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Monthly Archives: October 2013

My Obamacare Experience

I usually use this space to write about my adorable (I’m slightly biased) children and my eternal search for DaddyBalance.  Today, I thought I’d write and give you a Obamacare Experience from someone on the front lines of the issue.

Let’s start with a little background.  I’m a small business owner.  I’m structured as a sole proprietorship, all of my income comes through on a 1099. I have two W-2 employees, both work part-time.  I don’t provide health insurance for my employees and am not obligated to do so through Obamacare.  My wife stays home and cares for our boys, so I purchase my health insurance on my own.  I currently pay about $400/month for a high deductible ($7,500) plan for my family of 5 (wife, and 3 boys, ages 7,4, &1).  This plans provides us with good care and we pay out-of-pocket for most items.  A doctor’s visit is somewhere between $80-$140/visit.  Prescriptions run between $20-$60/piece.  We utilize a HSA to pay for most of our costs, and generally, I’m OK with this plan.  It’s not great, but it isn’t a disaster.

Let me also share with you my politics, because for this discussion, in the current environment, it matters.  I consider myself an Independent.  I’ve voted for Democrats and Republicans.  I lean fiscally conservative, while I’m more progressive on social issues.  I find myself in the middle most of the time.  The more extreme a position or politician, the less likely I’ll follow or listen.  I believe we are American first, Republican/Democrat a distant second. 

I’ve been curious about Obamacare from the start.  As you can tell, I spend a lot of money on healthcare and health insurance.  Between the $4,800 annual premium and the $7,500 deductible (which I hit this year due to my son’s epilepsy, which you can read about here), my total out-of-pocket (which I calculate by adding my monthly premium and my deductible) is around $12,300, or about $1,000/month. 

I was curious to see if my premiums would go down.  Would I qualify for a policy with a lower deductible? How about those subsidies, would they apply to me? Would I want to hold onto my current policy or head onto the exchange?

So on October 1st, the day the exchanges opened, I was on it, ready to go.  Let me be the first, or possibly the 500th person to tell you, the website is awful.  I’m 35 years old, I’ve been shopping on websites for most of my adult life, and this was the worst experience I’d ever had.  I tried to access the site everyday for about two weeks.  Each time I was stalled on at different step in the process.  First I couldn’t log on, then I couldn’t enter my family’s information, then I couldn’t see my results.  On and on it went until I just gave up. 

Fast forward to the 28th of October.  After logging onto Helthcare.gov, I finally, for the first time, was able to see my results.  Now, it’s still the clunkiest consumer website I’ve ever come across…it’s terribly slow, glitchy and user UNfriendly, but I found the information I was looking for, and have begun to answer some of my questions.

First, I don’t qualify for any subsidies.  Fortunately, or unfortunately, I make too much money to qualify.  I had 22 policies to choose from, but from only 2 companies, Anthem Blue Cross/Blue Shield and Coventry.  (Coventry, by the way, did not appear to have either my primary doctor or my kids pediatric doctor available.) I compared two policies, a bronze and gold, both offered through Anthem.  I did not see many differences in coverage between the two policies, other than the gold offered child dental, whereas the bronze policy did not.  Most of the other comparison services (ie pain management, pregnancy, depression, etc) were the same.

The cost for the bronze plan is about $700/month with a $15,000 deductible.  That’s a 75% increase in my monthly premium and a 100% increase in my deductible.  My total out-of-pocket (using the same formula as before) goes from my current $12,300 to $22,000, or about an 80% increase.  I can still use my HSA, and there are some eye doctor services that I would be getting under this new policy that I don’t currently have.

The cost for the gold plan is about $1300/mo with a $1,500 deductible.  This policy offers some dental coverage, for my kids only.  Once again, there is not a lot of difference in the covered services between my current policy, the bronze policy or this gold policy.

I have two major take aways. 

First, I don’t see a big difference in coverage between bronze, silver and gold policies.  What I do see is a big difference in monthly premium.  The 3 level metal system seems a bit disingenuous.  My assumption was that gold policies offered substantially more coverage, hence they would be more expensive.  Along that same thought, I figured you could have large deductible (HSA eligible) gold policies, and vice versa, small deductible (HSA ineligible) policies available in the bronze arena, but that’s not the case.  From what I can tell, each of the policies offer most of the same services (90% or so), the major difference is whether I want to pay a smaller premium or higher deductible.

