Good News Bad News

There sure are highs and lows when it comes to Obamacare news.

GOOD NEWS

I heard from a self-employed person in Benson that he got signed up through healthcare.gov for a Health Net Silver plan for $61 per month (after his subsidy). Because he lives in Cochise county his plan is a PPO that has the large, state-wide Health Net network. So he can see doctors in Tucson or anywhere else in Arizona.

Clay works hard at his business, but he has not had health insurance for a long time. I think he’s pretty healthy, but he hasn’t been to a doctor  in quite a while.  Now he can get preventive screenings and other services that will keep him healthy.

AFFORDABLE PREMIUMS IN TUCSON

I have helped several people enroll in health insurance plans without a subsidy. The premiums have been pretty reasonable and allowed these people to change from bare-bones, high-deductible plans to either a Gold plan or a Silver plan with unlimited doctor visits for a co-pay. Their new plans will be much better than what they have had and their premiums will be close to what they have been paying.

People enrolling without a subsidy can go directly through the insurance company. Enrolling is “like signing up for a library card” according to my clients.  That means it is really quick and easy.

BAD NEWS

On Facebook I hear news of friends and family around the country, and I heard some bad news from my old neighborhood in Connecticut.

A woman who is probably 63 years old and married is really upset about Obamacare because she and her husband are getting the shaft.  Their health insurance is being cancelled so they must buy a new plan offered through the Connecticut Exchange.  They don’t qualify for a subsidy, so their already-high health insurance premiums are going even higher – to over $18,000 per year!!!

I don’t know what this couple’s income is, but it is higher than the $62,000 cut-off for getting a subsidy. If their income is $65,000 and their health insurance premium is $18,000, that comes to 27% of their income!!! Holy cow! That is crazy expensive – but that is because health insurance in Connecticut is expensive and always has been.

It seems to me that the income limit for getting a subsidy in Connecticut and other expensive states should be higher than in Arizona. Paying 27% of their income for health insurance is most certainly not affordable.  So what happened to the Affordable Care Act for this woman (who was a supporter of Obamacare before she got slammed by it)?

In Tucson, a couple, both aged 63, can get a Platinum HMO plan with no deductible for around $1,000 per month. Or they can get a Silver HMO plan with a $1,500 deductible for $757 per month. And this is without a subsidy.

QUESTION

Why is healthcare so much more expensive in Connecticut than in Arizona?  I guess doctors need to make more money in Connecticut because housing is more expensive and taxes are higher there. So where does that leave their patients who can’t afford to pay for health insurance that will allow them to see those rich doctors?

SOLUTION

A fix to this problem for middle-class families in Connecticut is to raise the income limit for getting a subsidy. The subsidy should be based on the cost of health insurance where a person lives.  The rule in the Affordable Care Act is that a person should not have to spend more than 9.5% of their income on health insurance.  That woman from my old neighborhood in Connecticut would be happy to spend 15% of her income on her health insurance – but she’s paying much, much more – and it is not affordable for her and her husband.

I heard today that the Obama Administration will allow people like this woman in Connecticut to buy a catastrophic plan in 2014. But this woman and her husband do not want a catastrophic plan!!  Geeze. I sound like Fox News.

Dear President Obama:  Please don’t make me sound like Fox News.  Please fix the subsidy so it matches the high cost of health insurance in Connecticut and other states.

Dear Republicans in Congress: Please put aside the politics and work with Democrats to fix the problems with the Affordable Care Act.  The idea of people being required to buy health insurance through private companies (and not the government) was a Republican idea. It is working in Massachusetts.  I think it will work in Arizona and other states where health insurance premiums are affordable.  Please help people in Connecticut and other expensive states get affordable health insurance too.