Sunday, February 16, 2014

Obamacare Before and After

For a long time we didn't get health insurance from our jobs. I purchased health insurance for my family on the individual market. Last spring, I switch to a new employer that does provide health insurance. If we hadn't switched, I expect we would have been one of those families being told that because of Obamacare, we would be losing our health insurance plan. It wouldn't surprise me to learn that our previous insurer is no longer selling individual insurance in New Hampshire.

But that's OK. We didn't like our plan. We didn't care if we could keep it.

I didn't like the sign up process. The price quoted to me online was totally misleading. I couldn't sign up on online at all. I had to contact an independent broker to actually navigate the process. The actual price was much higher than the one quoted on the website.

I didn't like the fact that they wouldn't insure my entire family. They would insure some of us, but they would not sell a policy to cover my son - who is a generally healthy, normal kid. He was born prematurely with a low birth-weight. Preexisting condition. For him we had to buy a separate, more expensive plan. From a different insurer.

They wouldn't cover maternity. That would be too risky given our history. We aren't planning to have more kids. But I didn't like the idea of a for-profit health insurance company making that decision for us. Whether or not to have children is the kind of decision we should be able to make for ourselves.

We didn't really like having a $5,000 per-person deductible. The insurance didn't end up covering much of anything. If we had more than one incident in a year we could be out $10,000+ in addition to the money we were paying in premiums. That didn't happen every year. But it did happen.

We contacted the insurance company when the law changed and they could no longer reject children due to preexisting conditions. They waffled, delayed, and refused to quote us a new price for a policy that covered our entire family. When they finally relented, they jacked up the price so much that we were better off sticking with the separate plans. I didn't like that.

One time my wife had knee surgery at our local hospital. We were informed that the hospital was in-network. But the anesthesiologist in the hospital was not in the network. So, we were supposed to pay for that. We appealed that decision and won. But the insurance took the novel approach of simply never, ever paying the money they agreed to pay. I didn't like being told a dozen times, over many phone conversations, over several years that this would be taken care of. I didn't like collection agents calling us to demand the money that the insurance company had promised, but never paid.

We did not like our insurance plan. But we kept it. We renewed that plan year after year, ever as they kept jacking up the premiums. We kept our plan because there is no way we would take the risk of going without health insurance. We kept our plan because the alternatives were worse. Other options had ever more strict underwriting requirements and wouldn't sell  us policies at all. Or they were ever more expensive. Or provided even worse coverage.

I supported the ACA and was very much looking forward to being able to purchase insurance on the health care exchange. We started getting insurance through my new job before the exchanges were launched. But it's instructive to compare what's available now compared to what we were going through.

The insurance exchange in New Hampshire is far from ideal. We're part of the federal exchange and have had to deal with the complications that came with that. What's worse is that there is no competition, and not much to choose from within our exchange. Currently, there is exactly one insurance company that offers policies through our state exchange.

The good news that the sole insurer is the biggest, most reputable insurer in the state. They can no longer pick and choose among members of our family. They don't get to decide if we're allowed to have more children. And getting an accurate quote from the web site was quick and easy

Under our old plans, we were paying a total of $832 per month for multiple plans, each with a $5,000 per person deductible. On the exchange today, a comparable plan would cost us $730 a month. Even without subsides, we could save over $1,200 a year. Or we could pay what we're paying now for superior coverage, fewer hassles, and a more reputable insurer.

I've been a supporter of health care reform. I didn't support that effort because I wanted everything to stay the same. I recognized that system was terrible. The whole point of the reforms was to change it.

That's not a promise that was broken. It's a promise that was kept.