We received the letter in the mail a couple months ago. The good people at Regence Bluecross Blueshield were pleased to inform us that due to Obamacare, our current low monthly premium and comically high deductible medical policy would no longer exist come January 1, 2014. Pleased, because a new and better plan would be offered in its place. Old monthly premium: $578 for a family of four (non-smoking, helmet-wearing and paternally snipped). New premium: $1,123. A 94% increase.
Once the sound of boiling blood dissipated, I heard my Republican friends in my head chuckling at the sight of a liberal Democrat hoisted ten stories high on his own petard. How’s the view up there, Obamacare Ollie?
For the past 15 years my wife and I have made our living as freelance writers. (To young readers, I say: Do not do this. Your bliss is marvelous, but its following will need to be supported by a banker, plumber, union machinist or tenured faculty member.) As such, our health insurance is our own concern. Over the years we’ve held on to our coverage by letting our co-pay and deductible rise and our covered procedures fall. You may be aware that the three-tiered state exchange policies are labeled Gold, Silver, and Bronze, reflecting their price and level of coverage. If our policy still existed it would fall into the column of Wood.
But Wood we had—and Wood we liked.
No more. Okay, into the state exchange we go. I voted for it. Fair enough.
It is our good fortune to live in Washington State, where our Democratic governor embraced the Affordable Care Act and set up a state exchange that is, according to those who’ve studied such things, the best in the nation. The website allowed me to find a plan that looked reasonable. Premera Blue Cross had a Preferred Bronze 5500 for $889 a month. Okay. Not so bad. Downside: $3,600 more in annual premiums. Upside: Free eyeglasses for the boy!
The state exchange number put me on hold. I hung up and called Premera. “You can sign up with us directly,” a very helpful rep told me, “but if there’s a chance your income could qualify you for a subsidy, it’s best to go through the state exchange.”
So: Back to the exchange website. Enter birth dates, zip code, tobacco use, yadda yadda, monthly income. Stop. Ponder.
Which month, brother? For that matter, which year? Do you want gross, net, before SE (self-employment tax, a k a Social Security payments) or after? AGI (adjusted gross income) from last year’s 1040?
For every business futurist who hails the coming of the independent contracting economy, the future that is The Brand of You, there are thousands of us out here actually building The Brand of You. It ain’t an easy hustle. If you want to get an idea of our monthly and yearly incomes, imagine a sine wave drawn by a drunken sailor. Last year my wife and I, we made out all right. This year’s kinda lean. Which year did the exchange want? Unclear.
I went to a friend and colleague—let’s call him Peter—for advice. He also had his individual medical policy cancelled because of Obamacare. “I’m stuck on the same question—income,” he told me. Peter does a little writing, a little farming, a little this and that to keep the ship afloat. “I got through to the exchange, and the woman there told me to just estimate what my income would be this year.” In other words: Make it up. If he overestimated, he’d be screwing himself out of a subsidy, Peter said. If he underestimated, he’d be hit with a big fat bill. He wasn’t sure he wouldn’t also be accused of fraud. So he called his accountant, who’s also a lawyer.
That only got him so far. At a certain point in the conversation, the accountant/lawyer had to get off the phone. “I have to stop answering your questions,” he told Peter. “I can’t ethically advise you, because honestly I don’t know the right thing to do. Nobody does. There are no answers. Right now it’s a complete clusterfuck.”
Last week the frustration of people like Peter and me—Obamacare supporters who lost their current plans—was heard by the White House, which promptly panicked. On Thursday, President Obama announced a policy change that would allow insurance companies like Regence to keep customers like me on the old Wood plan for one more year. To that I say: Hah! Thanks for nothing.
The idea that an insurer like Regence can, or will, spin on a dime and revive our ol’ $587 Woody within the next six weeks is absurd. It skews the market and undermines the entire premise of the Affordable Care Act — which is that by balancing the halt (allowing pre-existing conditions) and the hale (forcing robust young adults to get in the pool), the exchanges will over time produce a system that offers quality health care at a price my family can afford.
Even Mike Kreidler, the deep-blue Democrat who serves as my state’s insurance commissioner, can’t support it. Hours after getting off of a conference call with the White House on Thursday, Mr. Kreidler announced that the State of Washington would tell President Obama to stuff it. “In the interest of keeping the consumer protections we have enacted and ensuring that we keep health insurance costs down for all consumers, we are staying the course,” Kreidler said. “We will not be allowing insurance companies to extend their policies.”
Which is how I found myself applauding Mike Kreidler and seething at a President I helped elect. Out here in the Land of the Brand of You, we don’t want cheap twelve-month extensions. We’re willing to suck it up and pay our fair share for health insurance. We want the exchanges to work. We’re not demanding a last-minute reprieve that threatens the stability of the entire system. What we’re asking for is clarity and competence.
Bruce Barcott is a former Guggenheim Fellow in nonfiction. His work appears often in National Geographic, The New York Times Magazine, Outside, and On Earth.