My youngest daughter just joined the ever-increasing number of Americans who have lost their health coverage due to Obamacare. She received a letter from her insurance carrier indicating that the individual policy with which she was eminently satisfied, and that she could more or less afford, would no longer be available after the end of the year. In its place, the insurer offered a plan whose premiums will be nearly double what she has been paying for the cancelled policy. Her monthly premium was $127. The premium for the replacement policy, if she can find no alternative, will be $243.
Anyone tempted to attribute this to the greed of insurance company executives would do well to remember that the essential benefits mandated by Obamacare rendered millions of existing health policies illegal and led to mass cancellations in 2013. A second wave of cancellations was expected just prior to the recent midterms. In order to avoid the inevitable voter outrage that would cause, President Obama issued an executive order permitting insurers to keep noncompliant plans in place until after the election. Well, the election is over and the cancellations are once again pouring forth.
I wasn’t surprised when one of these missives landed in my daughter’s mailbox. I knew her policy didn’t cover all of the 10 health services that the President and his accomplices deem “essential.” Indeed, the fact that her premiums had been relatively reasonable was due to a conscious decision to buy a policy that lacked “benefits” she was never going to need or use. Nonetheless, as I began to help her explore various coverage options, the true perversity of Obamacare came home in a way that was breathtaking even for a longtime critic of the President’s “signature domestic achievement.”
She can’t get coverage through her employer, a large retail chain at which she began working while in still in school. Obamacare requires companies of that size to offer coverage to all full time workers, but has redefined “full time” to mean 30 or more hours per week. These rules have created perverse incentives for large retailers and the way they manage employee benefits. Walmart, for example, will soon stop providing health insurance to employees working fewer than 30 hours a week. Likewise, my daughter’s employer is studiously holding non-management staff like her to 29 hours or less per week.
Which brings us to those Obamacare exchanges about which we have had so many good reports. She went to Healthcare.gov and discovered that she would have to pay $388 per month for the kind of coverage she had when she was eligible to be included on my plan. That was obviously out of the question, so she looked at the cheapest plans on offer. The lowest priced catastrophic plan offered in our state has a monthly premium of $206 and comes with a deductible of no less than $6,600. This isn’t quite as awful as the plan offered by her current insurer, but it is still $79 per month more than she has been paying.
Then, in a fit of irrational exuberance, I suggested that her limited income might qualify her for “premium assistance.” This elicited what P.G. Wodehouse would have referred to as a “hollow, mirthless laugh.” It turns out that she doesn’t make enough money to qualify for tax credits or any other subsidy. Her income fails to reach the minimum threshold for “marketplace savings,” which means that her only “coverage” choice isn’t really coverage. Healthcare.gov puts her remaining option thus: “If your yearly income is below $16,105 and your state is expanding Medicaid, you may qualify for Medicaid coverage.”
Most of the previously uninsured applicants getting coverage under Obamacare are being dumped into Medicaid. This is a cruel bait and switch. The payment rates associated with that program are so low that primary care physicians can’t afford to treat the people it “covers.” Consequently, most of the care these patients receive is delivered in the nation’s overcrowded emergency rooms. Moreover, as I pointed out in this space last January, long-term medical outcomes for Medicaid patients have been shown to be no better than the outcomes enjoyed by people who have no insurance coverage at all.
In reality, the “Affordable Care Act” has rendered health coverage unaffordable for my daughter. Were I her age, I would go without coverage and pay the penalty. She’s young and healthy, so she could probably get away with that until she finds a full time job that offers a decent health plan. But I won’t let her do that. She’ll sign up for the catastrophic plan through Healthcare.gov and pay the full monthly premium of $206. That will cover three primary care visits and pay the costs of a serious illness after eating up $6,600 for the deductible. Under that plan she will no doubt apply for the “Dad subsidy.”
The one choice she does not have is to keep the coverage that she likes. President Obama and his congressional accomplices, despite their oft-repeated lies, have made sure of that.
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