Is the Affordable Care Act (ACA) Really Affordable?

Dear Mr. Lewis,

“A few weeks ago we notified you about upcoming changes due to the Affordable Care Act (ACA) and explained that your current Blue Shield medical plan will end December 31, 2013…”

These were the words I was dreading to hear! When I received our cancellation letter, I was very upset to learn that it was being cancelled at the end of 2013 because it was not “compliant” with the “Affordable Care Act” (ACA). Blue Shield of CA offered us another plan in its place that was “comparable” in coverage, but it really was not. The deductibles, co-payments, and out of pocket expenses on the “new” plan are significantly higher than the “old” plan, and the overall quality is inferior.

Besides our family, over six million Americans received cancellation letters from their insurance companies because of the ACA, and they have had their health insurance plans cancelled despite our president’s repeated promises, over and over again, that…

President Obama Contemplating Obamacare.

The First Time Our President Contemplated Obamacare.

“If you like your doctor, you will be able to keep your doctor, period.” “If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” and “I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premium by up to $2,500 a year.” Blah, blah, blah…

Well, we had a health insurance plan with Blue Shield of California for many years. It was called the “Shield Savings 3500/7000 PPO” plan, and we were very happy with it, despite the fact that President Obama felt it was a “sub-standard” plan. Since we were repeatedly told that our premiums would be going down approximately $2,500 a year, I was trying to keep an open mind. However, that was not the case.

We were paying $975.60 per month for a family of 8, and that included dental and prescription drug coverage for all of us as well as relatively low co-payments and deductibles. I thought that our premium on the Shield Savings plan was a little steep, but when I found out what our new ACA premium was going to be, I almost fell over!

Despite the fact that “Dirty Harry” Reid accused me (and thousands of other Americans) of being a liar this past week because the information in this blog is allegedly “untrue,” our ACA premiums more than doubled! Because of the “Affordable Care Act,” the health insurance premiums for our family went from $975.60 per month to $1,995.48 per month!

"Dirty Harry" Reid

“Dirty Harry” Reid

And unlike our Shield Savings plan, the ACA health plan only included dental for three of our six kids and no one else! Our premium would be even higher if the other five people in our family selected dental insurance. On an annual basis, we were paying $11,707.20 per year for our Shield Savings plan ($975.60 x 12 = $11,707.20), but the annual premium for our new ACA health insurance plan is $23,945.76 per year ($1,995.48 x 12 = $23,945.76)! Is that supposed to be “affordable?” I think not!

By the way, our new $23,945.76 per year ACA plan that I’m referring to is a basic PPO “Bronze” level plan, which is the “cheapest” of the four ACA metallic plans. This is the “ACA-compliant plan” that Blue Shield recommended because they told us it was the most “comparable” to our Shield Savings plan. Here is the description of the basic PPO “Bronze” level plan that we received from Blue Shield of CA:

“With low premiums, a high deductible, and more out-of-pocket costs, our Basic plan is designed for people who want affordable coverage and protection in the event of a serious medical emergency. You’ll have the basics such as three doctor’s visits prior to meeting the deductible and preventive care services.”

Now I’m not sure about you, but I don’t consider $23,945.76 per year to be either a “low premium” or more “affordable!” And regarding the “three doctor’s visits” and the “preventative care,” it would be much more cost effective (cheaper) for me to keep the old plan and pay for these expenses myself.

Furthermore, our deductibles and out of pocket costs increased significantly under the ACA plan. On our Shield Savings plan, our calendar year medical deductible was $3,500 per insured or $7,000 per family. On the ACA plan, it is $4,500 per insured or $9,000 per family. Our calendar year out of pocket (OOP) maximum on the Shield Savings plan was $5,000 per insured and $10,000 per family. On the ACA plan, it is $6,350 per insured or $12,700 per family!

With office visits (primary care doctors and specialists) and urgent care visits, lab and X-rays on the Shield Savings plan, we paid NOTHING after meeting our deductible. On the ACA plan, we still have to pay 40% of these costs AFTER meeting our deductible! And the same is true with Outpatient surgery and Inpatient hospitalization!

With generic drugs and preferred brand drugs, we paid $10 per prescription for generic and $35 per prescription for brand name after meeting our deductible. On the ACA plan, we still have to pay 40% of these costs after the deductible! I won’t go on and on with these boring details, but I hope that you get the point that the new ACA Bronze plan is significantly more expensive than the Shield Savings plan that we had, and it’s even more expensive when you take the additional costs of co-payments and deductibles into consideration.

If a family should end up in a situation where they have to pay a $9,000 family medical deductible as well as $12,700 in out-of-pocket costs (in addition to their obscene (non-subsidized) ACA health insurance premiums), there is a good chance that they are still going to end up bankrupt! So what’s the point of having insurance??? “The only thing worse than going broke is going broke with insurance!”

I hope and pray that people will wake up and repeal Obamacare or defund it because it is bad legislation that is destroying the quality of our health care system as well as hurting our economy and killing jobs. Then again, if enough young and healthy people don’t sign up for it, I think there’s a good chance that it will implode on itself and self-destruct.

As Nancy Pelosi famously said “We have to pass the bill to find out what’s in it.” President Obama and his administration purposely and repeatedly misrepresented the truth about the ACA, and it was sold to the American people as a pack of lies. Now that we know “what’s in it,” the majority of Americans don’t want it!

Nancy Pelosi

Nancy Pelosi, a little mixed up, as usual.

I would be curious to hear of your ACA experiences, both good and bad.

Thanks!

6 thoughts on “Is the Affordable Care Act (ACA) Really Affordable?

  1. I have been enjoying your comments at Stephanie’s LMM blog.

    What an atrocious result of the ACA!!!!! With millions of new insurance customers, how can this be possible?

    Our health insurance provider cancelled the plan we were on, and the premium and deductibles also went up this year. We received several notices “explaining” that this was because of Obamacare. Funny. Our coverage was better than the minimum requirements, and premiums went up and coverage went down every year before Obamacare. I am angry at insurance companies for cheating us customers and blaming the ACA.

    Our president’s promise was to sign a bill that met his criteria. He promised to sign a bill that allowed you to keep your service providers and coverage. Bills were introduced that did these things. Unfortunately, he did not receive such a bill to sign. Nor was he able to sign a bill that required insurance providers to offer fair plans. I was glad that he signed SOMETHING that had a chance of improving this country’s health care crisis. I share your disappointment that it did not do enough, and is hurting many people.

    I agree that we need a much better solution to our crisis than the ACA. It sure sucks for a lot of people.

    I’d like to keep in mind that the ACA is bigger than the current issue of ACA enrollment. It also addresses preventive medical care, Medicare coverage, provider quality assessment, pre-existing conditions, and patient rights.

    Thanks for sharing your perspective on this issue. You got me thinking, and doing some research. I love doing research.

    • Thanks for commenting and for sharing your perspective as well! It will be interesting to see where all of this takes us, and where it will end. Hopefully, not too many people will be hurt in the interim.

  2. Good article. I talk to dozens of patients every week who are just as frustrated and feel betrayed by the bait and switch our government as played on the masses. An eye opener at best.

  3. Great looking blog. You have a new Follower. I think you saying in the last paragraph, “Consequently, I’m not a big fan of Obama care” is about as much as an understatement as Abe Lincoln’s wife saying, “I didn’t much care for THAT show.” !!! Nice post.

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