As a small business owner who pays 100% out-of-pocket for health insurance the recent and upcoming changes to our health care laws in the United States are of particular interest to me. Over the last few years I've seen my insurance premiums rise about 100%, and this increase in cost has made my family change our insurance policy to a high deductible one. Today I have a high deductible policy that costs more than the low deductible policy I had just a few years ago. This has been the trend for every American paying 100% out-of-pocket for their health insurance. It's been the trend for employers who pay for their employees' insurance policies as well. With employer-provided insurance an employee is generally shielded from the total cost of their policy (the employee may only have to pay $50 or $100 per pay period for their insurance, while the employer picks up the rest of the cost), so some people who receive health insurance as a benefit from their employer aren't aware of the steep increase in costs of insurance policies. The increases are real, they're painful, and they're only going to continue to get worse.
My wife and I recently received a letter from our insurance company that states, in part, the following:
"Some of the affordable types of coverage - like those with very high deductibles - will be eliminated and replaced with plans that offer more extensive services, but also will cost more."
Our insurance company, and insurance companies across the nation, are writing to their beneficiaries to let them know that many insurance policies will be eliminated because those policies don't meet the requirements of the Affordable Care Act. Because the Affordable Care Act requires policies to include certain types of coverage which many current high deductible policies don't include - including, but not limited to, coverage for dental, vision, birth control and substance abuse treatment - the high deductible policies can no longer be offered to people. Further, individual states have their own requirements for coverage which may include coverage for treatment like acupuncture and massage therapy. These common state requirements combined with new requirements of the Affordable Care Act are all aligning to make health insurance anything but affordable.
When analyzing an issue, it's always good to look at the extremes (or, in mathematical terms, the "limits") to understand concepts. Let's look at a couple of "limits" as they relate to this issue.
It can easily be argued that a 60-year-old woman doesn't need an insurance policy that includes birth control. This is common sense, but all women (and men, for that matter) regardless of age will have to pay higher insurance premiums for coverage like birth control which they will never need and will never use.
Single Healthy Recent College Graduate with Near-Perfect Eyesight
I know this is a very specific scenario to look at, but it's also a fairly common scenario. This guy isn't going in for eye exams or new glasses on a regular basis (any maybe not at all), and probably won't have any issues with his eyes until his lenses start to harden in his forties or fifties, leading him to need reading glasses. Why should he have to pay for vision coverage for 20 years when it's unlikely he'll ever need it when he's younger?
My family of six includes four young boys, my wife and me. Like the 60-year-old woman scenario, we're never going to need birth control. Ever. But we're going to have to start paying for it even though it's coverage we don't want to pay for. I can tell you first-hand, too, that we don't want to pay for coverage of acupuncture or massage therapy or even dental. As an example, we've determined that taking excellent care of our teeth and going to the dentist less frequently and paying the dentist out-of-pocket makes more financial sense than opting for dental coverage. We have purposely elected to forego dental insurance because it just makes more sense for us to do so.
Unfortunately, as things stand right now, it doesn't matter what we as a family think or want. We're currently being forced to pay for coverage we don't want thanks to the State of Washington Insurance Commission, and soon we're going to be forced to pay for even more coverage we don't want thanks to the Affordable Care Act. The Affordable Care Act will, without a doubt, make our insurance coverage more expensive. And it will, without a doubt, make insurance coverage more expensive for millions of people. Sure, we'll all be getting more coverage along with the more expensive policies, but in many cases it's coverage we don't want or need.
If you wear a watch occasionally to tell the time or as jewelry, imagine if you were told that you can't wear any watch you want. Only Rolexes were going to be allowed. No Timex. No Casio. No Bulova. No Gucci. Just the expensive Rolex. Sure, the Rolex is a better watch, but do you really want to pay for it? Can you even afford it? Maybe. Maybe not. This concept is absolutely absurd when applied to watches or other products or services, so why does anyone in America think it's okay when applied to a product we call an insurance policy?
I think it's absolutely great that as a nation we're trying to come up with ways to help people get affordable health insurance. But I wonder why we just didn't come up with something simple, like making sure MORE (not fewer) affordable high-deductible policies are available, and actually allowing insurance companies to reduce coverage or provide a-la-cart policies tailored to individuals and their specific needs. I also wonder why the Affordable Care Act is designed to punish people like me by INCREASING my cost of health insurance and taking away my choices. I was reasonably happy with my health insurance five years ago when I paid $700 a month for a $750 deductible policy. I'm less happy today because of the cost increases, but I'm still reasonably satisfied. When I think about how much I'll be paying a year from now, I know I'm going to look back to today and long for the days when I had to pay $700 a month for a $7,000 deductible policy.
If the new laws could ensure that millions of people wouldn't have to start paying more for health insurance, I'd be more open to them. As the laws are written today, though, millions of us are going to be worse off financially.
I know this a controversial topic from a political perspective, but I like to keep politics out of discussions like this and stick to the facts. I've always thought that Republicans are Republicans and Democrats are Democrats, and there's not a thing you can do to change that (I can explain my "brain filter" theory if you're really interested). Regardless of your political affiliations, I urge you to take a close look at how the Affordable Care Act will affect you, your family, your employer, your community, and the nation as a whole. As responsible stewards of the democracy we've been charged with, we owe it to ourselves and our forefathers to make sure we're doing the right thing.
Personally, I say, "read it FIRST, then sign it in to law." But that's just me.
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