What Obamacare means to my family

The anticipated and dreaded letter from my health insurance company arrived yesterday.

Dear Member:

We are writing to let you know about some important changes to your individual health insurance coverage … Your health insurance plan will no longer be available after December 31, 2013.

We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different price.

Wow. You bet it does. Looking at the enclosed rate sheet, I found my family’s new monthly premium for the cheapest available plan (Bronze HSA, non-smoker) for 2014 will be a whopping $1,024.59!

We currently pay $563 a month, so that new premium is a rate hike of 82%. Ouch. I knew it was going to hurt, but now I know how much.

Better coverage for the price?

One proponent of Obamacare likened the new, “more benefits” plans to trading up from a Prius to a Mercedes. Sure, it’s more expensive, but it’s a better car, isn’t it? Enjoy the ride!

Well, maybe I spent a lot of time shopping around for the best car to fit my family’s budget, ideology and lifestyle. Maybe I loved my Prius and wanted to keep driving it forever.

But let me look at the new list of covered benefits (included in my letter) to see what driving a Mercedes health plan would be like:

  • $10,000 family deductible (my current deductible is $7,500)
  • $12,500 out-of-pocket maximum (my current OOP is $10,000)
  • Pre-paid preventive care (included in my current plan)
  • No annual or lifetime limit (included in my current plan)
  • Maternity care (don’t need it)
  • Pediatric dental (don’t need it)
  • Pediatric vision (don’t need it)
  • Substance abuse counseling (don’t need it)
  • Mental health counseling (hmm, might need it)
  • No adult dental (now that I could use)
  • No adult vision (ditto)

So am I really trading up for a better value for money? Actually, I will be paying 82% more for less financial protection.

Rather than a Mercedes, I feel I am being forced to drive a tank. Sure, it’s got bullet-proof windows and a cool machine gun, but it’s not really suited to my family’s needs.

What are my options?

Very few, unfortunately. On October 1, I can shop around for a new plan on my state’s (Washington) health insurance exchange. But I have already looked at the available plans and prices on the insurance commissioner’s website, so I know that the bronze-levels plans are comparable in price. I might be able to reduce the monthly premium by $200, but not much more.

The best reason to buy insurance on an exchange is if you qualify for a subsidy. I don’t.

Prices for plans outside of the exchange are also pretty similar. Because all the insurance carriers have plans on the exchange as well, their off-exchange plans are “metalized” and ACA-compliant. That is, they adhere to mandated “essential benefits” and cost-sharing guidelines, and actuarial values.

What would I really like? More freedom of choice to pick the benefits I need at a price I can afford.

Unless another option presents itself, I will be forced to leave the insurance company I have been with for over 20 years, and try to find a plan that is at least a little less expensive.

I understand that the premium hikes are necessary to provide broader coverage to more citizens, including those with pre-existing conditions.

As a nurse, I have long advocated for better coverage — universal coverage — for all Americans. But helping one group of people by causing financial harm to another cannot be a workable solution to our health care crisis. Can it?

“Frugal Nurse” is a nurse who blogs at her self-titled site, Frugal Nurse.

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