What the Affordable Care Act means to one American

I don’t feel qualified to wade into the American health care debate. I know many Americans feel like it’s an economic disaster, and others think that it doesn’t go far enough. But the question of how lower income Americans actually manage to afford health insurance is one that often seems to get ignored.

A regular reader and occasional commenter on this blog, who is a full time musician and a lay employee on the staff of an Episcopal church, yesterday published a post about the impact the Affordable Care Act (AKA ‘Obamacare’) will have on him. I urge my readers to go over to Andrew’s blog and read what he has to say. Note that, as he says in the post, he is not especially a fan of President Obama.

Before Matins this morning, I turned on the computer and went to the official site for the Affordable Care Act.

When I saw their splashpage with the big title: “The Health Insurance Marketplace is Open!” I shed some tears. It has been a long time coming…

…Our diocese offers three medical insurance plans, and it is mandated by canon law that the local parish must pay the full cost of participation in these plans for the clergy. As it currently stands (2013), I may enroll in the insurance plan should I wish to do so. The cost for single-person coverage is about $9,000 a year; should I wish for my wife to also have insurance, the total cost would be slightly north of $20,000. The congregation would pay zero; it would all come out of my pocket — which is not sufficiently deep for numbers like this.

Thus, my wife and I purchased individual coverage from the state Blue Cross/Blue Shield affiliate. We are on the cheapest plan they offer, which has such a limited list of coverages that it does not cover what the ACA calls “essential health services.” We are both in excellent health, but have had “pre-existing conditions” ruled out — for me, there was no coverage for anything related to the eyes, because I am sufficiently nearsighted to be at high risk for retinal detachment. The deductible for this policy is $11,000 a year — that much has to be spent in medical bills before the plan pays so much as a penny. The premium is about $500 a month, covering the two of us; this premium has approximately tripled during the twelve years that we have had the policy. This is a “high deductible health savings plan” and is accompanied by a Health Savings Account, to which we can make tax-free contributions, and we have done so every year, right up to the maximum allowed. This money sits in a HSA earning about 0.5% interest with a $25 annual fee eating away at it.

In my opinion, this is not a satisfactory arrangement. But it is the best we can do, balancing affordability with at least a minimum of insurance — for, if you are uninsured in America, you are one accident or illness away from bankruptcy.

Correction: you WERE one accident away from bankruptcy. Today, that all changed.

Read the rest here. Do.


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