How an insured family, mine, ended up on the ACA exchange
The New Hampshire Union Leader originally published this column in March 14, 2014:
The Cullen family spent $26,934.89 on health care last year, mostly insurance premiums and the rest normal out-of-pocket expenses. That was up nearly 22 percent from the year before, when we spent $22,121.50 on our family of five.
That’s $49,000 over two years that didn’t go into college funds, retirement accounts, paying down the mortgage, replacing my wife’s 11-year-old car, finishing the attic, private school, or a vacation. Health insurance costs have crowded out other priorities, as they do for many families.
I know how much we spent because we’re in the individual market. We pay the full costs directly; premiums aren’t hidden in a benefits package and paid for in the form of lower wages. The individual market is a tough place to be in New Hampshire. “Reforms” sponsored by Jeanne Shaheen during her years as a state senator and governor resulted in only one provider, Anthem, offering plans on the individual market in New Hampshire. Guaranteed issue and community rating, which prevents insurers from charging different rates to people who pose different risks, prompted nearly a dozen competitors to cease state operations.
When I was a young invincible, I went years without health insurance. Now I have a spouse and young kids. We experienced a searing health emergency with my newborn daughter a couple of years ago. Not carrying insurance isn’t really an option.
At the start of the year, I contacted Anthem hoping that by adjusting our coverage we could lower our premium. Tough noogies, the form-letter response read. What I’d asked for was not “Affordable Care Act compliant.” Like the Little Sisters of the Poor, we had to keep buying coverage for things we didn’t want or need.
Two weeks later, a different form letter arrived. “Starting July 1, 2014, we are no longer offering the individual health benefit plan you currently have,” it read. Our existing plan didn’t conform to ACA mandates either and is being canceled.
I don’t blame Anthem for this mess. If anything, I sympathize with the company. How can you run an insurance business when the government keeps moving the goalposts and changing the rules by fiat, first saying you can’t issue certain policies, then saying you can or even must renew them?
Our agent scouted the Obamacare state exchange for options. There are plans available that could save us money and are compatible with our Health Savings Account. So earlier this week, reluctantly and with trepidation, I logged onto the infamous healthcare.gov website.
Whatever problems existed last October, the site is pretty impressive now, intuitive for people who are used to using smartphones and tablets. Navigating the site took most of an hour. The program did crash once while I registered my family, but when I logged back in it took me right back to where I’d been without losing any information.
The programming isn’t perfect. The software asked whether my four-year-old pays alimony and if my three-year-old has student loans. I suppose those sorts of questions have to be asked in a system that considers adults up to age 26 to be children.
Some security features made me think we’ve been under National Security Agency surveillance. At one point the software verified my identity by listing the name of a company I’ve done work for in the past, without my having provided that information. Somehow, it just knew. Later I had to identify from a list of four high schools the one I had attended. I picked “none of these,” which the software knew was the correct answer. The program also prompted me to register to vote, so you know President Obama’s political strategists must have been involved in the redesign.
And so it is with considerable irony that the Cullen family, committed free-marketers and opponents of the Affordable Care Act, find ourselves signed up for private health insurance through the exchange. We have an Anthem-administered bronze plan, my premium is dropping nearly $1,000 a month (with higher out-of-pocket costs expected), and we may apply tax credits to the bill.
Of course, the exchange wasn’t meant to attract a family like mine: We already had insurance. I’m sure it will all change again next year.
Fergus Cullen, a freelance columnist, can be reached at firstname.lastname@example.org and followed @FergusCullen.