Breaking Obamacare News: It Still Sucks

Breaking Obamacare News It Still Sucks - picture of two stethoscopes from above

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Last week, I wrote about how my health insurance premiums will effectively double under the Affordable Care Act.  And, although I’m happy that more people will be covered under the new healthcare law, I’m less than thrilled with the added expense.  But, before I get to all that, let me explain how much I am paying now and how that will change in the near future.  (These premiums were quoted for my family of four, two 34 year-olds and two children in Indiana.)

My Current Plan:

  • Anthem with an $11,000 deductible
  • covers 100% after the deductible is met
  • $377 per month

Cheapest ACA Plan:

  • Anthem plan with a $10,000 deductible
  • covers 60% after deductible is met with an out-of-pocket max of $12,700
  • $738 per month

Obamacare News: An Incentive to Earn Less

One of the biggest problems with the Affordable Care Act is that it actually creates an incentive for people to earn less.  According to healthcare.gov, subsidies are available for families making up to 400% of the poverty level, which equates to  $45,960 for individuals and $94,200 for families of four.  We don’t qualify for a subsidy, which isn’t a problem.  However, this is how it would look if we did qualify for a subsidy.

  • If we made 94K, we would get a $2,670 subsidy.
  • If we made 65K, we would get a $5,878 subsidy.
  • If we made 50K, we would get a $8,235 subsidy.

(Use this calculator to figure out if your family is available for a subsidy.  And if so, how much.)

Why is this a problem?

I know that nobody wants to hear me complain about how my healthcare costs are going to go up.  Because I can afford it.  Because I make more than $94,000 per year, which is apparently the new cut-off for the fabulously rich.  (I’m eating caviar as I write this, by the way.)  But, what if we made only $50,000?  How would the new healthcare law affect us?  Let’s take a look:

Here are a few of the options that were available to us, including the cheapest and most expensive:

Anthem Bronze Access Direct (the cheapest plan available)

  • Premium: $738.83 per month
  • Deductible: $10,000
  • Maximum Out-of-pocket: $12,700

MD Wise Marketplace

  • Premium: $901.42 per month
  • Deductible: $7,000
  • Maximum Out-of-Pocket: $12,700

MD Wise Marketplace Gold

  • Premium: $1,222.53 per month
  • Deductible: $2,100
  • Maximum Out-of-Pocket: $6,000

Anthem Gold Access

  • Premium: $1335.26
  • Deductible: $2,000
  • Maximum Out-of-Pocket: $4,500

So, accounting for a subsidy of $8,235, this is how much we would pay for each plan if we made $50,000 per year:

  • Pay $630.96 per year/$52.58 per month for a plan with a $10,000 deductible and $12,700 maximum out-of-pocket
  • Pay $2,582.04 per year/$215.17 per month for a plan with a $7,000 deductible and $12,700 maximum out-of-pocket
  • Pay $ 6,435.36 per year/$536.28 per month for a plan with a $2,100 deductible and a $6,000 maximum out-of-pocket
  • Pay $7,788.12 per year/$649.01 per month for a plan with a $2,000 deductible and $4,500 maximum out-of-pocket

As you can see, the plans that are currently available might be cost prohibitive for many families making $50,000 per year.  The least expensive plan looks nice, of course, as long as no one got sick….ever.  How many families making $50,000 can afford a $10,000 deductible each year?  I mean, a family making $50,000 per year with an effective tax rate of 15% brings home an average of $3,542 per month.  So, hitting their deductible would mean losing three months of their annual take-home pay.  Is that sustainable?  And, of course, the more expensive plans have lower deductibles that are much more reasonable.  However, can a family making $50,000 per year afford to pay $649.01 per month….just for the privilege of being covered?  Some, maybe.  Most, probably not.

***Update, there are also some cost-sharing subsidies for low-income individuals.  Using this calculator, the family earning $50,000 might get between $1,700 and $2,400 to help pay their deductible and out-of-pocket costs.  However, this is only available for silver plans, and would not apply to the low-cost bronze plan I used in this example. 

From Kaiser Health News:

“Cost-sharing reductions will be applied automatically for consumers who qualify based on their income, but only if they buy a silver-level plan, considered the benchmark under the law.”

Obamacare News: A Dream Scenario for the Rich

But, wait.  It gets worse.  Much, much worse.

According to Kaiser Health News, income, not assets, will be used to determine subsidies in the new healthcare exchanges, creating a dream scenario for those who live off of investment income.  Basically, a wealthy individual who lives solely of off dividends or other non-taxable investments, like a Roth IRA, may be able to get free or drastically subsidized healthcare premiums through the Affordable Care Act.  And who pays for this?  We all do. Furthermore, asset tests may not be used to determine Medicaid eligibility either, according to FamiliesUSA.org.

“Beginning in 2014, states may use asset tests only for determining Medicaid eligibility for individuals who are eligible because of other aid or assistance, elderly individuals, medically needy individuals, and individuals who are eligible for Medicare cost-sharing.”

What is your take on the Affordable Care Act?  How is the new law going to impact your family? 

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103 Comments

  1. Obamacare is a big reason why people should be looking to maximize their income from investments. In a lot of states though if you make $50,000 you’ll qualify for Medicaid, which is a government run health program for the poor. That is the intent of Obamacare.

