Anyone who pays for a health insurance policy on the private marketplace, and who does not get subsidies or government assistance, is being greatly impacted by the dysfunction in the market. I pay for health and dental insurance on my own. I do not work for a corporation that provides coverage to me and I do not qualify for any government subsidies that are given to the poor (through Medicaid) or any financial assistance that is given to low income families as part of Obamacare, otherwise known as the Affordable care Act. The fact is that I am, as are others who pay for health insurance on their own, in effect paying for an increasing portion of other families medical costs who are in the ACA program.
My health insurance, which is from Blue Cross and Blue Shield, is a Gold Level Plan policy, so it is more extensive coverage. For this policy I pay almost $600 month for medical and $50 for dental in 2018. This is a total of $650 / month in insurance payments for just me, one person. While each state and rate plan may be different, in general larger households, families with children and others who do not have Obamacare subsidies would be paying that same amount; if not even multiples of that if they are covering more people.
Studies show that many of them can no longer afford this private health insurance. The New York Times had a great article on this topic in the Sunday times, and see how there is a huge disparity in monthly rates and also how some people get free medical care. Nothing like reading the Sunday Times in the morning with a cup of coffee.
That $650 month rate, which also increased about 10% in 2018, is my monthly cost even though I am 42, my doctor(s) say in better shape and I have much better vital signs than many people much younger than me, etc. Heck, I may as well drink beer, eat fast food every day, never exercise, lay on the couch to watch TV and gain weight as my health insurance premium is not impacted by how healthy (or unhealthy) I may be. I even just slipped off the treadmill this morning and banged up my knee, hip and elbow all in an effort to exercise and stay healthy. Sometimes, even for a split second, the thought crosses my mind as to why I bother exercising at all (ha!)…it is not for my looks (or lack of them!) or to save money on health insurance (as that isn’t happening in this system!). But then I remember all the other benefits to exercising.
Now I totally understand that America does have a social safety net system in place for the less fortunate. It means that anyone who pays income taxes is in effect having a portion of their tax dollars go to pay for benefits for the poor, disabled, or elderly such as Medicaid, food stamps, TANF cash assistance, etc. I have no problem with this concept, but there is something wrong with how Obamacare is working in that the rates are going up 10%+ per year (for multiple years), there is limited or no competition, and the cost paid by each covered person has no bearing on how healthy someone is. There is also no effort made by the ACA insurance plans to make the other people who are insured (who I am paying for) try to address underlying medical needs.
The NY Times article, among many others, shows how Americans who do not qualify for government aid as part of the Affordable care Act are in fact facing much higher rates than we would otherwise be paying for our insurance. We are paying more of the total cost for those families that qualify for financial aid, and some of them who get government help from ACA may even be more moderate income households. The problem with the insurance marketplace was bad in 2016 and 2017, and it has become much worse in 2018. Not only our the health plans pricey, our choices are limited when it comes to insurance as well.
For example, in South Carolina only has one option in 2018. The insurance company that operates in the individual marketplace is Blue Cross and Blue Shield, so they in effect have a monopoly on the state. I also would have liked to have a platinum plan policy (which is even better coverage) but Blue Cross and Blue Shield did not even offer that coverage in SC as they have no reason to offer it…no competition.
No competition is problematic as it allows organization such as Blue Cross to set prices, policies, coverage, etc. as they would like as regulators would be hesitant to push back. No competition also of course limits choices to consumers. Over 1,000 counties only had one Health insurance company for families to choose from in 2018, per this map (see the orange). So hundreds of thousands of people are faced with the same lack of choice as me. Talk about limiting choices.
The system also hurts independent contractors. As an example, we at needhelppayingbills can contract out work or certain tasks, and many of those team members also need to buy their own health insurance coverage as they are “contractors”; not full time employees. We also outsource some of the website hosting on a contract basis. The cost of insurance for those who need to buy their own coverage hurts many others as well, including Uber Drivers, artists, independent writers and anyone who does contract type work. Those cost of medical bill and dental insurance can be prohibitive to them as well if they are not also working for a corporation that gives them that benefit.
Solutions for people who buy insurance on their own
Unfortunately the choices are limited in 2018. You can go without health insurance and take a risk of not getting a serious medical condition. Or you can look for different forms of care, such as from Christian Health Insurance Plans or alternative health insurance policies. But the fact is if your income is not low enough, you will not qualify for care from clinics, the government or other benefits. It is really pay up or go without…those are the two main choices.
I hope, as well as I am sure a good number of the hundreds of other thousands of Americans that pay for their own care feel the same way, that a better solution is found. As at this rate I may soon be paying a grand per month just to get my own health insurance plan. The Republicans have started to plan for short term health insurance policies to be rolled out in 2019 that allow consumers to be more selective in what specifics they want. Maybe that is the solution; time will tell. But the system does not attention and needs to be fixed.