Tag Archives: Obamacare Delivers in California. Obamacare

My Obamacare Experience, or Why is it that Republicans Hate Small Business/Entrepreneurs?

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Obamacare, the ACA (Affordable Care Act) has been a godsend to me.

Republicans Hate Entrepreneurs. Sad!

 

 

 

 

 

 

 

 

 

Alas, the Republicans think it’s bad (even though it was their plan) and so they’re going to replace it with something cheaper and much better (according to their new leader). I can only think this will be Medicare for All. Yeah, I wish, and don’t we all?

Just looked up some old stats: In 2007, when I was freelancing full time, I was paying a $502 per month premium for Kaiser HMO coverage. I was (and am) a single man in Los Angeles, aged 52 in 2007.

This past year, I had an ACA (Obamacare) policy through Covered California, again it was a Kaiser HMO plan, and I paid $180 per month. I got a significant subsidy because of my income level. The actual monthly premium was $663. For this year (2017) the premium is $734/month, of which I’ll pay $200. (The same plan — it went up 11%.) The subsidy goes directly to Kaiser Permanente. I never see a penny of it. So for those who hate the subsidy idea, please be reminded that the funds go to overpriced insurance companies, big Pharma, medical device companies, and doctors. The subsidies don’t go to the patients. Your tax dollars are going to support those megaindustries, not for actual healthcare for Americans.

So I’ll be 62 this year.

As a freelancer (I write B2B copy and am an author) with pre-existing conditions (including glaucoma and a history of cancer) I could not get insurance with the system we had before. Or, if I could (like the example above, from 2007), it was a catastrophic plan with high premiums and high deductibles and co-pays, which means basically that I was just insuring my assets against a catastrophic health care loss. Those assets were a condo (since sold) and an IRA retirement account. I wasn’t getting any actual health care for the insurance premiums.

That catastrophic plan also did not cover any prescriptions, which I paid for out-of-pocket.

My current Obamacare Silver-level plan does cover prescriptions, and the co-pays for visits and lab work are affordable (I think I pay about $8-10 per a visit to either; scripts are $10-20 for a 90 day supply.)

If the Republican zeal to roll back things like pre-existing conditions becomes reality, I will again be unable to find insurance. Who, at age 50 or better, does not have a pre-existing condition? Life is a pre-existing condition. This is absurd.

There’s a couple of other issues that I want to touch on. One is Ageism – and the near impossibility of finding an appropriate full time job with health insurance at my age. I haven’t been able to find a full time job in my field since 2010, hence the part-time work and freelancing. Also, employers are moving away from providing benefits in large part due to the ACA and the ability for an individual to buy a policy on the exchange. Decoupling health care from employment, isn’t that the direction we wanted to go? Do we really want to go back to that?

Which brings me to my last point —

Why do Republicans hate small business and entrepreneurs? I always thought they were the party of personal responsibility and commerce. Keeping health insurance tied to employment is 1) arbitrary, and 2) stupid. How many people keep their jobs JUST because they get their healthcare insurance through that job? How many Apples or Facebooks or Starbucks never come into being because people can’t afford to gamble with their health coverage to become entrepreneurs?

So, no, Paul Ryan, you’re wrong, again. Obamacare isn’t a nightmare or a disaster. It’s a lifesaver. It has problems, easily fixed. Why don’t you just do the easy thing and try to fix it instead of throwing the baby out with the bathwater? Oh, right, it’s named after that black president, isn’t it, and we certainly can’t have that. That is the real issue, the whole country knows it.

Obamacare – my journey so far with the ACA, health, and the healthcare industrial complex

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Oh but where are we headed? It looks dark.

Oh but where are we headed? It looks dark. I hope not.

So I’m at a totally unrelated-type doctor appointment (eye, of all things), but what do they always do first? Always! You got it – the blood pressure reading.

148/94. Sheesh. This is not a good reading. And it was the second time, the first time the first number was over 150. Technician: Are you on medication? Me: No. Technician: Take a deep breath. Me: Breathing. Technician: Take another one.

and so I do, and so she takes the reading and it’s 148/94.

And I am so disappointed and feel like such a failure. I do more cardio than anyone I know. I lost 20 lbs. earlier this year, though that’s settled out at about 15-16 lbs. since. My BMI is 23. I don’t smoke or drink and haven’t done either in decades! I am a fixture at the Farmer’s Market. Yet my BP readings have only steadily climbed over the past few years.

So there’s nothing I can do about my age (58). Or my genes, what I’ve inherited from a family with a history of heart problems on both sides.

Salvation in technology, right? As Jesse Pinkman might shout, Yay Science! So I go to Amazon.com, and buy a BP monitor. This way I can torture myself by doing self-readings every day. Or maybe I’ll find out it was the coffee and the nervousness/busyness of going to the doctor, not something I do very often.

Because, while I do have health insurance, the plan I have is a high-deductible one (catastrophic, perhaps) and I can’t afford to actually go to the doctor much, though I do pay the c. $300 per month hedge against total financial ruin (aka as the monthly health care premium – though it has nothing to do with care, really, now does it?)

All this is a roundabout way of saying that yes, Virginia and others, I do benefit from the Affordable Care Act (Obamacare!). How so? See my list:

  • I live in a progressive, forward-looking state that wants to make huge changes in the way health care is delivered to its population, #1. So, we have an Exchange (where you can buy a plan – coveredca.com) that’s been working since Day 1.
  • I get a better plan. My old plan with the Kaiser HMO did not include prescription coverage. Under the ACA, you can’t do that anymore, you actually have to have a plan that, you know, covers you.
  • The plan costs less. Why? Because I work only part-time (self-employed), I get a subsidy. So it’s about 2/3 less than what I was paying before. And even more if you consider that the premium for the same plan (now with prescriptions) went up about 60% from what I was paying in 2013.
  • Copays are slightly less, as is the out-of-pocket maximum for the year, which is a small benefit, but one in the right direction. I believe it’s $4,500. Which, while a lot of money to be shelling out if need be, is a whole lot better than financial ruin, bankruptcy, etc.
  • While not a perfect solution, this is a detour on the way to single payer – which we’ll eventually have, I predict.

So those are the specific benefits to me so far. Better plan, lower cost, no impossible to work through bureaucracy. I wanted to post this, as prosaic as it may be, because of the shrill voices in the media only finding disasters. There are successes — and there will be many, many more — you just have to look.