    1. Maximizing your investment income is a great idea….but I earn regular income too. Apparently, it is frowned upon!

  2. I definitely think there are a lot of issues to work out. As I said in response to your previous post, it will be interesting to see how pricing evolves over time as people adjust to the new system. I doubt that what we see now is what we’ll see long term, for better or worse. One big thing I would like to see is a level playing field when it comes to taxes for employer- vs. individually-purchased insurance. It makes no sense to me that health insurance provided by an employer has a tax incentive but you get nothing if you buy it on your own.

    1. I totally agree. It really doesn’t make any sense.

      1. Shouldn’t you be able to buy health insurance through your LLC and deduct it at least in part as an employment expense? I thought this was a work around for self employed folks.

        1. Self-employed people can deduct the cost of health insurance as long as their spouse’s employer does not offer coverage.

          But, the problem is, many people who are uninsured and have to buy through the exchange are not self-employed. Many people just don’t have employers that offer benefits. The mortuary industry, for instance, is notorious for having awful benefits since most mortuaries are small and run by a handful of people.
          And, small employers are exempt from having to offer their employees health insurance or pay a fine. (I believe the cut-off is having 50 employees in most cases)

          1. Small employers are exempt but the law also provides nice incentives for them to offer coverage. Are there a large number of people who are not self-employed who make $94,000 or more a year and whose employer does not offer health coverage? Seems like a small subset, but I don’t know. I agree that asset testing should be a part of the subsidy calculation since those wealthy enough to live off of investments should be on a level playing field.

  3. I’m worried about what this will do to my company’s group insurance plan, now that underwriting is going away. We’ll lose all the advantages of having a young, healthy company, and I already pay $420/month for my family plan– which doesn’t include me (my company pays for my coverage, I pay for the rest of my family). Yikes!

  4. A large percentage of my work as an accountant has to do with implementation of health care reform, so it does keep me employed (though I’m sure it would be easy to find other things to work on than complying with this particular law). While it certainly is not that affordable, I’m fairly confident there were countless models ran when pricing the insurance plans. Most people are expecting those who enroll the first year to be those who really need the insurance, i.e. people who are going to use it and potentially max out their insurance. It’ll be interesting to see how it all plays out over the next year, but I think that expensive health insurance is here to stay.

    1. You know, I keep hearing (and reading) people say that it’s “here to stay”. It’s as if everyone wants to keep repeating it to make sure that it stays true. It certainly doesn’t have to be here to stay and I could see it getting trashed down the line.

  5. Excellent post, Holly. This is why, although I agree that health insurance needs to be fixed, I am staunchly against ACA. It only serves to make the economy worse in this country, like we need that.

  6. I’m just glad I still get health insurance through my employer and my wife will be the same way. If that wasn’t the case we’d definitely have to be cutting our budget back elsewhere to afford this awesome coverage…

  7. The main purpose behind ACA was to make insurance so expensive that it would drive people to the government exchanges. If private insurance companies lost all their customers they would go out of business and then the government would step in and say “see, we need a single payer system” with the government being that payer. Then they would be in charge of everyone’s health and be able to choose who received care and who did not. No one I’ve talked to likes this law, yet we (as a collective – not me personally) re-elected all the people who put this monstrosity into law. We get what we ask for.

    1. I think you’re right, Kathy! I personally would love single payer without the health insurance companies involved or all of these convoluted levels of payment and subsidies. They sold the ACA as the “next best thing” to single payer. It isn’t!

    2. I think you’re confusing “government exchanges” with a public option. Everything on the exchanges comes from private insurers like Aetna, Excellus, Blue Cross/Blue Shield, Cigna, etc. who will continue making plenty of money now that the government is actively subsidizing premiums for low-moderate income households.

      That said, I think the more likely result of this is that employers will eventually stop providing their employees with health benefits… which may not be a bad thing since a) people shouldn’t have to worry about losing their job AND their health insurance at the same time, and b) employees should be able to shop around and choose a plan that is right for them rather than simply taking whatever they are given by an employer.

      1. I think a lot of people would feel more freedom if they weren’t stuck in jobs they hate just because it provides insurance for their family. But at the same time, some less caring employers may drop health benefits just to reduce costs, without offering employees pay increases to make up the difference. It could lead to people working harder for less compensation.

        1. That’s definitely a risk. I’d like to think that most employers would try to be fair to their employees by increasing compensation after dropping benefits, but probably not in this market. 🙁

          1. Unfortunately, that is probably wishful thinking =(

  8. Ok, I may be totally out of the loop but will you not be able to continue on your current plan with Anthem? Since we’re military (and therefore insured through them) I’m a little out of the loop on Obamacare. I should really do more reading! 😉

    1. Anthem is discontinuing our plan because it doesn’t meet the Affordable Care Act guidelines. And, catastrophic plans like ours will no longer be available beginning in 2014.

  9. I am a public health nurse and at this time we keep going to seminars and conferences about ACA. The more I learn about it, the more discouraged I get. I really thought this would be a positive thing. I DO know that health insurance needs to change in America. But at these premiums, deductibles and THEN with the insurance only covering 60%…its ridiculous. That doesn’t even include that people will need to pay co-pays out of pocket, as well. This just makes me really upset and you’re right, Holly–it makes people want to not make more money. Which is SILLY! *sigh*

  10. In your example of a family of four earning $50,000 you also want to factor in cost sharing subsidies. Many people know about the premium subsidies, but families earning less than 250% of the federal poverty level also get assistance with the deductibles and copayments.

