WASHINGTON -- The former chair of the New Hampshire Republican Party will save $1,000 a month in premiums for his family's health care package after signing up for a new policy through the Obamacare exchange.
But Fergus Cullen said the savings aren't enough to turn him into a supporter of the new health care law. He said he anticipates higher out-of-pocket costs with his new Anthem-administered plan, and he's frustrated by what he sees as a lack of information about coverage options. His old plan, which was pricey but covered what he needed, was cancelled by his insurer because it didn't meet Obamacare regulations.
"Fundamentally, the plan I wanted to buy is one that gives me catastrophic coverage for my family and lets me self-insure for everything else," Cullen said in a phone interview with The Huffington Post.
Stories similar to Cullen's are being told by folks across the country -- that the Affordable Care Act has benefits that must be weighed against its downsides. What makes his tale a bit rarer is that he's one of the few Republicans of stature willing to acknowledge the tradeoffs.
Cullen, who runs the consulting firm Fergus Cullen Communications, was chair of the New Hampshire Republican Party in 2007 and 2008. He wrote about his Obamacare experience in the pages of the conservative-leaning New Hampshire Union Leader. He acknowledged that other Republicans had warned him that the article would be picked up by defenders of the law as evidence that it worked even for staunch, free-market oriented conservatives.
But his personal experience with Obamacare -- and his assessment of the law –- is not an endorsement. If anything, it's part approval, part condemnation, and part withheld judgment.
First, the facts. Per Cullen, his family of five spent $26,934.89 on health care last year, a combination of insurance premiums (the majority of the cost) and out-of-pocket expenses. The year before, that number was $22,121.50. In other words, his costs were rising prior to Obamacare exchanges going into effect.
Cullen called his insurer to see if he could lower the cost. The company said no, and sent him a letter explaining that on July 1, 2014, his individual health plan would no longer be offered. It "didn't conform to ACA mandates," Cullen wrote. His insurance agent searched for new plans and found options comparable to his old one that potentially saved money. Cullen then logged on to healthcare.gov. Since New Hampshire did not set up its own exchange, he had to use the federal website.
Cullen acknowledged that he was pleasantly surprised by the experience. "I didn't need to start and stop and didn't need to call a friend," he said. But he wondered if his less tech-savvy parents would be able to do the same. He described the experience in the Union Leader:
Whatever problems existed last October, the site is pretty impressive now, intuitive for people who are used to using smartphones and tablets. Navigating the site took most of an hour. The program did crash once while I registered my family, but when I logged back in it took me right back to where I’d been without losing any information.
He ended up with a bronze plan (the least comprehensive of the tiers available to his family) that will save him in premiums about $12,000 a year. And this is before applying for tax credits, which he said he was thinking of doing. Tax credits are available to a family of five with an income of less than $110,280.
So what's to complain about? For one, Cullen said he's worried about out-of-pocket costs, which he said may be unpredictable. But under the law, out-of-pocket costs are capped at $12,700 a year per family. So at the most, he may end up spending $700 more this year than last (the difference between the savings on premiums and the out-of-pocket maximum).
Second, Cullen said there's a lack of general information about what his plan actually does for him and his family.
"I don’t know what prescriptions are covered exactly," Cullen said. "We don’t have dental, for example. So I'm expecting that my out-of-pocket is going to be higher."
The main issue that Cullen has, however, is that he doesn't want to pay for services he feels are unnecessary or redundant. The analogy he uses is car ownership. "You don’t buy car insurance for your oil changes," he said. "You buy it for those things you can't predict." In other words, he thinks he shouldn't have to pay insurance costs for preventative services because he can handle those expenses himself.
What Cullen wants, instead, is a form of a la carte insurance with catastrophic care component. Since he is paying lower premiums now than he did prior to Obamacare, and since catastrophic care generally has a high deductible, it's unclear how much that would actually save him. Cullen acknowledged that he may, indeed, end up with lower costs.
"Am I complaining about the outcome? Not as much as I am complaining about the process and my total lack of confidence that they fixed the system," he said.
And that brings him to his final, larger critique. Cullen said he believes Obamacare does too little to streamline health care services and reduce costs.
"I don’t think this addresses any of the fundamental broken aspects," he said, "which is that consumers don't know the costs and the providers have no incentives to hold down costs and that huge amounts of our economy are being directed in non-productive ways."
Jeffrey Young contributed reporting.