On the Front Lines of Obamacare


Let me start by first saying that the Affordable Care Act (ACA), by and large, is a beautiful thing, and a major step in the right direction. The numbers do not lie, during the two open enrollment periods over 15 million Americans had health insurance for the first time thanks solely to the ACA, which is an unprecedented level of progress. Furthermore, over 5 million young adults under the age of 26 were able to stay on their parent’s insurance plans, and around 18 million people enrolled in Medicaid over the past two open enrollment periods. Total those three categories up and you have about 38 MILLION Americans who now have health insurance at a more affordable rate than ever before, and some who even have insurance for the first time ever.

With all that said, there is still a lot of room for necessary change within the ACA. I worked during the second open enrollment period as a Certified Application Counselor in New Jersey, which is a fancy title for a person who helps people complete the healthcare.gov application and choose the plan that best fits there needs. During that time I helped many people, most of which received financial assistance or were able to enroll in Medicaid. The vast majority of people left with a smile on there face and the newly acquired peace of mind that if they were to have an accident or fall ill, they won’t go COMPLETELY broke.

I say completely because if an otherwise healthy person were to select a bronze level plan at a low monthly rate then unexpectedly come down with a serious illness and have to have extensive medical care, they would be stuck with their deductible and out of pocket maximums in addition to their monthly premiums. According to census.gov, the per capita income in the USA is $28,155 and the lowest cost bronze plan with that income for an individual would max out at $10,900, which includes the Deductible, out-of-pocket max, and the premiums. That is nearly 40% of the per capita income. So, in theory, if you’re an average 30 year old American in good health who happens to fall ill you will be losing 40% of your income to medical expenses. Now, I don’t in any way claim to have all the answers, I am simply pointing out what appears to be a major flaw in an otherwise good system.

Average Americans who have an accident or unexpectedly fall ill are not the only ones drawing the short end of the stick. There is a much bigger, and much more common issue at the heart of the ACA. Take a family of three for example, and say they earn $80,000 per year as a household total. The ages of the parents are 59 and 56 and they have a child who is 20 years old. Sounds like your run of the mill American family who has the income to live a very modest lifestyle, right? Well, this family would be a mere $840 above the income limit to be eligible for a tax credit under the ACA. The lowest cost plan available to this family of three would be $1,217 per month, and that is for bare bones health coverage, basically accident insurance. This hypothetical family would have to dish out 18% of their income for the lowest cost health plan available, or be faced with the tax penalty, which in 2014 was 2% of the total household income. Their options are clear, pay 18% of your salary and have awful health coverage, or pay $1,600 and have no health coverage, I would choose the latter.

Please, bear in mind that these are just two flaws of the ACA, and there are many more, such as the issue of the states Medicaid agencies being so backed up that some people that have their applications sent there by the ACA never hear back from them, and the changing of networks, which gained plenty of notoriety when President Obama said “if you like your doctor, you can keep him.”

But, for the most part, the ACA is very much a positive and a step in the right direction. The number of people who receive the short end of the stick is far less than the number of people reaping the benefits of the ACA.

The worst thing that could happen is a total repeal of the Affordable Care Act, which may very well happen this summer. I know I am just one unimportant voice in a country of over 300 million, but I urge everyone to rethink their stance on “Obamacare.” It is far from a perfect law, and it does need a lot of improvement, but is EXTREMELY better than what we had before. In 2009, the year before the ACA was passed, there were 49 million uninsured Americans, so reverting back to those times is an actual death threat for some Americans.