    If the family earned a tiny bit less they would qualify at the 200% level – $46,100. The cost sharing subsidies take a silver level plan (which covers 70% of expected medical costs), and transforms it into one paying 87% of expected medical costs.

    1. Cost-sharing subsidies are not available on bronze plans, like the one in my example. They are only available if families but the more expensive silver plans. But, I did update my post to reflect the fact that families can get cost-sharing subsidies if they but the more expensive plans. However, I don’t see how it can help that much.

  11. Thanks for the well researched post Holly. I know our current plan is locked for the next year…well 11 months. After your post last week we emailed our insurance person to see what/how it will be impacted in light of Obamacare. There re obviously issues to be worked out with it, my big hope is that this will actually do something to bring about some needed change and fix the system as a whole.

    1. Mine expires next December. After our plans expire, we’ll be forced to be a part of this mess!

  12. For me, the ACA will be good. I’ve never had insurance before and will be happy to have it. Although I just began reading a book on ObamaCare, which according to, I would probably fall in the income levels to receive Medicaid. And, since millions of “new enrollees” will also be eligible there’s likely to be less doctors willing to accept it because of the low pay. The are raising Medicaid payments for one year, expires at the end of 2014, when then many doctors are not going to want to accept it.

    On another note though my exhusband had chest pains a few years ago. (He was healthy and in his early 30’s) the dumbass local hospital thought he was having a heart attack and careflighted him to a bigger hospital. Ended up he wasn’t having a heart attack and we got a $50,000 bill which killed us. Neither of us worked for an employer who offered health insurance and didn’t qualify for Medicaid. And, as a family of four grossing around 50k a year combined we couldn’t afford to purchase health insurance ourselves.

    There are some issues to be worked out. But coming from someone who’s never had insurance I don’t think the ACA is all bad.

    1. Alexa,

      Don’t take this the wrong way because I think you’re awesome and respect everything you’re doing over there. You rock!

      But, if you’re going to get Medicaid for free, then it isn’t surprising that you’re on board. Hell, if my healthcare was going to be free I would be on board as well.

      But, if you plan on increasing your income, which I know you do, you should be concerned. What if you double your income next year? (I think you can!) Then, all the sudden, you’ll be a part of this mess as well. The more you make, the fewer subsidies you’ll get.

    2. OMG! A $50,000 bill?!?! What did you end up doing??

      I am for Obamacare exactly for people like you and your husband to get insured and prevent this crap from happening!!

  13. I don’t think I’ll be affected too much as I get my insurance from my company…though I guess there may be an affect on the premiums. While I do think that something had to be done with the healthcare system in our country, I think the ACA needs some work. Thanks for explaining the effect of the ACA.

    1. You’re welcome! I did my best consider how incredibly complicated it is!

  14. The fact that you’re right on the cut off is really rough. I understand all your arguments, but I believe that some system, even imperfect, is better than what we have now, as a whole. Hopefully (and that’s a big hopefully) things will be amended as we start using the system and figuring out what adjustments need to be made.

    1. No, I am nowhere near the cut-off. If I were anywhere near the cut-off, I would just put additional funds in my health savings account or SEP IRA that I’m getting ready to set up since I’ve become self-employed.

      And, it isn’t better than what we had before for everyone. Obamacare has winners and losers. People who are getting free or heavily subsidized care are winning. People whose premiums are doubling (or tripling) are losing. Self-employed people who are forced to buy health insurance the on the expensive individual market are definitely losing.

  15. I think it’s just like everything else for the most part. The poor and the really rich are taken care of and the middle class who gets out and bust their hump are the ones who get the shaft. I’m sure if you make $25000 per year, $94,000 seems like a lot of money, and it is, but when you have to pay 10% of your income just for premiums that don’t even cover you until you hit $10,000 in medical bills, that’s a hit. I think it’s wonderful that people who don’t make much money are going to be able to have health care, but I see lots of people not getting coverage and just taking the penalty, which is why this system is not going to work. When my premiums go up to $900 a month, I might do the same. If you can risk the 90 days it would take to get on coverage if you got sick, I can see the appeal in that, although I would probably be a walking nightmare afraid of a car accident or something.

    We have a year on the same plan as we have now. I’ll see how it all shakes out, but if it is still that expensive, I will totally look at my salary and see how low I can make it to not piss off the IRS and take everything else as a dividend. I believe you are incorporated too and might want to look into that. If we can keep our income below the subsidy line, that would help. It also bodes well for retirement before Medicare age. I wonder how rental income is considered or is it all based on W2 income?

    1. Agree with everything you said!

      I think our income is too high regardless. Since I’m self-employed, I can put up to 20% of my income into a SEP IRA (I believe that’s still the case). And, I contribute a certain amount to my health savings account (not sure how much that is) . But, even then, I don’t think we would be close to getting a subsidy.
      I’m not sure how rental income is treated. Again, I don’t think its going to matter in my case. I agree, when you make 25K, 94K or more seems like a lot. But, when you’re there you realize that it really isn’t that much….especially when your insurance is going to be $738 per month with a 10K deductible.

