My Experience With Obamacare

affordable-care-act-logo1(Editors Note:  Please be advised the following post has nothing to do with cycling)  A few months ago I swore to stop posting political opinions on facebook, and more importantly to stop commenting on others.  I posted political opinions infrequently but all to often I felt like I needed to offer an opinion or “fact check” other peoples posts.  Turns out that is a good way to tick people off.  I eventually realized how much time I was wasting with nonsense on facebook and stopped.  So rest assured, this is not a political piece, in fact I’m going to avoid expressing an opinion as much as possible.

As the Affordable Care Act is making such headlines I’ve begun to think that most people debating it really don’t know much about it.  In all honesty I’m not expert on it, but I do know what it was like to purchase insurance on the exchange using with a government subsidy.  So here’s my experience with Obamacare.

Lets first go back to 2002, I had been hired to teach art full time in CUSD #1 Galatia.  To my surprise I couldn’t afford the healthcare they offered.  It would take one of my bi-monthly paychecks to afford the healthcare plan for me and Shauna.  They also offered a catastrophic plan that would have cost about a third of one of my checks, but would only be useful if, as the name implies, something catastrophic happened.  Considering we were both young and healthy I opted for the third choice which was to get my insurance benefit put into an annuity.

We attempted to purchase private healthcare.  I remember a salesman coming to the house and showing us this plan which would cost about 200 dollars a month.  I don’t remember the details, but do remember it seemed good.  Unfortunately Shauna was smoking cigarettes at the time and they refused to cover her, though they were happy to cover me.  Since I hadn’t been to the doctor in years we didn’t pursue it.

A few years later I began teaching in Marion and enjoyed a healthcare plan which I could easily afford.  In 2012 I was laid off during a round of budget cuts and found myself with no job and insurance.  We didn’t have health coverage for over a year and during that time we were lucky not to need it.  We also found, at least at some providers, that those without insurance can get a substantial discount for services if they pay promptly with cash.

So finally we arrive to Obamacare.  I avoided the early sign up on when the site was experiencing technical difficulties.  With the prospect of a fine for not having insurance, and the fact that I was eager to get some form of affordable coverage we signed up.  I can’t remember exactly when we signed up but I think it was near the end of 2013.  I found the website to be user friendly and didn’t experience any issues.

I remember entering some financial information, some health information, and then being offered a selection plans on the healthcare market.  There were various tiers of government assistance and tiers of coverage.  I went with the cheapest one available, which cost about 70 dollars a month, while the government chipped in the other 340 dollars.  Since all plans had to meet ACA standards it was a great plan that covered everything, with one small problem; the 6000 dollar deductible.

Had I stepped up to a higher tier plan I could paid around 120 dollars a month for a plan with a smaller deductible and the government would have paid a larger chunk of the cost, but it was still a higher deductible than I could afford.  The truth was to purchase a plan with a deductible that wasn’t greater then the amount of money that I currently possessed I needed to spend about 300 dollars a month.  I remember being annoyed that if we’d made less money we would have qualified for a higher tier of assistance and been offered a plan with an affordable deductible at an affordable premium.

So what is the point of having insurance that you can’t afford the use?  I suppose that is debatable.  One way to look at it is that I wrote a check for 70 dollars a month and the government paid 340 for nothing because I’m quite certain that the entire time we carried that insurance we never had more then the occasional doctors visit.  It never paid out a cent.

Another way to look at it is that we were covered.  If some horrible health problem would have occurred then we would have been treated, sure we would have ended up with a huge deductible to pay off, but considering that the cost of cancer care is 10,000 dollars per month it would have been in out favor.

That brings us to the Crux of healthcare insurance, it’s really only affordable when everyone is contributing.  People should think of it as sitting aside money now for when you’ll need it later, something that most Americans can’t grasp.  What’s increasingly clear is that healthcare is incredibly complex, as our President has recently learned.  Best of luck fixing it, but I won’t hold my breath.



About Matt Gholson

Cycling, school teaching, husband.
This entry was posted in Barn Door Cycling, lifestyle, Stories and tagged , , , . Bookmark the permalink.

4 Responses to My Experience With Obamacare

  1. Sean says:

    I’ve always thought that many of these reforms are going about it the wrong way. Health insurance is such a big topic and every one has a solution. Two things you stated that I always hear reference to: if you pay in cash, you will get a substantial discount; and it costs xxxxx to get treatment, and if you don’t have coverage, you’re screwed. Well, there in lies the problem. It shouldn’t cost 30,000 to get your appendix removed. Maybe a grand? That should cover the costs of a night stay, some drugs, and an hour of a surgeon”s time. The cost of everything is ridiculous. …. and insurance coverage is what’s partially causing it!

  2. capejohn says:

    I belonged to a union all my life. I didn’t have to pay one cent for health insurance till I went on Medicare. For that reason alone, I think every blue collar worker should organize to give themselves the power to negotiate a fair contract that offers livable wages and benefits. It works fine all over the world, but for some reason, American think it’s a bad thing.

  3. drtlmyers says:

    Thank you for sharing your experience. It is an incredibly complex issue. My experience was our private insurance deductible through my husband’s employer went from $1500 per person to $6000.00 per person. We have 3 in our family. We were much better off before the ACA went into effect. I work in health care and heard from many blue collar workers that they were better off before the ACA. I don’t think everything about it is bad, but it did seem to hurt a great deal of working people in my community. I think rather than more people getting insurance, the insurance system needs an overhaul. If I need to make a certain amount of money to keep my doors open them I need to charge much more so the insurance company can write off a big chunk of the charge. The insurance companies never pay the full charge. Meanwhile people without insurance must be charged the full amount. What if we lowered the fees and the insurance companies just paid what they were supposed to pay without the write offs? Just a thought.

  4. Matt Gholson says:

    Thank you for your replies, they are all interesting and I appreciate everyone’s opinion.

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