I am self-employed, and losing the ACA could potentially have disastrous results for me.
I was insured through my husband’s employer. When he moved here from Australia, this was our actual strategy, that one of us be employed by an employer offering good benefits. Since I was already self-employed part time and was ready to give up the day job, we decided it would be him.
Then he died very suddenly. I was able to COBRA his insurance plan for 3 years, but it was very expensive. Still, that’s what I did.
Then I was on my own. In Oregon, health insurance companies were schmucking people off regular insurance and into “high risk” categories as fast as they could. First they ignored the continuous coverage proviso in ERISA that forces them to ignore preexisting conditions by simply not offering coverage until the ERISA continuous coverage period (66 days, if memory serves) expired. Then they required me to fill out a massive pages-long preexisting condition application and then find any reason they could to designate me as “high risk.” In my case, it was a note made in my chart by a physician nearly 5 years previous that I suffered from age-related spinal stenosis. I do, but it hardly bothers me at all. I was just curious why my hands sometimes go to sleep at night when I sleep in certain positions. I’ve never had any medical treatment of any kind for this affliction. But that little note in my chart cost me big, I can tell you.
My “high risk” policy cost me nearly $1,000 per month. In my mid-50s at that time and continuing to present, I am fortunate to have virtually no health issues. I really only wanted catastrophic coverage and basic medical checkups. When I couldn’t afford the nearly $12,000 per year for “high risk” insurance, I finally caved and purchased a straight catastrophic policy, self-insured for the periodic checkups and lab work. For doing so, the insurance industry barred me from obtaining regular coverage for 2 years. But that’s what I did, gambling the ACA would pass. Luckily, it did.
I finally have coverage for a reasonable price, with some decent choices (until this year, anyway) for a policy that best fits my needs. If they take away the ACA, I’ll be back where I was before: Self-insuring for most things and carrying a catastrophic policy for anything else. Basically fingers crossed that my good health continues until I qualify for Medicare. But… oh, wait. They’re planning to make severe cuts to that, too.
You can do everything right, but for fuck’s sake, don’t find yourself a self-employed widow and no ACA.