        1. Sweet. Even better. Maybe I will get close to getting a ooey gooey subsidy after all.

    2. When you make $25,000 a year and do bust your hump to earn it, it’s difficult to feel sympathy for people making $94,000 a year, though. Paying 10% a year to pay for healthcare sounds like a lot, but it still leaves $84k a year, twice the median household income in the US.

      Since people can get a car and a house and food and clothes on a salary as meager as $25k a year, I think people on the lower end of the salary range are confused about what people making close to 100k are actually spending their money on, and why they’re worried so much about having to pay a little more.

      1. No one is asking for sympathy here, but I do believe that we should ALL be concerned when our taxes or healthcare costs increase significantly, no matter what income level. I completely disagree with the premise that high earners have no right to be concerned when their healthcare costs double.

        As far as what people can spend $100,000 on, I obviously cannot speak for everyone. But, I’ve worked tirelessly to decrease my expenses and increase my earnings over the years. I don’t have any cable television. I don’t have a fancy smartphone. I drive an old paid-off car that many would probably be embarrassed to be seen in.

        What do we do with our income? We save it. We invest is. We use it to fund our dreams. I shouldn’t be penalized just because you think I’ve reached some magic income level where all financial problems should melt away. I have two children whose college I would love to pay for. I have bills. I have taxes as well.

        And, a family making 100K paying $738 per month AND hitting their deductible of 10K and out-of-pocket max of $12,700 would actually pay 20% of their income toward healthcare. I think that is unacceptable at your income level or at mine.

        1. It’s not that high earners have no right to be concerned. They certainly do. High earners have plenty of legitimate things that they use their income on, including investments, savings, children, funding their dreams. But even paying 20% to healthcare still leaves 75k, and from the perspective of a family getting by on a 25k, you’re still bringing home triple what they are AND you have great healthcare to show for it.

          Is it ludicrous to pay almost 20 thousand a year for your healthcare? Sure it is. I’m not disputing that. You’ll have less cash you can divert to your savings and investments and your children’s college funds and your dreams.

          But people making 25k deal with those same problems. They have children whose college they would love to pay for — and often have to make the choice between helping their children do that, or paying for their own retirement, because they have no means to do both. Sometimes they don’t have the means to do either. They have bills, too, and taxes. Funding their dreams is often so far off the table that it can’t even be addressed.

          Many of these people work just as tirelessly as you do, and many of them love the jobs they work. Are there things they could be doing better? Sure. There’s probably a lot they can learn from your experience, because they want to eventually get there. But it doesn’t make them lazy and it doesn’t make them moochers to want to be able to get healthcare, and the ACA isn’t about them wanting to steal your hard earned cash away from you. It’s about them wanting to not live in dread of a medical emergency that utterly destroys them.

          For people who don’t have insurance, losing 20% of their annual income to healthcare is a reality right now, and it can come from stuff as mundane as having a few too many sinus infections throughout the year. If you’re sick and actually need it, your $738 a month and 10k deductible is going to provide you with more care and cover more complex and expensive and life-altering emergencies than someone who only makes $25k can get with their $5000 out-of-pocket, and at the same time, it’s far less likely to jeopardize your ability to feed, clothe, shelter, and transport your family.

          The ACA isn’t a great program for a lot of reasons, chief among them being that it does nothing to actually address the fact that getting medical care in this country is ridiculously overpriced, and I think a lot of companies are going to use the ACA as an excuse to drop workers’ hours/wages/benefits in order to cut costs and boost their profit margins. But higher premiums for people who make $94,000 a year, while inconvenient for the people in that income bracket, isn’t going to damage their futures as much as the very real way healthcare costs damage the futures of low-income earners right now.

          1. Listen, I can’t solve the plight of people making $25,000 per year. I certainly cannot fix all of the problems that are out there or can I fix the fact that healthcare is outrageously expensive. However, I have to ask why we draw the line at $94,000. That’s a two-income family, with one spouse earning $44,000 and the other $50,000. When the income and wealth gap is as HUGE as it is in this country, is this where we really should be drawing the line? Is $94,000 now considered rich?

            I highly suggest you watch this video:
            http://www.youtube.com/watch?v=Gk5OJBry2ss
            Then, ask yourself if people making $94,000 per year should shoulder the burden of the Affordable Care Act.

            And, for the record, I am a proponent of single payer universal healthcare for all. No bullshit red tape. No disincentives for working. No 20% off the top straight into the pockets of the wealthy health insurance industry. I truly believe in 100% single payer, where no one ever goes bankrupt or loses their home because they’re sick. And, where people aren’t stuck in a job they don’t like because they can’t afford their insurance.

            But, it should be funded through a progressive tax system. You should be penalized for making 95K and get a huge subsidy for making 94K. And, there shouldn’t be disincentives for trying to earn more or taking on a part-time job.

      2. So long as you are paying more to subsidize others, it’s all good. If you are a beneficiary of Obamacare then it’s not right to put down those who are paying the subsidies. Got to at least say Thank You!

  16. I’m very interested to see how this is going to play out. We definitely needed an overhaul of the health care system, but this is not what the majority were promised or expecting. I’m especially interested to see how it will affect us personally with respect to my husband’s income once he is a physician.

  17. Holly,

    Fantastically researched post with real numbers. Although I am for Obamacare to ensure the poor and uninsured get affordable care, I’m also actively looking to be lower middle class if and when I do need ACA.

