My insurance, via my husband’s job, actually changed in 2013 “to comply with Obamacare” and while it may be better insurance for some, it’s not for us.
So yes the new, ACA-compliant plan cost more and covered less.
The company came out with a chart showing that, what with lower premiums, we would not spend any more out of pocket than we had been. And I can well believe that might be true if you were a person who took it to the max every year. But what happened is that we used to pay whatever it was for insurance, which was deducted pre-tax from the pay, and when we had to go to the doctor or an ER (and we have a teenager, so ER every year) it was a copay that was very reasonable. Now, it’s the whole amount until we hit our deductible limit, and then it’s 80% until we hit some other limit, so what used to be a $15 copay becomes a $180 dr. visit and what used to be a $50 ER copay becomes a $7000 bill, which gets halved because that’s what the ER hospital negotiated with the insurance co.
Now the other thing is that if you look at it, our premium actually went up because one of us passed an age barrier. You could say that would have happened without Obamacare, and you would be right.
So the result of this is that now my husband, who is old enough, is on Medicare and pays $100 a month for something additional (you know, after having $$ deducted for Medicare from every paycheck in his life), my son is on a policy of about $150 a month that pays for NOTHING until he hits the deductible–and (this really cheeses me off) it’s $50 a month more because he’s honest; one of the questions is if he has used nicotine in the past 6 months, they asked this in November and he and his buddies bought a pack of cigarettes after a 21-day backpacking trip in July–along with a bunch of junk food and soda–so yes, he had some nicotine within the last six months.
At any rate, the threat of having to pay $$ is certainly keeping us all out of doctor’s offices. And by that I mean that two out of the three of us are actively avoiding them.
Sadly, the health care that we do use often does not even count toward the deductible. If I go to get my annual eye exam and see the optometrist and not the ophthalmologist, it does not count. The cost of my contact lenses does not count. The eye drops I use are no longer on the insurance co.'s formulary and they are outrageous (but the eye dr. gives me a couple of samples), but I think it does count toward the deductible…I’m not sure. My son’s acupuncture does not count (and don’t get me started on whether it works because I don’t think so, but I’m not the one being stuck here, except for the $$). Mental health care does not count on a dollar-for-dollar basis. There is some formula. Everything is full pay out of pocket when it used to be copays.
So yeah, higher premiums + higher cost for care = less care. I am way not happier with my current insurance. Paying more, getting less. I assume that low-income people are now getting more or are getting subsidized, and that things are working well for them.
Nothing in the ACA has addressed the reasons for the higher costs, but this attitude is very typical in this country (e.g., let’s make seat belts mandatory, let’s put in airbags, let’s make cars that survive crashes better, not let’s make safer highways, educate drivers, and pull bad drivers off the road even if they’re not drunk). In fact the ACA looks like it will contribute to higher costs.
