Showing posts with label satisfied unsubsidized. Show all posts
Showing posts with label satisfied unsubsidized. Show all posts

Friday, January 27, 2017

Help me tell ACA stories

Greetings, dear readers: I would like to tell stories about people's experiences with lesser-known ACA benefits -- or shortcomings. Writeups may appear elsewhere -- healthinsurance.org or other publications -- or here.  These are the categories I have in mind:

1) Donut hole: I'd like to speak to Medicare enrollees who have benefitted (or not so much) from the ACA's gradual closing of the "donut hole" in prescription drug coverage.

2) Lifetime coverage caps: pre ACA, in 2009, 59% of people insured through employers were subject to lifetime caps on coverage -- typically $2 million by 2009, but often $1 million. The ACA banned lifetime and annual caps.  In a recent post, I  dug up a 2007 study finding that 20,000-25,000 people would hit lifetime caps by 2009.and forecasting that 300,000 would max out by 2019 if the caps were not raised. I'd like to speak to anyone who ever hit the caps, or was saved from the caps by the ACA, or is worried about hitting the caps (because of an expensive chronic condition) post-ACA.

Thursday, March 20, 2014

When a 30 year-old's health insurance decision was a matter of life or death

Yesterday the Atlantic ran an article of mine about the ACA's satisfied unsubsidized -- those who earn too much to qualify for ACA subsidies but were happy with the insurance they found for 2014 under ACA rules because they or a family member have a pre-existing condition.

The original draft was cut down quite a bit, necessarily and appropriately for a general interest publication. Personally, though, I find the full stories of how these "health insurance veterans" navigated the individual market over the course of a decade or two fascinating. One outtake is below; I'll put up another tomorrow.

An individual market vet prefers PPOs

Frank, 40, a film producer, and his wife Sharon, also 40, a film editor, live and work in Los Angeles, among the legions of independent contractors in the film industry. The couple has a 5 year-old son. Sharon has a preexisting condition -- she was diagnosed with thyroid cancer in 2003, which was fortunately caught early and treated successfully.  Intuition and prudence probably saved Sharon's life, as well as the couple's finances. Frank's recollection of the way two young professionals navigated a world in which health insurance was not a given provides a window into the problems the ACA is designed to address.

"At that time, we usually didn't get health insurance," Frank recalls, "but Sharon was working on a program that did provide insurance.  The job ended, and she was going to move on to another thing, and was like, you know, 'I am going to pay for the COBRA and continue my health insurance.' She felt there was something wrong with her neck.  I remember thinking, you don't really have to do that. I didn't have health insurance. I had left where I was and was trying to do some writing, and my attitude was, 'we don't have the money.' She said, 'I really think it's important.'  And she was dead on the money, because she had thyroid cancer.  She was lucky, it wasn't terribly severe, she caught it pretty early, but it took some time -- she had to have three separate surgeries."