    With a business, I’m thinking you can look poorer in the eyes of the government too?

    Great point on having a large financial but. To investment income and not working anymore!

    1. Sam, I cannot wait to subsidize your healthcare premiums. That is actually a dream of mine. =)

      1. Thank you so much! America appreciates people like you to help care for others. This is what our country’s foundation is all about 🙂

        And for those who do public income statements.. best to keep below that $94,000 threshold! Big brother is watching.

        1. Ha! I agree.

          But, if you put money in retirement and health savings to get under the 94K threshold, you won’t get in trouble. It’s perfectly legal! =)

  18. It’s that last part that has always bothered me about the ACA. Anytime you create a moral hazard or incentivize people to stop working or hide income, other people who don’t do these things will end up paying the price.

    Still, I’m torn. If we were suddenly financially independent and could quit our jobs – would we take a subsidy since we’d draw a low enough income from investments that we’d be eligible? Morally I wouldn’t want to, but what if the only policies that were available for purchase were double what they had been before since the govt is making many people buy coverage they don’t need or want. It’s harder to feel okay with being hamstrung into buy stuff you don’t want and still feel okay with paying full price for it.

    1. Wealthy people who live off of investments WILL take the subsidy. Why? Because it’s a tax credit. It’s not like using food stamps or other types of public assistance that is obvious. The only person that will now you take it is your tax preparer, and the IRS obviously.

      Anyway, I wouldn’t blame people who are financially independent and choose to take the subsidy. But, I don’t think the system is a good one.

    2. It’s not a moral issue At all.

      The government is smart. They are encouraging people to save, invest and secure their futures in exchange for subsidies. That’s a good thing for the country!

      1. I don’t blame anyone for taking a subsidy, no matter how rich they are. I would take the subsidy as well since it’s just a tax credit.

  19. Is there anything coming from our government that is actually straight-forward? I think the premise behind the ACA was a good idea, but the execution was poor. They are going to price people right out. The plan was always to charge healthy/younger people more, so the poor could get cheaper insurance. That is really how it works.

    As with anything this big and new, there are going to be many, many mistakes and hopefully changes come from it. If we don’t see changes over time, then we all better move!

  20. I have to admit this is hurting my head…and is still confusing the hell out of me. I’m just waiting to see if and how my current insurance plan will be affected. If it goes up $50, so be it, but if it’s a lot more I’m not sure what I’m going to do…

  21. You’ve hit on two major gaps with the ACA: an incentive against earning more, and an incentive to live off certain types of income (i.e. – not earned income). These subtle nudges will influence behavior, but it’s too early to see whether it’ll significant change behavior. For example, our progressive tax system similarly provides an incentive to stop earning beyond a certain point (my take is that the jump from 15% to 25% for federal income is the most jarring). But, in general, people still try to earn as much as possible.

    The incentive to live off of investment income (which is our early retirement plan, in a nutshell) has potentially huge impacts. This may benefit us personally but is not a great plan for our country as a whole.

    A third impact seems to be that the self-employed are getting the shaft, in particular. Does Greg’s employer offer another option to insure the family?

    I’m really sorry that your premiums are going to double. That’s awful.

    1. Greg’s employer is currently paying us a dollar amount per month to help with our coverage. Most of their employees are covered through the county’s coroner’s office because they work there part-time.

      They probably only have about ten employees so they don’t have a group plan.

  22. That is an incredible amount to pay for health insurance. At this point I am extremely glad to still be covered by my mom’s insurance for another three years. Hopefully things will be sorted out by then. I have to admit I haven’t been paying this as much attention as I should, so thank you for the analysis! My coworker’s mom lost insurance coverage through her job when this all hit. It’s really unfortunate how it’s affecting people.

    1. Yes. I feel bad for people who are losing employer coverage. What a huge mess to be in!

  23. First off, I completely understand why you would be upset. I wouldn’t want to see my premiums double either. However, I’m actually surprised at how little you were paying for a family plan. You couldn’t insure a SINGLE person for $377 in New York before the ACA (even with a high deductible).

    Based on what I’ve seen so far, it seems like premiums are “averaging out” which is great for some people and horrible for others. In other words, the states with ridiculously expensive health insurance are seeing rates go down while states with affordable health insurance are seeing rates skyrocket. As you said, this creates winners and losers and will only serve to polarize our country’s politics even more. Maybe if we’re lucky, though, it’ll open the doors for competition across state lines (since insurance regulations are becoming more standardized).

    1. I live in a low-cost state so the rates are rather shocking. $738 is more than my family spends on food each month. It’s more than I spend on full-time daycare for my two children. The only thing I pay more for is the roof over my head, and that’s because I’m a very short-term mortgage.

      1. I know it’s shocking to see your rates go up so much at once, but I just wanted to make sure you realize how fortunate you’ve been up until now with such low insurance costs. (I’m assuming this is mostly because your state allowed insurers to deny coverage for pre-existing conditions and maternity care?) Yes, paying $738 per month for health insurance is going to suck, but obviously you can still afford it… so the government can say it did its job.

        I would definitely be curious to see what a single-payer system would look like in the US. It would be nice to simplify the health care system, have guaranteed coverage, and not have to worry about various doctors/specialists accepting your insurance or being in-network. However, from a cost standpoint, the upper-middle class would probably still end up footing most of the bill (since 43% of American households don’t even pay federal income taxes).

