An Unaffordable Aspect of the Affordable Care Act

When I started my PhD program at Florida State University, I had the option of waiving the student insurance, which I chose to do. Living on a measly stipend, even with the aid of student loans, did not lend itself to what I saw as a luxury: paying thousands of dollars for insurance to cover me and my wife. I know; crazy, right? A little over six weeks into my first Fall semester, I developed severe abdominal pain: appendicitis. Within 24 hours, I found myself slipping under the influence of anesthesia. I checked myself out of the hospital as soon as I safely could, and Leah Marie and I anxiously awaited the medical bills, which rolled up toward $20,000. The hospital stay alone rang up to over $16,000 of those bills. In the end, we were among a few of the lucky ones. We survived having to pay a little over $900.

The same surgery and same hospital stay can cost more than $10,000 less in other countries. And when people cannot pay for their own healthcare, everyone else pays for it, primarily, in the form of premium hikes. Therefore, my wife and I had high hopes when Barack Obama was elected president, as his platform included a significant overhaul of the healthcare system in this country. Leah Marie and I hoped (foolishly, I suppose) this would lead to universal healthcare or a single-payer option. Neither happened. While the Affordable Care Act (ACA) has made healthcare available to millions of men, women, and children who would otherwise suffer needlessly (in sickness or in debt), it has failed in one significant category. Millions of people still suffer because they cannot afford healthcare. I don’t blame President Obama. I blame the fear in the hearts of conservative Americans, a fear that is driven by lies and ignorance. But before I address that fear, I will share my current situation, and how devastating it is for so many middle class Americans.

By the time I was wrapping up my PhD, I had interviewed at the perfect job, exactly what I was looking for: a professor at a small, private liberal arts college. I felt like I had hit the jackpot when the job offer came. And in many ways, I had. I have some wonderful colleagues, and the students rock. Unfortunately, the pay leaves a lot to be desired, but I thought I could deal with that. It seemed like a sufficient living wage for my family. All I really cared about was the benefits. Finally, my wife and I, as well as our children (who had benefited from Medicaid thanks to our poor-married-student financial situation) would all have insurance, and we would have the same insurance.

As I looked over employee healthcare options, a bitter cold settled in my chest. “There’s no way I can afford these premiums,” I thought. That wasn’t entirely true. I could easily afford the cheapest insurance coverage for me: a basic catastrophic type plan, where the insurance would start covering a certain percentage after I hit my deductible. Adding my family to that more than quintupled the costs. The best insurance coverage offered (and not a very good plan at that) was out of reach for just me, but covering my family meant over 20% of my pre-tax salary would disappear toward health insurance premiums for coverage that was far from absolute or comprehensive—still plenty of out-of-pocket expenses to worry about. Fortunately, our children qualified for Medicaid. This meant my wife had no insurance. In fact, in the last eight years of our marriage, Leah Marie has had insurance mostly when she was pregnant, and that was Medicaid.

When the ACA was about to go into full swing, Leah Marie’s research into coverage options destroyed our renewed hopes at its original passing. This is when we learned about the “glitch” in the ACA. The title of a recent post on NPR’s health blog says it all: “Obamacare ‘Glitch’ Puts Subsidies Out Of Reach For Many Families.” Because my employer offers insurance for me at an “affordable” price, no one in my family qualifies for any of the subsidies the ACA offers. It doesn’t matter that my realistic employer option to cover my whole family is well beyond my financial means, plus thousands of dollars. So we are stuck. We cannot afford healthcare coverage for the family, but we are not poor enough for everyone to qualify for Medicaid. This is why universal healthcare or at least a single-payer option makes perfect sense. But, oh, no, how dare America, land of the free and home of the brave, consider such a socialized system. Who cares about all the people needlessly suffering and dying?

The following words, from the comments thread on the NPR article I referenced earlier, nail it. I have reproduced it without concern for typographical or grammatical errors:

“Since so many in America think it can’t be done we must just be worse at this than socialist Germany, Sweden, Norway, France, Belgium, the Netherlands, Great Britain and several other countries that beat us hands down in quality of care, outcomes and reduced cost. Britain spent approx. $3500 for each patient in 2013 vs. almost $8700 in the US. So those opposed to single payer are saying that the US (‘we’re number one’! ‘greatest country on earth’!) is nowhere near as proficient at accounting and medical care than at least 10 other countries that whip us at it repeatedly. How embarrassing. Our response… Increase corporate profits. That always fixes everything. Look how many jobs it’s brought back.

“Oh and by the way… Did you know that the once income taxes and health insurance for a family plan are taken out of US paycheck there is actually a larger percentage paid (about 3% higher) than a paycheck in any single payer country including their dreaded ‘high taxes’. Yes, families willingly pay more out of our paycheck for the solace in knowing we are giving that money to corporations instead of the government even when the outcome is worse. Many don’t care to understand this because it’s just easier to scream ‘Socialist’! All hail shareholder Capitalism. Take a knee for Wall Street.”

Millions of people in the US will continue to suffer, and healthcare costs will continue to soar out of control compared to most of the rest of the developed world, where people will continue to have access to healthcare without concerns. And we, the American people, as Leah Marie often says, will continue to be so focused on protecting ourselves from the government that we will let the private sector rob us blind.

2 replies »

  1. Sadly, the best a lot of people in America can do is cross their fingers and hope to not get sick, injured, pregnant, etc. This from the most powerful economy in the world.

  2. I could write a paper on other glitches not mentioned here. Some people say ACA is “better than we had before” because they think it’s better that some people now have some sort of coverage when they had none before. So far (five years after passage), four out of every five former uninsured are still uninsured. One in five now has what is still horribly unreliable, over-priced coverage provided by a broken, amoral, inhumane and fiscally irresponsible model (forced privatization) that puts money before morality and profits before people (which is totally bass-ackwards and unworkable when we’re talking about protecting people’s access to medical care). So far ACA leaves no less than 40 million human beings completely uninsured. At best five MORE years from now it will leave no less than 30 million people uninsured (according to CBO, not me)….plus tens of millions more dangerously and unreliably under-protected. It’s not OK to leave even one human being that way. It’s not OK to leave tens of millions of people uninsured, and to leave those with insurance at the mercy of private health unsurance corporations that have no mercy. We all need to be given the right and the freedom to join a reliable, sustainable, not-for-profit public plan (the bigger the better) and discrimination in medical care needs to be made illegal. It’s like saying it’s OK to leave tens of millions of people without fire or police protection, or the right to an education (which is not life or death like access to medical care is). It’s like saying we all have to hire private police and fire fighters under a model that lets providers who refuse to protect people make more money than those who actually do the job. This is insanity. What ACA continues and enlarges upon is a model that is perverse and contrary to the good of our whole. It is morally unacceptable and fiscally irresponsible. If we take a balancing scale and weigh all of the good things about ACA on one side and all of the bad on the other, the bad parts outweigh the good by FAR. We need honest healthcare reform to replace this deviously disguised pro-corporate-welfare scam AKA ACA, ASAP.

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