My first day back to work after Hurricane Michael knocked out power to my home in Florida, I received a call that my job was eliminated. I was officially unemployed and uninsured for the first time in a decade.
ACA Coverage for 2017
My options for health insurance were COBRA for $600/month or an ACA Blue Cross HMO which, based on my expected unemployment income and subsidies, would be $60/month.
I chose the ACA Blue Cross HMO. For the next year, I received at least 3 letters a month urging me to do something that I had already done or encouraging me to take advantage of a “free” checkup.
This was just one example of inefficiency and waste that noticed with the ACA system. Another was that the website never had answers to my questions – which couldn’t have been that unique. Another inefficiency was that it was never clear if I should call the ACA or Blue Cross when I had questions about my plan. This resulted in a “Who’s On First” Abbott and Costello routine. Whoever I called always told me I needed to call the other one.
Once I received my insurance card, I began to look for a primary care physician. None of the ones I was looking for were “in network”. I was assigned to a group of physicians I never heard of.
Throughout the year, I was healthy and saw no doctors. I paid my $60/month regularly.
I didn’t find a new job, but did some self-employed consulting work the second half of the year. Because this work was unpredictable, I couldn’t make any income projections to revise my ACA income estimate.
At the end of the year, I had to repay all of the subsidies I had received because of my self-employment income. This cost me an additional $5000 at tax time. My total number of health care visits was zero for the year. The total cost for this was $5800.
Health Insurance Options for 2018
Despite Trump and our Republican controlled Congress vowing that the ACA individual mandate would be immediately overturned and that better, cheaper health insurance would be available to everyone, it was no surprise to me that neither happened for 2018.
Instead, I had fewer options for insurance and all cost more.
Here’s what it boiled down to:
- Blue Cross HMO (via ACA) This time I would pay anywhere between $175 and $700 per month for the same coverage as the previous year. The range was because I couldn’t predict my income for 2018.
- A religious Healthshare plan. ~$200/month. These are not insurance but more like a collective of individuals who “voluntarily” contribute to pay medical expenses for members.
- Nothing. In which case, if I had a catastrophic medical issue, I’d be screwed. Plus, I’d have to pay the IRS a penalty for being uninsured.
Despite going into 2018 with no consulting projects lined up, I wasn’t willing to take on a potential $700 monthly insurance plan with a high deductible.
I chose Liberty Healthshare for $200/month.
What I like and dislike about Liberty Healthshare
I like the concept of a health share plan. It’s a community of people joining together to reduce risk and share healthcare costs responsibly. It’s like what a family does to take care of its members or what the Amish do for their community.
I like Liberty’s monthly newsletter that transparently details claims, contributions and shortfalls. I like that they encourage and coach members on how to negotiate health care discounts. I like that they seem to legitimately care about members.
I don’t like that there are no guarantees of payment. I am also a little concerned that there is no regulation. If Liberty turns out to be a scam or if I have a big claim that gets denied, I’m on the hook for the full cost.
That said, I’m very experienced with medical insurance denying payments because my wife has a long history of health issues. Despite all of the industry regulations, there’s no guarantee that insurance will cover a particular procedure or cost. In fact, my experience with most health care insurance is that you are guaranteed to have claim payment denials, hassles and problems.
I don’t like the religious requirements. However, only a few healthshares were approved as “ACA compliant” by Congress. All had religious requirements. I’d prefer a secular alternative but Congress didn’t approve any. I’m not even sure any exist.
(If I have any claims while covered by Liberty, I’ll update this post with my experience.)
The Problem With Health Care and Health Insurance in the US
I could write an entire book about medical insurance and healthcare problems in the US. I won’t because most of us are aware of the issues.
Here are two changes I’d like to see.
- Price transparency from all medical providers. We should be able to receive an accurate price for service. I’ve never been able to get this for any medical or dental procedure.
- Accurate information regarding medications, diet and exercise from unbiased sources. I simply no longer trust big pharma, big medical, big food manufacturers, big agriculture or news organizations. All have demonstrated repeatedly that they are focused on profits. All rely on marketing and advertising to convince people that their “solution” is what we need.
I have no simple solution for health care or health insurance. I believe there are some individuals like me who are fortunate to be healthy. There are others, like my wife, who would be financially devastated and/or dead without health insurance.
I think that putting the burden for health insurance on the unfortunate individuals who need it most is not the way a community or a society should operate.
Perhaps in the future, we’ll see an improvement.