        1. Actually SArah, weve only had this plan since July. Weve had premiums everywhere from the $377 we pay now to the $1,000 we paid when i was pregnant. We chose a catastrophic plan with an 11k deductible this time to keep our expenses low.

  24. This thing was designed to fail so that we can all be forced into a single payer system. That has been the plan all along. I work at a hospital, and it’s already killing us, and the pain has just started. Many of the almost 20 new taxes directly affect us, especially that stupid medical equipment tax. What do we do with the illegal’s we treat for free now? Will they have to get insurance, or pay a fine? Ok lets just make them all citizens then what? They will all be eligible for subsidies right away right? Talk about a debt ceiling? What about all the pregnancy flights from all over the world? I know of many women flying in from all over to purposefully give birth in the United States, just so they get the citizenship benefits for these kids. Then they fly home all the time laughing and we are stuck with the bill. I even know one that’s a doctor in her home country. Our Social welfare system is so broken that even European elites fly here to take advantage of our system. I know people that have good jobs with benefits, and even successful small businesses, and all their kids are on HUSKY. Everybody has the latest Iphone too even the little guys. Everybody wants everything for free that’s the bottom line.
    My employer provided, premiums co-pays, and the amount I contribute have gone way up in the last three years. If I get dropped I am looking at even higher premiums, and costs under Obamacare because I guess I am considered rich because between me and my lady we make too much money. We struggle paycheck to paycheck even though we work over 100 hours combined a week. I pretended to sign up and looked at the plans and they cost twice as much. They have a deductible that is insane because I have to pay for maternity care, and crap I don’t need because we have been spayed and neutered already. Maybe I should lie like everybody else and tell them I only make $14,000/year because it’s on the honor system, just so they can get as many people on the tit as possible. Then like they did with Medicare and Medicaid pull the rug out from under us like they did in Connecticut to the hospitals. Wait until other Governors decide to balance their crazy spending sprees like Governor Malloy is doing in Connecticut. The only hospital that is safe is State run U-Conn because they take 100′ of millions from all the hospitals all the while giving hundreds of millions to U-Conn. The rest of us are screwed.
    The Statists won’t be happy until we are all going to State run hospitals where we can get the European treatment with no privacy, no consultation, no compassion, one approved treatment for your Cancer, and in some cases no toilet paper no towels, just bring your own. Italy where here an IV is considered a luxury. If you’re conscious they force you to drink. Or how about this? you’re too old for this, or waiting 9 months for a triple bypass surgery like my friend in Scotland He died waiting in the emergency room eventually. You cannot complain to anybody because it’s FREE? Ireland too young for Hip emplacement, or too old for Hip replacement because you’re only allowed one. All examples given from my own ad friends experiences ITALY, IRELAND, SCOTLAND, SPAIN. I was happy the way things were a few years ago but maybe I am just a rich 1% elitist. Yup me and my two over ten year old cars with over 300,000 combined miles and my little two bedroom apartment for the four of us. My basic point is that the system is full of fraud. I can argue that it is almost encouraged the way it is setup, and this new program will be even worse. It’s not about healthcare, or insurance in the end it’s all about government control. They really don’t care about us, just our votes, and keeping control. I agree we should all have skin in the game but when 48% of the US population pays no income tax and a good portion get money back on top of that, what gives? I pay a combined 25% in State and federal income taxes, and I get a little back so I know I have plenty of skin in the game. Not to mention a 6.35% sales tax and an annual property tax on each vehicle every year so easily almost a third of my income goes to taxes. Plus the second highest gas tax in the country I only think Hawaii or California is higher. Do I sound FRUSTRATED? This is now the recipe for success in America now.
    1. Work off the books
    2.cash for everything (no bank account hide the money in a safe deposit box or P.O. BOX
    3.get kids on Husky (free medical you pay for nothing even braces), free lunch program, free or subsidized after school program.
    4.Get section 8 Housing because you have only claimed part of your income
    5.Apply for Social security disability (You have a a MOOD disorder or some other ailmant that cannot be proven. If denied first time go to the judge. You will be guaranteed to be approved second time. REMEMBER YOU’RE STILL WORKING OFF THE BOOKS…yes you must cheat the same sytem you’re benefiting from, (don’t forget top go to church though)
    5.5) after a couple of years you qualify for Medicare, and or Medicaid depends? Since you are both poor and disabled now.
    6.go get your handicap sticker you now qualify for
    7. Get free Obamaphone because now you qualify
    8.If you have babies you now qualify for WIC they will also push any other program on you too.. Once you have 5 kids you hit the jackpot they help you even more.
    9. Apply for financial aid for private school, if you’re not happy with public school. Helps if you’re black or Hispanic (my kids are Hispanic so I would have that covered)
    I am sure I forgot a few things..

    1. Kasey

      Isn’t Ironic how we pay into a program all our lives, and then when we get really sick or die the government takes the money they helped us with out of our estate even though we paid in all our lives. It’s a bunch of crap.

  25. Sorry I screwed up. you take the Free Obamaphone and you lose it a few times each time you sell it on the black market because you already have a much better phone (I hear they have cracked down on this one because a private business is involved. Also completely forgot about the EBT card (Food Stamps) just go to ATM machine and cash out because it’s no longer for food even gets accepted at Auto parts stores around here.

