Thursday, February 12, 2015

A History of the ACA as told by one who "benefits" from it

Dear Mr. Senator,  
                                                                    
Today I qualified and signed up for insurance through the new marketplace implemented for the Affordable Care Act… This is a momentous occasion but not something that my family will be celebrating. You see, we have had privately held insurance since 2009 when my husband lost his benefits at work. At the time we shopped around and found an option that worked for our family. We chose a catastrophic insurance plan. It was the best fit for us since we did not use maternity care and did not use prescriptions. We seldom, if ever, went to the doctor. Most importantly, it allowed us to save enough money in a tax-free H.S.A. account to meet our high deductible in case of a catastrophe. This plan, for our family of 6, initially cost us $165 per month.

At renewal the next year (February 2010) our rate went up by 4% per month to $171. The increase came with a notice citing the new changes that may come into effect because of Obamacare letting us know that if the law passes, the coverage that we have chosen will no longer be deemed acceptable.

Several months later, our insurance- which we purposely chose to fit our needs- notified us that they would now be required by law to cover preventative care at 100% regardless of the status of our deductible. We were also notified that they could no longer offer the insurance plan that we had set up to new customers; however, as an existing policy holder we could continue coverage as a grandfathered policy. 

Our 2011 renewal came with a 15% increase putting our plan at $196 per month. We were also notified that our plan was now required to cover cancer screenings along with covering 100% of preventative care and immunizations. According to the letter in our renewal packet, this was what caused our rate to go up. We renewed our plan.

Later that year, our oldest child had some severe mental health challenges. Our insurance plan did not cover mental health but the provider did give us the option of switching to a new plan. I looked at other options and found that should we purchase another catastrophic insurance plan with mental health coverage, we would likely lose our insurance when the ACA went into effect. Our “grandfathered” plan status would no longer be in effect. We paid out of pocket without the help of insurance for my son’s medical needs and stuck to our grandfathered plan.

The year 2012 brought us another 20% increase bringing our rate to $234 per month. We were also reminded by letter that this plan did not meet the requirements of the ACA and we may end up losing coverage soon. We shopped around and found that our grandfathered “sub-standard” health care plan was half the rate of anything else that we could find. We renewed.

The year 2013 again gave us a 20% increase bringing our rate now to $291 per month. We were finally told that we could keep our insurance because of its grandfathered status without paying a penalty.

The glorious health care market place opened late 2013. Out of curiosity, we checked it out and found that the basest bronze-level plan was more expensive than our “sub-standard” insurance. However, because of our income, we would qualify for “tax-credits” to reduce our premium. We weighed our options and ultimately decided against signing up for other people’s money. We had been able to pay our bills and we could afford (barely) our insurance, so we stuck with it. 

In February of 2014 we received a notice that our insurance would again be increasing by 20%. Our rate was now $350 per month for a high deductible catastrophic plan. We could no longer afford to contribute to our H.S.A. with this new rate, but we did renew our plan.

That history now brings us to this monumental day in 2015. Our rates have gone up again, by another 20%. In the past five years, our insurance has increased by a whopping 250%. Our income… has stayed the same. The friendly letter reminded us that if we don’t like the rate increase we can always “visit Healthcare.gov and look at other Marketplace plans.” We received our letter 5 days before the marketplace closes... 

We are starting to see a pattern and realize the predicament that we are in. Our grandfathered plan will continue to try to price us out by increasing the rate each year. $412 per month is more than 10% of our income and we are down to the wire. I've talked to several private insurance agents who have all told me there is nothing less expensive on the private market than our plan. Our Health Savings Account is empty... and we are out of options. Today we canceled our insurance.

I literally cried. I cried for the future of this country. We have never been wealthy- not even upper-middle class. But, for our entire marriage my spouse and I have been able to pay our bills, stay out of debt and avoid any kind of government assistance. We have almost always qualified for reduced school lunches and I’m sure other government programs- but we have never needed it and we willingly chose not to partake. We budget, we save, and we flourish with hard work and sacrifice. Our children have never gone hungry and are, in fact, quite healthy. As I filled out the application and chose a new healthcare plan- I was required to check a box stating that should our income ever drop to a level that qualifies us for Medicaid, we would cancel our marketplace insurance and enroll in welfare.

We do not want handouts! But we have literally been forced onto government assistance along with countless other Americans. We have just signed up to receive money “from the government”… money that our government can only get through taxation, penalties and fees from ourselves, our neighbors, our friends, and our posterity… and even projections of this “revenue” falls far short of covering this staggering cost.

In the meantime, we have been priced out of our “substandard” insurance which had a lower price tag overall than the bronze level plan we have just signed up for. Our catastrophic insurance plan, even with the rate hike, was 50% less expensive for premiums than the cheapest government subsidized health plan available. It also had a max family deductible of $10,400- covering everything at 100% after that deductible was met- which beats even the highest priced bronze level plan on the marketplace.

Mr. Senator, I realize I am not telling you anything new in this letter. I merely want my voice to be heard. I want people to know how the Affordable Care Act is directly affecting one family who it proposes to benefit. We do not see this as a benefit. We are not happy. I sincerely hope that you will continue to do whatever is possible to repeal this outrageous infringement upon our families’ freedoms. With every dollar that we add to our debt and with every healthcare option that is ripped away from us, our country falls deeper into a state of dependence and becomes less and less like the free America that our founding fathers fought and died for... all in the name of social justice.

Your constituent,

Sheryl Rose