Second, I want to keep my current policy!  If I’m not getting substantial better coverage, why would I want to be forced onto the exchange?  My current policy is not a “catastrophic” policy, it’s good coverage and a much lower premium and deductible. 

I recently received a letter from my current insurance company.  They told me they were in the process of reviewing my policy and would let me know if they were going to cancel by the end of the year.  I’ll hold out hope, but I’m not encouraged.  I’ll keep you posted.

If you are interested in learning more about my Healthcare.gov experience, shoot me a note or make a comment, I’ll do my best to answer.

UPDATE: A letter arrived yesterday to inform me that my policy will cancelled Feb 23rd.

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Happy 7th Birthday, Henry. (The Most Important Thing I’ve Ever Written)

 

You is kind.
You is smart.
You is important.
– The Help

Oct 1, 2006

I remember two things about the day you were born, son. The first is that it was a Sunday and the St Louis Rams were playing on TV. When your mother and I arrived at the hospital the evening before, I realized that our in-room TV had only 3 channels. Wondering if this was 1986 or 2006, I was happy to pass the time that Sunday afternoon watching football. I had one eye on the game and one eye on you as you made your much-anticipated entrance. The second thing I remember is that after you were born, I went out to get your mom some dinner. It was late, and on my way back to the hospital, I stopped at a local gas station and bought a 6 pack of beer. I wish I could say this was a spur-of-the-moment act by an over-joyed new father, looking to make a celebration. The truth is, it was pre-meditated. So much so, in fact, that as your mother prepared for your arrival by filling  her Mother- To-Be suitcase with your first onesie, pacifiers and stuffed animals, I was preparing by being sure I had a cooler in the trunk of the car. I knew, 36 hours before you were born, that I would need a way to sneak booze into your hospital room. As you took your first sips of milk, I was downing Bud Lights.

Oct 1, 2010

I snapped the above video  on October 1st, 2010, your 4th birthday. There is nothing particularly unique about this video, except that I don’t remember taping it. Earlier that day, I participated in a local charity golf tournament. The 11:00am shotgun start was also my signal to crack open the first beer. I drank all day and won that tournament. About the time I should have been celebrating the 4th anniversary of your birth with candles and cake,  I was toasting my victory with a bottle of red wine. The next morning, I awoke to see that I had posted this video on my Facebook page.  As I stared at the screen, watching you and your brother, Charlie, run around the house, I knew something had to change. If I kept this up, I thought, I might not see your 5th, let alone 7th birthday. I didn’t realize it at the time, but that would be the last time I was ever drunk.

The following Monday, I entered a library, found a book titled “The Best Life Diet”, and checked it out. At first, I thought I needed to get in shape, which I did. What the book taught me  was there was a bigger reason why I struggled with my weight.  The diet suggested that I take 30 days off from drinking. I did, and it was the best month of my life. I found energy, time and you. I found your brother and your mother and it  was amazing. Shortly thereafter, I decided I wasn’t going to drink anymore.

Oct 1, 2013

Today marks the 3 year anniversary of that golf tournament, and I’ve been sober ever since. With this confession today, people will treat me differently, they may treat you differently, as well. Unfortunately, we’ll be judged. It would be easy to continue to give half answers to direct questions as to why I no longer drink. After all, why endanger the relationships I’ve worked so hard to build?  Why not keep this our little secret?  A pact between a father and son, never to be told, never to be repeated.

The answer lies in why I’m writing to you today.

Henry, there will come a time when you are asked to stand up for what you believe in, to stand up to a crowd of “nay-sayers” & “cannots”. There will be a time you are made to feel the outcast, like you don’t belong.  The fear will overwhelm you like a boat against the power of the tide, paddling as the waves crash upon you. Exhausted, you will be asked to find the courage to rise above and be yourself. And at that moment, when you feel the urge to turn to me and say, “Dad, I can’t”. I want you to think back to your 7th birthday, when your father sat down in front of a computer and proclaimed to any who would listen, “My name is Greg Younger and I’m an alcoholic.”

On a day we celebrate your birth, I want to thank you for giving me life.

Happy 7th Birthday, Henry. (The most important thing I’ve ever written)

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