  26. The “affordable” care act is definitely not aptly named, unless you’re part of certain groups. If you’re middle class or wealthy – making an income, your premiums and out of pocket costs are going to be going way up.

    A lot of employers are dropping their plans or having to drop plans that don’t meet ACA requirements, and employees end up having to pay. Those who were uninsured before or who are the working poor may have a better situation now because of subsidies, etc, but those who are in the middle class are going to be shouldered with a majority of the burden. It’s a house of cards with disincentives to be productive – and it can’t last.

    Not only all that, but a lot of places aren’t planning on accepting plans bought on the exchanges, so the number of people insured will go up, but places to get care will go down.

    I think a lot of people are in for a rude awakening when they check what their costs will be under ACA.

    1. I think they call it affordable because most people who did not have insurance will now afford. However, the middle class and rich will still afford except that it is not nice for their premiums to be doubled as in the case of Holly.

  27. I guess one important question would be how much were those people making $50,000 paying *before* the ACA went into effect? And how high a deductible did they have?

    Yes, health care is expensive… but is it more expensive than it could have been?

  28. I’m relieved that my company offers health insurance – and that will DEFINITELY be a deciding factor when I start job hunting next January/February!

  29. This was a bit of a “mind F$*&” for me.

    As I mentioned in my post earlier this week, I’ve been woefully ill-informed about my insurance policy. Because it’s “free” as in my company pays us a lower salary than the industry stanard and covers insurance 100%, I haven’t had to put much thought into insurance. However, I know this won’t be the case for long at all because I won’t stay here forever.

    As this rolls out it’s been really interesting to hear what’s happening to other folks. My parents’ insurance (for just the two of them) will be going up $1,000 per month. Or, they can opt into whatever ACA options are offered, but their regular doctors won’t be taking ACA. They’d have to leave the practice they’ve gone to for over 15 years.

    1. Yuck!
      So, their regular doctors aren’t going to take ACA plans? I’ve heard that that might happen but hadn’t seen any specific examples yet.

  30. It’s disheartening that the political sales pitch isn’t what’s actually occurring during its implementation (though sadly am not surprised). Thanks for the detailed research, it’ll be interesting to see how this develops over the next few months.

    1. We’ll just have to see. We have no choice anyways =/

  31. No government program is meant to satisfy the “middle class.” It may evolve into a better program, but I am expecting more cost containment.

  32. Sorry to hear about your premiums doubling, that is a hard cost to swallow. When I was first saw some of the chatter about the changes to our employers health plan, I thought I was going to have to pay more. We would have a smaller monthly premium but the deductible was going up. That combined with the fact that prescription co-pays wouldn’t kick in until after you hit the deductible. I figured I was in line to pay quite a bit more.

    However, since we now all have a high deductible plan, we are all eligible for HSAs. The tax savings I’ll be getting combined with my employer contribution to the HSA will actually offset the higher cost of my medication. I’ll be saving $700 under the new plan despite not being eligible for any subsidies.

    Of course, in the end I would just prefer a single payer system. If my employer couldn’t provide health benefits, the other parts of my compensation package would have to go up (salary, vacation days, etc.).

    1. I’m glad that it’s working out for you! And, its awesome of your employer to contribute to your HSA.

  33. All I have to say is that I am glad my employer sponsored plan is not going anywhere. My parents are having to wade through this stuff and every scenario that have has their premiums rising in price with reduced coverage. Where’s the political reset button again?

  34. How does that caviar taste?

    It’s so ridiculous how one-sided these rules are. They effectively do punish those who earn above a certain level, which basically neutralizes us into all being the same. Do you think this could ever lead to the rich fleeing America if we continue to keep this up?

    1. The rich are already fleecing America as it is. Have you seen that upworthy video that I posted higher in this thread?

      $94,000 is not rich. It is solid middle class. People who earn 94K could easily be two married teachers or two married police officers for that matter. I cant believe we’re setting the bar that low for wealth distribution. All the while, the top 1% or 3% of earners are laughing at us.

      1. Holly Baldwin says:

        Hi Holly!
        I am a new follower of your blog (my name is also Holly!) and I just LOVE this post you did about Obamacare. The top 1% ARE laughing all the way to the bank. I agree with you 100% on everything. I am grateful that so far, my husband’s insurance will not be changing (he is a federal worker with the Air Force). I can’t imagine trying to afford those premiums…..there’s no way we could do it! We would have to sell our home and move into a small apartment in order to afford that. It’s just INSANE! I am so sorry it is going to affect you so much too. I have never been so disappointed in my government as I have been this year. 🙁 Keep up the great work! Love your blog!

        1. I’m glad that your husband’s employer offers coverage. Hold onto that man for dear life! It’s just frustrating when you work so hard to lower your expenses and are constantly having to pay higher costs for something that is completely out of your control.

      2. Down with the 1%!

        Or maybe the 1% is laughing at the very people who were laughing at them, going after their assets and wanting to raise taxes.

        The 1% have always known the government would eventually come for everyone. Mwahahaha 🙂

        Sam

  35. Pardon me, I’m new here, but loved your post on DailyWorth about zero-sum budgeting and am now following you. We just completed our first zero-sum budget!

