General Discussion
In reply to the discussion: Health Insurance Rate Shock-California Obamacare Insurance Exchange Announces Premium Rates [View all]haele
(12,646 posts)The difference is that you now are netting after taxes over $4100 a month, and the electorate feels that you're now making enough to handle paying up to a quarter of your monthly net income on health care and not hurt to much, because you can still deduct half of those costs on your income taxes when they're due.
You should be able to get back as much as $6K a year on your taxes above that amount. It's not right, but that's what they thought they could promote just to get 40% of the citizenry at the lower economic scale out of emergency room health care.
I would have rather seen them put the drop-out at $90K - especially in California, where people can be attempting to pay off both student loans and mortgages up to $3500/$4000 with a net of $5500 a month of income.
So, the upshot is that if your household income is under $63K, the ACA is much cheaper than anything you can get on the market. After that, you're stuck with market costs.
I'll agree, it's not comfortable for those who have a household income around or above $63K; but luckily for some in that category, if you have a dependent (which adds significant costs to a household) you do get the tax credit applied.
It's very affordable for those who are on the margins, who are eligible for EIC, and who don't usually have a job that gives them health coverage.
Unfortunately, a lot of us - probably around 10% of this country - who are just above that line, but not well-off enough that $1K a month is disposable income, it still stings.
But this is what it comes down to for me:
Single Payer - vs. - Health insurance/health access plans/ACA -vs.- Health insurance/health access plans with no ACA in place.
It's not "ACA" vs paycheck. It's access to health care that doesn't depend so much on the whims of insurance companies and the cost is somewhat regulated more fairly.
What I pay now in a health-care premium from my employer-provided insurance for just me and my spouse (if we were both 55) is 2/3 the cost of what it would be under Covered CA, and our Aetna plan is considered comparable to most.
If we were both 55 and had a household income of $63,000 right at, the CA plan would be only $300 a month more than what we pay now, and give us the same benefits we have now.
If I lost my job, I would have to come up with over $1450 a month while on unemployment or doing part-time work to pay for COBRA to keep a continuance of a comparable insurance we have now until I could get another employer-provided insurance plan - if they had one.
Right now, we would be paying significantly less between the CA plan/my employer's plan with up to a household income of $62,000. Frankly, if I wasn't so close to the 55 age level, and our combined household income wasn't well within $10K of the upper level with a potential to go up this year, I would definitely consider going with Covered CA for ten years or so vice the employer plan and hope to transition into single payer that way. If I didn't have health care, I'd go ahead and suck it up.
I've gone the emergency-room health care plan route in the past, and as I get older, there are more things going wrong; I can afford the bills I have now, I couldn't if I didn't have health insurance to cover most of the costs I'd be facing without it.
So I see it this way - if I had to, $1K a month in premiums is cheap when the insurance company is "negotiating down" an additional monthly average of $2400 in medical costs due to chronic problems (some thanks to that period of "emergency room health care", others due to age).
Last year without health insurance, out of pocket for both me and my spouse would have been $57,653 for basic treatment of chronic health issues.
Not counting any of the emergency/urgent care visits - which came up to an additional $80K plus, according to the statements from my insurance company. $10 for an anti-nausea pill. $112 for an IV rig. $75 for the CNA to draw blood. $700+ for labs (bills for which kept coming in for 3 months afterwards) $1,200 for a 2-hour "room" stay at the Urgent Care. $220 for the follow-up doctor visit.
The main problem with the ACA and all of the exchanges is that it isn't single payer. And so, we get hung up on the term "affordable" - which single payer would be marginally more so.
The hope is that, like Social Security and Medicare, is that the ACA builds a framework to become a single payer or cost-regulated system that is truly affordable and mostly out of hedge fund manager and CEO hands.
And honestly, as bad as it might look now, it looks as if this hope is possible - especially as these state exchanges will work for the majority of their populations.
Haele