It's always exciting to be part of a chapter in American history. I happen to be one of the hundreds of thousands of people whose insurance coverage was canceled for not complying with the terms of the Affordable Care Act. As a result, not only will I pay more, but I have had to divert many otherwise useful hours to futzing around with websites and paperwork.
President Obama promised, "If you like your health insurance, you can keep it." It was a more ambiguous promise than it sounded. Who likes his or her health insurance? But it was there, and it did its job.
I probably need to be clear straight off that I am not presenting myself as any kind of hard-luck case. Maybe from some social justice perspective it's perfectly fair and reasonable to load all the costs of health reform onto people like me. The trouble is, this administration has been less than candid about what those costs would be.
As best I can tell, the ACA will require me to pay $200 a month more for a policy that is marginally worse than the one I have now.
Here's the before and after contrast:
My family was enrolled in a Carefirst high-deductible plan that cost $667.63 per month. In-network deductible, $5,400; out of network, $10,800. Out-of-pocket limit: $6,400 in-network; $12,800 out of network. The plan was joined to an HSA.
The most directly comparable plan on the D.C. health exchange will cost $865. The deductibles are somewhat higher: $6,000 and $12,000. The out-of-pocket limits are very slightly lower: $6,000 and $12,000.
That $200 a month differential seems to be the cost of community rating: I had to answer a bunch of questions about my health before qualifying for my prior plan; the new plan will be issued, no questions asked. Presumably somewhere there is a D.C. resident who smokes or who has some pre-existing condition who will receive a corresponding $200 a month windfall.
If that extra $2,400 per year in insurance premiums were the end of my ACA costs, I'd congratulate myself on getting off easy: I'll also be paying considerably more than that in higher taxes to support the program. As I said, I'm not a hard-luck case.
The ACA was ingeniously designed to deliver benefits to Democratic constituencies and impose costs on Republican ones. The big surprise in the ACA rollout is that this design is going awry. It's not only plutocrats and one-percenters who will find themselves worse off; not only the comparatively affluent retirees enrolled in Medicare Plus programs. Self-employed professionals who earn too much to qualify for ACA subsidies will soon discover what I have discovered: They are paying more for a worse product.
The District of Columbia is an expensive place in which to live. Those Washingtonians who earn too much to qualify for subsidies probably do not regard themselves as wealthy. An extra $2,400 a year to keep a high-deductible policy may feel to many of them like—if not a hardship—then certainly a serious nuisance. Unlike me, they probably voted for President Obama. Unlike me, they probably believed his promise that the ACA would deliver improvements for them personally.
How do they feel right now? Or, more exactly, how will they feel when and if they find the time to work their way through the kludgey website to discover what I've discovered?