    On Obamacare, we differ. I’m self-employed too, and was unable to get coverage for pregnancy on the individual market before Obamacare passed. Literally unable – no private insurers offered it at any price in my state. My husband quit his job at a hi-tech startup to go work for a big employer to get us health insurance that covered pregnancy and I felt like fifties housewife, barefoot and pregnant.

    Employer-based healthcare is just stupid. You get too sick to work, you lose your job, you lose your employer-based health insurance, you go bankrupt from health care costs. Every time.

    Obamacare is better. If healthcare costs are more expensive now than they ever were, it’s because healthcare costs are more expensive now than they ever were. Health care providers and insurers need to read clubthrifty!

    I am sorry about the loss of your catastrophic plan. Frankly, I don’t know enough about that provision to comment one way or the other.

    But, my net is, Obamacare is the first sane step in the right direction. It’s even causing the market to start managing it’s own costs – http://www.nytimes.com/2013/10/14/opinion/keller-obamacare-the-rest-of-the-story.html?nl=todaysheadlines&emc=edit_th_20131014

    1. Oh, my bad. I read your zero-sum budgeting post on Lifehacker not DailyWorth.

      Just one more note, you’re right that Obamacare is tough on the middle class. My understanding is that the history there is the concessions made by congress to let states determine how to extend medicare upward using federal subsidies. However, Republicans want(ed) Obamacare to fail and so in many Republican-led states it seems its execution is partial at best and fails many.

      1. But, here’s the thing: Obamacare still ties health insurance to employment. Sure, you can now buy plans on the exchanges if your employer doesn’t offer coverage. However, they are incredibly expensive unless you’re heavily subsidized.

        I’ve been there with the whole maternity thing. When we wanted to have our first child, we had to buy insurance on the open market. The state of Indiana does have plans that offer maternity but they are crazy expensive! I was actually denied for the first few plans that I applied for because of a back surgery I had in my early 20’s. When I finally got approved, the insurance was close to $800 per month AND I had to wait 6 months before I was “allowed” to get pregnant. What kind of insane health insurance policy is that?
        Anyway, by the time I had a baby, the policy was well over $1,000 per month. Shortly after that, work started offering a group plan.

        I am happy that maternity and pre-existing conditions are now covered. However, I think that Obamacare fixes a few problems and creates dozens of other problems. And, as a self-employed person, how do you feel about people making $94,000 per year being forced to subsidize everyone else?

        1. Holly, totally get that Obamacare may fix some problems and create others. I’m just happy that anyone managed to get any reform passed. It was an entirely untenable situation – costs out of control, more and more uninsured and bankrupt, even employers were having to offer worse and worse coverage at ever higher cost-sharing rates.

          I’d rather push a fix, force some things to improve (or at least slow the spiral), and then fix the rest as the politics allow. I think we were all in denial – except the uninsured 10% of us who were denied or unable to afford coverage.

          I think the rich, frankly, should pay to subsidize the poor if it can allow everyone to – say – have maternity care and other preventative services. $94k, unfortunately, is not what I would call rich. But then, paying exorbitant fees would have happened with or without Obamacare… my premiums were up 20% a year the last 5 years.

  36. Yea the Government is great at redefining rich, soon it will be anyone who owns a home. I agree with Kathy that the ultimate goal is the make the big bad insurers the scapegoat and come in to save the day with a ‘single payer system, after all it works in Canada and France, even though they have about 1/10th of our population.

  37. I’m not American, so I can’t really speak to Obamacare. I mean, I’ve read a lot about it and have done a fair share of research, but still. I don’t think it’s fair to form an opinion when you aren’t effected by something. Interesting post though!

  38. As much as I feel ACA will benefit the people who could not afford insurance before, it is unfair for people like you who are in the middle class to pay double. And like you are saying, the people who are way rich won’t experience the effects like people in your income bracket.

  39. affordable care act 90 day says:

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  40. James Jung says:

    Wake up. Bronze plan, low income family can not afford to pay 40% of a major medical issue.

  41. The “unfortunate” reality of the ACA is that now insurance companies can NOT cut you off if you get sick. All of their business models were based on NOT paying out.

    Now insurance premiums reflect the ACTUAL cost of care rather than giving you a “pending approval” status until you die.

  42. the other jim says:

    Anyone who supports this bs Obama care obviously has their head seriously misplaced. Our grand daughter has a rare disease – with no cure, but treatments and hopes for a cure one day. Her parents were just notified that their insurance is not good enough under this bs plan so they are now forced to go find something else. THIS after they spent YEARS finding (and being accepted under their insurance) 1 of 4 places in the US that specializes in the disease their child has. God only knows where this god-forsaken cluster is going to leave that little angel.

    For those of you who still think this crap is great – go read a history book (oh, and you might want to study the constitution – that whole separation of powers thing might strike a chord) – not with the dip-sh** in the white house ’cause he disregards it anytime it suits his fancy – at the expense of hard working Americans, not the leaches and the loads that just suck off all government bs programs.

  43. how can I , making 25, 000 a year, pay a deductible of 4,000 to 6,000 a year???? Are they stupid? This was a way to get the working people in the US to give them there income tax. The only time of the year I can fix anything, get tires for my car, Fix stuff at my house,, what a ripoff. Obama was a Dam Lyer!!!!!

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