The View From Your Obamacare

Apr 24 2014 @ 2:19pm

Not all of the experiences from our readers are positive:

I was going to get a new car, but the increase in my premiums sapped up the income I’d set aside for the additional expense. So I guess I’m stuck with my 12 year old truck. Oh, should also mention that my deductibles nearly tripled and my coverage sucks in comparison.

Another reader:

While I recognize the large-scale benefits of the ACA, we found its implementation absolutely devastating to our small business. Our company is a medical device developer/manufacturer with about 12 employees. Because we employ mostly high-pay, high-skill engineers and scientists, almost none of our employees qualified for any sort of subsidy. Most of our employees are married and have kids, so they needed the most expensive policy, the dreaded “Self + Family” option.

Because we are a small-business, we did not have the H.R. resources to shop for private insurance and had to contract a third party to do so for us. And because we are a small company, we had virtually zero bargaining leverage with insurers. Larger companies in our area ended up with much better group policy offers from the same insurer as us. In general, our policies went up about $300/month per employee, and our deductible increased from $2,500 to $3,850.

But what is the absolute worst is that insane 2.3% medical device tax enacted to “pay for” the ACA.

It taxes gross revenue, not net profit, so even if our company were to have a down year where we actually lost money, we STILL have to pay that tax on our total proceeds from sales (no matter what NYT columnists claim, most medical device companies aren’t enjoying massive profits via monopolistic evil).

This is completely absurd. I am a wildly left-leaning proud socialist, and I recognize the utility of taxes to pay for things, but the idea that gross income is taxed instead of net profit is a giant FUCK YOU to medical device companies. And worse yet: the pharmaceutical industry doesn’t have the same tax! If net profit were taxed, let’s say, then medical device companies could pour their profits into R&D prior to being taxed, which would foster innovation, bolster high-pay scientist/engineering jobs, and generally help the sick in this and other countries.

Long story short, someone obviously had to get the short end of the stick in ACA, and it is patently clear that it is the small, high-tech businesses who had no lobby.

Another:

I have been a supporter of the President and the ACA since the beginning. I certainly understand the political compromises that had to go into the development of the law and it’s far from perfect, but I was certain it would help a lot of people and help bend the cost curve of medical expenses.

However, my personal experience was somewhat shocking. I pay the full price for my family health insurance plan and my premium costs went up by 21% over the previous year to just under $1,650/month. I still have a $1,500/ $3,000 deductible and my co-pays on both doctor’s visits and medication went up by a few dollars as well.

Being in Massachusetts, my plan didn’t have to change very much to comply with the ACA. Guaranteed insurability was already state law, and a few small additions were added to the plan; doubling of rehab visit days in a calendar year, mental health visit co-pays equalized with other doctor co-pays etc. They also added pediatric dental as a requirement, but looking at plans that didn’t have that provision (if you had external dental coverage you could drop it) only lowered the premiums by about $30 a month.

I’m willing to put my money where my mouth is and pay extra if it’s helping implement a law that I believe in, and I make enough money that I can begrudgingly afford it. But this experience tells me that the upset self-employed and small business owners on Fox News talking about the unaffordable costs of this law are not completely full of it.

I was really taken aback by how much my premiums increased – much more in both percentage and dollar terms than in any other year, yet health care cost inflation was supposed to have leveled off? Trust me, I shopped around so it wasn’t just my provider; all plans similar to mine cost within $100 a month of this one – and it’s still considered a bronze plan (HMO not PPO). I have yet to see any justification for this increase and I hold out hope that our Mass. Based insurers are just overestimating costs and I’ll get a nice fat check next February when Harvard Pilgrim pays less than 85% of their income in benefits.

Like I said, I’m willing to pay the extra money – but single payer still sounds pretty good to me.