Update On “My ACA Experience”

By , in Current Events Healthcare Politics Rants on .

Ben Garrison Obamacare

The prior article, “My ACA Experience”, for context

I recently received several letters from my insurance company in regards to my policy.  They informed me that I can keep my coverage through the end of next year.  One letter said that I would need to contact them to keep my policy.  Another said the following, in this exact formatting: “We are required to provide you with the enclosed communication prepared by the Department of Health & Human Services.  It suggests you contact us to keep your current plan, but that is not necessary.”  And in yet another letter, I was informed of my “mastectomy benefits”.

In a state of confusion, I called the insurance company and asked what was going on.  A representative seemed even more confused than I was, asked me information about the letters, and was unsuccessful in attempts to locate copies of what they sent to me.  After promising to take action within the company internally so that this situation doesn’t happen again, I was (finally) assured that I wouldn’t need to take any action to keep my policy beyond continuing to pay my premiums.  She made it clear to me that this confusion would not happen again, and that any further updates to my policy would be very clearly communicated.

A few takeaways I had from my experience:

  • The insurance company REALLY does not want to lose me as a customer
  • HHS and the Obamacare reps want me to cancel my policy and purchase coverage from the Obamacare Exchange
  • Insurers who issued ACA-compliant plans prior to the exchange rollout are at odds with HHS
  • My same policy would have been much cheaper before Obamacare was passed

My guess is that based on the questions they asked about my health history when my policy was issued and priced,  the insurance company was able to group me into a “risk corridor” with other similar individuals.  Since they no longer ask these questions, they want to retain as many customers as possible in the existing corridors, where the insurer views their risk as more properly priced.  The insurer feels comfortable charging whatever rate they are charging, even if it is lower, because they have a better understanding of the associated risks with the customer.

This is directly at odds with the HHS, which needs as many individuals like myself in the Obamacare exchanges as possible.  The letter that they were required to send me by the HHS detailed all sorts of information that my plan might not cover, mostly pertaining to “discrimination” on preexisting health status.  The letter said I had to contact the insurer to keep my policy, which the insurer directly contradicted in its own letter.  HHS clearly does not like the fact that I’ve chosen to keep my insurance, and is doing everything possible to dissuade me from doing so.

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This puts individual insurers who have pre-Obamacare exchange customers at odds with the feds.  Even though my plan meets ACA requirements, my insurance costs aren’t subsidizing any sicker patients.  Sooner or later, I should expect HHS to win out, and force my insurer to cancel my policy.  Importantly, no matter what I decide, I will under no circumstance purchase a plan through the exchange.

And all this “mastectomy benefit” stuff?  What the hell would a male on an individual policy ever need to see that for?  This is clearly something the insurer is mandated cover to all insured customers, no matter how asinine the thought of a male needing mastectomy benefits may be.  For me, the only thing Obamacare has done is needlessly drive up the price of my insurance, all so that sick people will end up paying the same rate as healthy ones.

So… what’s the best solution?  The most appropriate healthcare system would involve scrapping the insurance model altogether, and just having people pay for whatever healthcare services they use, with appropriate government restrictions.  However, given the inertia of the system, including tax credits for employer insurance, patients on Medicare/Medicaid reticent to leave, and insurers who will fight in every way possible to stay in business… I don’t see this happening.  Not now, not ever.

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See The Difference?

Yet, at this point, anything is better than Obamacare, even giving all uninsured patients “free” dogshit government-subsidized healthcare.  One of the key provisions of Obamacare was a massive expansion of Medicaid; how hard can it be to make something similar a baseline of government coverage?  Some will argue that this will create a “two-tier” healthcare system, but I don’t see how that is worse than our current system.   Obamacare is expensive, going bankrupt, and has effectively created the following five “tiers of coverage”:

  1. Employer sponsored insurance
  2. Unsubsidized individual insurance
  3. Subsidized individual insurance
  4. Medicare/Medicaid/Crappy Gov’t insurance
  5. Uninsured

Medicaid/gov’t minimum coverage isn’t a free market answer, but it is better than Obamacare. ERs don’t turn away people as is, and the taxpayer foots the bill.  This is the easiest and simplest way to get rid of the mess our healthcare system is in now.  If this country isn’t prepared to go the free market route on healthcare, so be it.  Just do something… ANYTHING… but Obamacare. 

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