inspiring.
The disability that has afflicted her and the hardships she has so stoically endured are saddening.
The harsh and uncaring system that has unfairly and unduly increased the hardship of her disability are infuriating.
One thing I appreciated about the diary was the clear picture it painted of what those who are the least well served by our current healthcare system endure.
The diarist indicated in her diary that she spends $660 per month on health insurance premiums and an additional $250 -- $300 for copays for doctor's appointments and medication.
I wondered how she would be affected by the pending healthcare reform legislation. So, I went to the Kaiser Family Foundation's website and used their
benefits calculator to try to figure it out.
Since the diaris said that these expenses of between $910 and $960 per month represented almost half of her income, I assumed that her income was around $30,000.00 per year.
Plugging that income into the calculator, I found that the diarist would be paying premiums of $2,657 per year under the President's plan, $2,724 under the House plan, and $2,699 under the Senate plan.
Then I learned something new. I've kept hearing about the fact that the insurance companies can charge people 55 and up up to 3 times what a younger person would pay. I assumed that that meant that someone over 55 would pay more in premiums. It turns out that I was wrong.
While the top line number (the actual cost of premium before subsidies) increases with age, the bottom line premium (amount actually paid by the consumer) stays the same regardless of age. In other words, while the amount the insurance company gets to charge the 55 plusers is higher than the amount they charge the under 55ers, the maximum premium paid by the plusers is the same as the underers (at least for those at 40% and under of the Federal Poverty Line).
As you can see the President's, House's and Senate's plans aren't that far apart when it comes to the premiums paid by the diarist. What I found as I played with the calculator is that the House plan is relatively more generous to families and the President's and Senate's plans are more generous to singles.
Another new thing that I'd learned is that while a basic plan covers 70% of healthcare costs with a cap on out of pocket expenses, there are subsidies on out-of-pocket expenses in each of the plans for lower income individuals that actually raises the percentage of coverage.
For the President's plan, the break down is as follows (the facts and figures below come from this side-by-side comparison on the KFF site):
$29,000-$33,000: 94%
$33,000-$44,000: 85%
$44,000-$55,000: 73%
$55,000-$66,000: 70%
$66,000-$77,000: 70%
$77,000-$88,000: 70%
Therefore, if my I am correct about the diarists income, she would be required to pay a copay of 6% of her medical bills. Of course, that number could get pretty large if medical expenses got high enough, but, fortunately, there's a cap on out of pocket expenses.
The out cap on out of pocket expenses also varies with income, and, in the President's plan breaks down as follows:
Reduce the out-of-pocket limits for those
with incomes up to 400% FPL to the following
levels:
– 100-200% FPL: one-third of the HSA limits
($1,983/individual and $3,967/family);
– 200-300% FPL: one-half of the HSA limits
($2,975/individual and $5,950/family);
– 300-400% FPL: two-thirds of the HSA limits
($3,987/individual and $7,973/family).
As a single person earning $30,000 per year, the diarist is at 277% of the Federal Poverty Line. Thus, her cap on out of pocket expenses would be $2,975 per year. Of course with coverage for 94% of her care, she would have to incur 49,583.33 before she had to pay the full $2,975 and everythin over that would be covered 100%.
So, putting that all together, the most that the diarist would have to pay in a year would be $5,632 a year or $469.33 per month under the President's plan, which comes very close to cutting her healthcare expenses in half.
Personally, I don't think she should have to pay that much, but this would doubtless be very beneficial to her.
And the bill offers her a lot more than the reduction in price. It offers her the peace of mind of knowing that she does not have to rely on her job to make her eligible for health insurance.
It gives her the ability to shop on an exchange for the plan that best suits her.
Creates a mandated and regulated minimum of coverage.
It creates a stronger ability to appeal unfair decisions by her insurance company.
And a lot of other things that I don't have time to go into right now.
A couple of items that get, what I feel are undue attention from progressives are the Public Option and the Excise Tax. For the diarist, the inclusion of a Public Option and exlusion of the Excise Tax would have precisely 0 practical impact on her situation.
So here's my proposal: following the healthcare summit tomorrow, why don't we all call our Senators and Representatives and tell them all to pass the President's plan ASAP?!