Wednesday, November 4, 2015

So Much For Affordable Healthcare

As many of you know, my mother-in-law from a foreign country is mid way through her process of immigrating to the U.S. and becoming a citizen. She has her greencard but now must stay here for the majority of five years before she can apply for her citizenship and she is just starting year three and will be about halfway done sometime this winter.

Healthcare was a big issue for us when we were discussing whether to attempt this or not. She has healthcare back home but it would mean flying home every time there was a problem. Not only was this expensive, if might not even be possible for serious health issues. We were looking into buying an insurance policy for her to cover catastrophic health events and just paying cash for her routine health issues. This was an expensive option however it was the only option at least until Obamacare intervened.

Once Obamacare was online, I along with millions of others suffered through months of website errors trying to get quotes on what it would cost us. Because we don't qualify for "aide", we had a lot of hoops to go through first before we were able to apply for healthcare. We had to first prove she wasn't eligible for Medicaid or state aid which was surprisingly difficult since both require citizenship. After months of filling out more forms, submitting proof and getting denied, we were able to go back to the Obamacare website, which by this time was working a bit better, and five months after I started, was finally able to get her signed up for a healthcare plan.

We have a high deductible plan that is quite a bit better than a plan we would have been able to purchase privately as far as benefits go. (As a result of Obamacare, it is now impossible to buy plans privately as they are no longer available for non-citizens.) However, it still had a pretty hefty price tag on it and I know in my area, one of the poorest in the midwest, it was out of reach of the majority of the population. After the first year of paying the premiums, when it came time for renewal, the premiums went up by 50%. We paid the premiums for a second year with still not a claim on them and guess what, I just got a notice that the premiums had gone up another 25% this year which puts it at 2/3rds of our monthly home mortgage bill, by far our biggest single expense.

I always laugh at the names politicians come up with for some of the legislation they pass like the Freedom Act which was all about giving up freedom. I think the Affordable Care Act is turning out to be just as much of a misnomer as the Freedom Act.  Hopefully we will be able to afford the next two increases for my mother-in-law's health insurance until she becomes a citizen.


Kelly said...

I know your current situation is not a laughing matter, but I did have to smile at your comment at the end about the "Affordable" Care Act. What I never understood was why they would fine those who didn't sign up considering a good reason they might not have signed up was because they couldn't afford it. No money for health care is going to equal no money to pay a fine. I hope it works out for y'all. You're a mighty good husband/son-in-law.

We're both self-employed, so that presented a whole other scenario for us.

Bob said...

Yes, affordable is in the eye of the beholder. Can she do a Health Savings Account? Don't know if it's available for non-citizens. The beauty of it is you can save for medical expenses (with a high deductible you'll have significant out-of-pocket costs in addition to your premiums) and makes it a little less painful if/when you have a hospitalization or costly illness.

Good luck with all of this.

sage said...

This "Compromise" was terrible, and somehow there has to be a whole overhaul of the health care system that actually allows competition in the marketpalce.

Ed said...

Kelly - Perhaps I was a little too misleading I guess with the way I worded things. We are in a position to afford it, especially since it is short term until my mother-in-law becomes a citizen of the U.S. But I know we are better off than a lot and I wonder how other's can afford it? Actually, I know the answer to that. They qualify for subsidies and I end up paying for that too with my taxes. What I was really trying to convey that I don't think the Affordable Care Act is affordable at all. It just shifts who pays for the healthcare of the poor.

Bob - My understanding is that having an HSA depends on having a job. She retired before moving to the U.S. to try and become a citizen and thus has no income and thus the reason I her son-in-law is paying the bill. We do have her in a high deductible plan, Bronze I believe, which is mostly for hospitalizations or something catastrophic. Fortunately, she is in fairly good shape and she still has a better plan in her home country if it is something she can fly back home for if need be.

Sage - I just don't think there are enough players in the market to allow for competition. I've always felt we have to go at the heart of the matter of why health care prices are so high and thus insurance companies have to raise premiums to make a profit. I think tort reforms for frivolous health related lawsuits would be a great start. Not only would this lower the malpractice insurance costs doctors have to pay for (this number would blow your socks off), but it would also lower the costs of just about every procedure in a hospital or clinic setting. I also think we have to look at the reason drug development costs are so high. Finally, I think we have to look at everything that is "covered" under healthcare plans and realize that perhaps not everything should be there. We are quickly becoming a society that believes everyone is "entitled" to whatever medical procedure they deem necessary, either by themselves or their doctors. In summary, the healthcare system is a perfect storm in which taxpayer pockets is the easiest solution. Like you said, until we really fix the entire system instead of slapping on band-aids, this is going to continue to happen until nobody is left to pay for it.

Kelly said...

I wasn't actually meaning you in my statement about not being able to afford it... just thinking how ludicrous that policy seems in general.

You've made some excellent points in your reply to Sage. As for the HSA, that's the route we took some years ago and it seems to be working so far.

Vince said...

To give you a picture of what you've got.
Here in Ireland we have 4000 different insurance plans paid by 50% of the population. But the State pays 18 billion to the health industry and the insurance sector pays 2 billion. The hospitals here would put Hollywood ones to shame. Our doctors are the best paid outside the USA, ditto the nurses. But if you are poor your chance of getting in in time before whatever ails you kills you is slim. We, in those 5* hospitals have a permanent cohort of poor on trollies, bath chairs and benches because the these people running the systm couldn't run a booze-up in a flipping brewery.
Ideology, nothing more is causing insane bottle necks. Unions, and there I mean the royal colleges of medicine along with civil servants have created a behemoth that needs obliterating and starting again.
Make no mistake the medics, hospitals and insurance companies in the USA are getting benefit under the taxation system all the way along. For instance, most municipal employees have paid for insurance, or greatly subsidised. If that insurance was calculated 'after tax' then the cost to the persons and the companies shifts dramatically, as does the insane costs that the health system can levy.
In the USA what would help, more doctors and nurses.

Leigh said...

Politicians are all about sales pitches. Thanks to the Affordable Health Care Act, our monthly premiums went from a little over $400 a month to over $1000 a month.