Obamacare really shines when it comes to people thinking of starting their own business, or those who already have. Which got me thinking of a whole slew of ways that health care reform will help people who decide to follow their own American dream and strike out on their own.
I started working on my own in 1997. I was 34 years old (or so), went looking for insurance on the individual market, and it was confusing as hell. Back then, in pre-Internet days (at least pre the ubiquity of information we have online today), you had to phone up the insurance company and meet with a rep. That was fun. I still remember the woman from whichever company it was asking me if I’d ever gone to a therapist. I said, honestly, “no.” And she said, “phew – we find that people who to therapist tend to be hypochondriacs.”
1. Easier to compare health insurance plans
Granted, it’s easier today with the Internet, but the amount of information, and the way it’s packaged, is still overwhelming. Fortunately, Obamacare is going to make that easier with the new “exchanges” we’ve been hearing about. From what I can gather, they’ll be online forums where all the different plans being offered in your state will be posted in a comparable fashion so that it’s easy to compare, and know which one is better. And what that does is provide a greater incentive for insurance companies to then compete with each other, which we’re already seeing in Oregon and California.
2. Cost containment
But there’s so much more. Before Obamacare, if you decided to leave your job – or lost your job – and went to work on your own, you went back to zero with the insurance companies. Let me explain. A good friend decided to move from DC to Arizon. He was paying $250 a month for his HMO here. When he moved to Arizona, the same insurance company, Kaiser Permanente, told him they were upping his monthly premiums to $1200 a month because of various pre-existing conditions. Mind you, it’s the same company. But because he was leaving his job on the Hill, and moving to Arizona to work for himself, he lost his health insurance and had to start over again from scratch, which means paying exorbitant rates because the insurance companies treat you as “new” and basically gouge people who work for themselves.
3. No longer turned away for pre-existing conditions
Not to mention, they could just tell him no all together. Another friend of mine, last year, got turned down by a major health insurance provider here in DC because he’s 35 years old, and has asthma and some skin condition, like psoriasis. That was enough for them to tell him thanks, but no thanks. That’s absurd.
Under Obamacare that won’t happen. Once the law fully kicks in, when you go to an insurance company to get a policy, they will charge you what they charge everyone else in your state and age bracket. You won’t pay more because you’re “new” to the plan – you will pay the same as the “old” people to the plan are paying as well. The hope is that this will moderate rates, and make it easier for you to set up your own business.
4. You can finally afford to go home to take care of mom and dad
But it’s really more than that. Mom and dad are getting old for a lot of us. And a lot of us don’t live in our home states any more. Americans are far more mobile, in my experience, than Europeans – partly because we have more options. France has one “main” city, Paris. America has several, including NYC, LA, Chicago, SF, Dallas, Miami and more. But what happens in American when you decide to move back home to take care of your parents, if you current live out of state? You lose your health insurance because you changed states (assuming you’re planning to work for yourself or not work at all). I know I couldn’t afford to move back to Illinois to take care of my parents. I’m already paying nearly $600 a month for my health insurance. God knows what they’d charge me with my asthma and retina problems if I moved. Obamacare will fix that.
5. No more worries about annual limits
I work for myself, and have the best self-employed PPO I could get from Blue Cross when I bought it in 1998 or so. Since that time, my monthly premium has nearly quadrupled. But another interesting thing happened. I found out that I have an annual limit on my prescription drug coverage – CareFirst BCBS will only pay $1500 a year for my prescriptions, and after that I’m on my own. That wasn’t such a big deal when I was younger. But nowadays, even though I don’t have any “grave” conditions, my annual prescription drug costs are far beyond the $1500 that BCBS is willing to pay for (my monthly asthma drugs alone cost around $450).
Oh but it gets worse. In the past 15 years or so, when my monthly premiums have gone up 400%, how much do you think BCBS raised my annual $1500 prescription drug limit? Zero. And if I kept this plan for another 20 years, they’d still only pay $1500 a year. That’s criminal.
Under Obamacare, annual limits are gone. Sadly, I need to switch to another plan that’s a good $250 a month more if I want to take advantage of Obamacare’s no-annual-limits, but I’m hoping that once the DC exchange kicks in, that price will go down.
6. You’ll no longer go broke if you decide to go out on your own
I remember talking to my general practitioner doctor here in DC a few years back about how insanely expensive insurance was on the individual market. He told me a story of a patient of his, in his young 30s, who has HIV and was excitedly telling my doctor about his plans to go work on his own as a graphic designer. My doctor told him he was nuts. No insurance company would take him, and HIV/AIDS drugs cost around $2,000 a month. My doctor made it clear that there was no way this guy was going to leave his job. And the guy didn’t. Obamacare will fix that too, since now insurance companies can’t turn you away for having pre-existing conditions AND they can’t charge you more for them – they’d have to charger you the same rate they charge anyone your age living in your town.
I’ve been surprised, and disappointed, at the way Obamacare has (not) been sold to the American people. The issue of kids being able to come home to take care of their parents is, in my view, huge to a lot of Americans. I know when I told my parents about this, they were flabbergasted. They had no idea the challenges I have with health insurance being on the individual market.
Granted, we still need to see what the rates will be, and how well this all work, but so far what we’re seeing in Oregon and California is promising.