Look Mom! I'm Insured! 10 Observations on Obamacare

Because of my income, I also wanted to compare Obamacare to the open market. Having read a lot of teeth-gnashing by people who felt cheated on both sides of the equation, I thought it was the responsible thing to do.
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This morning, Miss Penny is very relieved. For years, she has worried that I'm going to "drop dead of a heart attack" because of my very busy, stressful job, and "it runs in the family." I couldn't allay her fears because I haven't had a physical in forever as, until today, I have been uninsured for about a decade. I own and operate a small consulting firm, and I do not have the option of joining an employer's insurance plan.

For the last couple months I began to worry that I might be fined for failure to have coverage. My first attempts to check out Obamacare were wildly frustrating. We all know how utterly FUBAR the healthcare.gov website was last fall. Since January, it has been much more user friendly. However, as the clock ticked down, I had to postpone getting signed up for two very good reasons. First, I recently offered my 22-year-old nephew the chance to move up to Atlanta to live with me rent-free so he can save money for college. He is not covered by either of his parents, and he has pre-existing conditions, so we needed advice as to whether he could get coverage through my plan. It turns out, that was not necessary.

Because of my income, I also wanted to compare Obamacare to the open market. Having read a lot of teeth-gnashing by people who felt cheated on both sides of the equation, I thought it was the responsible thing to do. However, an insurance agent I had spoken with last summer seemed to have fallen off the map, so I was in search of another. It took me several weeks to find an agent whom I felt was not trying to flim-flam me or who wasn't just sending me a PDF from their favorite insurance provider. Heck, I could call Kaiser myself for that.

As it turned out, both the agent I selected and the government health care exchange offered me good plans from Humana. The Obamacare Platinum Plan with a $1,000 deductible was better than the Gold Plan with a $2,500 deductible offered by the agent. Plus, Obamacare was saving me $765 per year over the agent's plan, and I'm going to get dental coverage. Vision coverage was not offered by either.

It is worth noting that the quote I received from the other agent last year was $2,808 less than the quotes I had received every year for the past decade. Previous quotes were for $452 per month premiums. The plan he offered was for the same coverage at only $218 per month. I asked him if my age made the difference. He told me that my personal variables were the same, but that Obamacare was making the marketplace more competitive.

Beyond the savings, here are my ten personal observations about Obamacare:

1.) The website is still buggy, but it is very easy to use.

2.) If you are insured through a company benefit plan, that is not the same as buying insurance on the open market. That is part of a package they give you in lieu of paying cash for your time. See if you are allowed to opt-out of that plan. If so, you might get a better deal (without religious restrictions) on the open market or via Obamacare. Many of the complaints I've read stem from misunderstanding that employer-based plans are not the same as open market plans.

3.) Be sure to use your Adjusted Gross Income.

4.) Comparison shop. If you make a decent income, your coverage options, premiums and deductibles might be the about same or better on the open market vs. Obamacare. That's because the rates on the Healthcare Exchange are calibrated to assist lower income workers, students who are not covered by their parents' plans or entry-level folks. If you make a good income, you should be buying on the open market anyway, but you are not prohibited from buying your coverage thru Obamacare. You might get lucky like I did.

5.) If the point of Obamacare is to make it affordable for most people to pay for coverage (even minimal if one chooses) so that only the poorest of the poor and our seniors are being subsidized by Medicare and Medicaid, then that means consumers like you and me will no longer have the cost of giving free health care to the poor and uninsured passed to us through back door prices hikes.

6.) My confession: With no children, I could not justify paying $5,000-$6,500 per year on premiums with a $3,500-$5,000 deductible, especially when I had pre-existing conditions -- even though those things occurred 20+ years ago, I was still being penalized and priced out of the market. That's why I chose to be uninsured for so long.

7.) I also never understood why I was carrying costs for being "of child-bearing age" when the impregnators were charged 20-30 percent less, and their doctor visits were considered primary care while mine were charged as specialists.

8.) Obamacare is making insurance companies play more fair (no refusal of "pre-existing conditions," no coverage caps), and making coverage more broadly available and affordable.

9.) And this reform has happened on the free market. Not one insurance company has gone out of business -- they just have more customers now. Doctors and hospitals are still free enterprises, not government-run. The very few doctors who have shut down since the advent of Obamacare did so because they freely opted-out. Having handled marketing and PR for physicians, medical associations and peripheral services for 25 years, I can tell you that a doctor who closes up shop does so because he or she is a very bad business person -- just the way it happens in the rest of the marketplace. Doctors are just better whiners. Perhaps it's all of the golf.

10.) There is still reform I'd personally like to see happen, particularly a major reform of attitudes and work ethic in Congress, but I'm happy with these first steps.

Look Mom! I'm insured! And so is your grandson. He is getting medical, dental and vision for only $70 per month thanks to Obamacare.

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