I haven't posted here for more than five years, but I think my experience with healthcare.gov may be noteworthy.
For a monthly premium ($125) close to 1/4 what currently we are paying ($450) to insure my wife, we will insure three of us with nominal benefits 18 times better on a per-individual basis.
The Obamacare policy into which we are enrolling has a group (3 people) total deductible ($1500), which is less than 1/6 of the deductible we paid ($10,000) last December for my wife's individual plan.
The new deductible also amounts to 1/6 the deductible we paid in January this year (2013) again -- because a deductible starts anew at the beginning of the year. Take treatment in December continuing into January, and you pay an annual deductible twice in two months, we learned.
Our Obamacare policy has a maximum per family out-of-pocket of $2500 compared my wife's current individual plan maximum out-of-pocket of $12,500. Our new national-scale insurer will be new to this tiny (population) state. And no "pre-conditions" to lock us in to any plan we already have or lock us out of a new plan we might prefer. Competition!
Our story under the fold.
We are a nuclear family of four. My wife and I have been self-employed for more than thirty years with our own two small businesses. Our daughters, 21 and 19, are thriving. With the exception of my university years, I never have had health insurance. Our daughters were insured through a state medicaid program, then universities.
Until last year, my wife, like me, had gone without health insurance.
For both of us, this choice of going without health insurance was a risk calculation. We were young, we don't smoke, we maintain good weight with a BMI of ~21, we live active lives, we exercise daily, and we eat with a diet informed by nutritionfacts.org and published research. We played the odds partly by choice; partly by necessity due to expense; and partly also because of my distrust of the insurance industry in general. I have long regarded the insurance industry as a close cousin to the organized gambling industry. Odds usually don't favor the consumer.
As we grew older, we could see our risk factors changing simply due to aging. Three years ago, we started casting about to see if we could find a health care plan. Our shop-and-compare process stymied us: the insurance vocabulary was new to us, it involved huge detail complexity, and its fine text seemed designed to confuse and mislead. Formats varied by insurer making it even harder to compare options.
Over the next year and a half, life intervened. We didn't get insurance partly because of the complexity, because of the time sink involved just to understand what we were looking at, and because of the cost, which could exceed the cost of payments on our house, and, as mentioned earlier partly due to my distrust of the industry.
Fourteen months ago my wife was feeling agitated about remaining without health care insurance, so we embarked on our efforts to understand our options again. After two weeks of serious study in the evenings and weekends, we finally decided to purchase a high deductible ($10,000/$12,500-max-out-of-pocket) individual plan just for my wife. For myself, I would bet on myself and continued good health and remain without health insurance.
Twelve months ago, a year and a week ago, my wife was diagnosed with breast cancer. That was a shock. For nearly three months after first diagnosis, everything was in flux. It took nearly three months to narrow down her prognosis which for months ranged statistically from could-live-a-long-life to could-die-in-months. (At this point, her prognosis is great. At that point, we couldn't know.)
After diagnosis last December, my wife scheduled a mastectomy as soon as she could so as to be able to recover for holiday family gatherings and a wedding.
We made it through last December and January, but internally, I was frazzled with the uncertainties, our rapidly changing circumstances, and cognitive dissonance. Our care providers could not tell us costs in advance. And the bills started coming in.
The bills were huge in amounts, and number, and hard to unravel. First piles. Separate bills from different parts of the hospital. Overlapping communiques from our insurance company. Then every procedure and expense has a code. Number codes without text to clarify. Inconsistencies. And, in January we realized our insurance company was embarking on a process to deny coverage by determining that her cancer was a "pre-existing condition."
I began researching bankruptcy, too -- in addition to continuing to try to understand the nature of my wife's particular brand of breast cancer to be able to assess treatment options, and in addition to continuing to deal with insurance.
We met the insurance company at their game (process). Doing so was torture; nothing less. I am so pleased that with Obamacare nobody should have to go through that again to deal with "pre-conditions."
Over the last year, nominal costs associated with my wife's cancer treatment exceed $250,000. In the end, thanks to insurance (I acknowledge) and some willingness to negotiate on the part of some of our providers our cost will be only in the multiple tens of thousands. We'll survive the hit, but I still resent the system-source hurt.
So I first logged into healthcare.gov in September. By October, the site had lost my login details. In November I began the application process for our family. It lost my application, which hadn't been finished due to the server going down. On a new application, it got stuck in a loop. Last week I started over. It got stuck in a loop. I started from anew again, and with telephone help, I learned a hack to get around the loop bug.
For me, trying to work through healthcare.gov's birthing problems frankly has been tedious. No less. The process is long, which I find understandable. But the site still is clunky. I should not have to start at the beginning, reentering all "Family and Household" information just to edit an item in the finance section. I code, so I understand the insidiousness of buggery in a complex app. Give me open source methods, though. The site does not even offer a simple method to report a bug. ?!!? There still are broken links. Sheesh.
Yesterday I finished the application, and got immediate acceptance and results! That worked! Today I enrolled. That appears to have worked!
And bottom line: For a monthly premium ($125) close to 1/4 what currently we are paying ($450) to insure my wife, we will insure three of us with nominal benefits 18 times better on a per-individual basis.
The Obamacare policy into which we are enrolling has a group (3 people) total deductible ($1500), which is less than 1/6 of the deductible we paid ($10,000) last December for my wife's individual plan.
Our Obamacare policy has a maximum per family out-of-pocket of $2500 compared my wife's current individual plan maximum out-of-pocket of $12,500. Our new national-scale insurer will be new to this tiny (population) state. And no "pre-conditions" to lock us in to any plan we already have or lock us out of a new plan we might prefer.
This is not a "train wreck." I prefer to regard it as a beautiful baby on the way to a single payer system.