Reports Of Your Insurance Plan's Death Have Been Greatly Exaggerated

There’s something I have to get off my chest.

Human interest stories about people whose insurance costs are "skyrocketing" under the ACA are starting to blossom. These articles are at best misstating what’s going on or--at worst--deliberately misleading consumers about the Obamacare changes. If I may:

1) Most Americans--including me--are insured by their employers who, in turn, get tax incentives to subsidize their employees' insurance. In my case, I pay about 20% of my premium. My employer covers about 80% of my total plan's cost. That's pretty typical. 

My cost is going up by about $20 next January. Is that annoying? Yes. Is it good for me? Yes! To comply with the ACA my insurance has to change to cover pediatric care (including vision & dental); emergency services and hospitalization; maternity and newborn care; lab services; rehabilitative care; preventative care including free screenings and physicals; mental health and substance abuse treatment; and prescription drug coverage. 

Plus! There's no lifetime cap on benefits and they can't terminate or change my plan suddenly if, say, one of us got sick. Or it's possible my son will need treatment for dyspraxia. Before the ACA, there was a lifetime cap on how much treatment my insurance would pay for. Or consider someone with a chronic disease. Now that person can't exhaust their benefits. 

I mention this because it's the insurance most people are familiar with. About 80% of people with insurance have policies subsidized by their employers. So, when they see stories about rising premiums and see their own premiums increase, like mine, they're undoubtedly concerned. 

There's a second type of market, though. Individual plans for the self-employed or for people who don't have an employer-provided plan. 

Importantly, this market hasn't been "in the light," so to speak. A lot of the complications and changes that are getting media attention are simply things on the individual market seeing the light of day.

Which brings me to...

2) The policies being cancelled are mostly limited to the individual market. A lot of them are low premium, high deductible plans with low lifetime caps. For instance, some plans might be $56 a month. But they cover, essentially, nothing. If a person with a catastrophic plan like that gets sick they're shit outta luck. Their insurance might pay, say, $10,000 (being generous) and the rest of the $200,000 falls on the patient's shoulders. 

The policies are being cancelled because they don't meet the minimum requirements under the ACA. Those plans have to actually, you know, provide benefits. These junk plans are grandfathered if they existed before March, 2010 and haven't changed since. 

So, I understand the sticker shock and I get the frustration when people see premiums go from $70 a month to maybe $300 or more. 

On the other hand, the ACA offers a federally funded expansion of Medicaid for low income families, children, and the elderly. Almost all Democratic state legislatures have expanded the coverage and are accepting the additional funds. Some Republican-controlled states like Ohio have expanded Medicaid and are accepting the funds. Most Republican states have not. So their residents are going to be stuck between getting Medicaid and getting help paying for a private plan. 

Which is another major point. Depending on someone's income, the sticker price of a private plan isn't what someone would actually pay. Someone getting a $400 a month plan might qualify for subsidies that lower their monthly total to $80 a month. Much easier to handle. 

Still an extra cost? Yes. But, much cheaper than betting against getting sick, having a child, needing medication, or having an accident. Statistically speaking it's like betting red on a roulette table with only four red spots.

Don't get me wrong. I understand the concerns. And even the idea that you should be "free" not to buy insurance and take that bet. But, if you do, you're only making everyone else's bills higher.

It's frustrating that the headlines are *technically* correct but extremely misleading. They don't mention those expanded benefits. They don't point out that insurers canceling plans or raising costs exponentially are private insurers padding their bottom lines. Or, in some cases, trying to defraud their customers (http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare).

End rant.

Put Down The Scissors

Everyone should be talking about the House Progressives' budget proposal. Not everyone agrees that we need to cut, cut, cut to reduce America’s deficit.

America doesn't have a spending problem. We have an investment problem. Despite the popular trope, a government budget is not the same as a household budget. We need to stop thinking of it as grocery list and think of it as a form of mutual fund.

We as taxpayers pay the government and, in turn, the government invests money to produce a return for the taxpayers. The discussion should not be, “what to cut.” The discussion we need to have is, “what to invest in.”

"We have been here before." Graphic CC Sean Thornton

It's not a waste of money to invest in bridges, roads, and schools. Programs like WIC, Social Security, Medicare, and Medicaid contribute to the general welfare of the country. Bridge and road projects create jobs, contribute to public safety, and help spur business development in new areas. Schools can create the next generation of software programmers or engineers that can help America compete in a crowded global market.

Our investment in defense is wasteful. We invest more in defense than the next 13 countries combined. What return are we seeing on that? It’s wasteful to invest almost $4 trillion in a decade long war in a country that posed no threat. It’s wasteful to continue spending $1.5 trillion on an over-budget fighter jet that can’t fly without knocking out its pilots.

We need jobs. We need well-paying jobs that provide people a living wage. We need to make sure people can afford health care. We live in the richest nation in the world. There is no excuse for children to go hungry or die from preventable diseases here.

People are a good investment. People are the smartest investment America can make. But it’s a responsible investment that the "party of fiscal responsibility" doesn't believe in.

Fiscal responsibility isn't about cutting spending and being afraid of taxes. It's about using our money in ways that will do the most good. We can get a solid return on our investments. But only if we choose the right priorities.

Your Moral Exemption is my Objection

So, how do these "moral exemption" laws work?

So, if my employer has a "moral objection" to birth control, they don't have to cover it with their benefits package, right?

Say I work for a Jehovah's Witness. Can they refuse to cover blood transfusions? How about Christian Scientists? We can just refuse all medical procedures on "moral grounds."

Moreover, isn't this tantamount to telling employees what they can and can't buy with their compensation? Health insurance IS part of any competitive compensation package, after all.

If my employer objects to alcohol, should I take up a paper route to pay for beer?

I'm confused. This all seems very arbitrary to me.