Obamacare exchange rates, and the pros and cons of the Affordable Care Act, have people worried about their budget.
Unfortunately, many Americans don't know Obamacare and the Affordable Care Act are the same thing, but seem to prefer the latter because of its better-sounding name. But what are the facts about the Affordable Care Act and is the ACA really affordable?
The average Obamacare exchange rate is supposed to be $328, but the prices can vary greatly depending on your particular circumstances. This writer thought it would be a good idea to compare the pros and cons of the Obamacare exchange rates by looking at actual facts and not hypothetical scenarios. What better way is there to do this than to compare my actual private health insurance against the Obamacare exchange rates?
I was one of the unfortunates who ran into the Healthcare.gov security questions glitch. Even after I created an account, I still couldn't log in. Eventually, I gave up and called 1-800-318-2596, which ironically enough corresponds to 1-800-F*CKYO. I was expecting to spend at least an hour waiting, but the wait time was surprisingly less than a minute.
Unfortunately, the call center can only help with the applications process (be ready with all your personal information), but you still have to use Healthcare.gov to make an Obamacare rates comparison. In the end, I had to stay up until 4AM just to create my Healthcare.gov account.
Obamacare Pros And ConsTo begin with, I live in Florida and I'm married with one child. I have a pre-existing condition rider which is no longer allowed to be uncovered under Obamacare. So, that's one Obamacare pro in my book along with support for preventative care which my prior insurance plan did not provide. There's also the Obamacare rebates under the 80/20 rule, which affects all healthcare plans, not just the Obamacare exchange.
Unfortunately, one con is the Obamacare donut hole that allows states like Florida to ignore the Medicaid expansion for those under 133 percent of the poverty level, but my income is too high so that doesn't affect me personally. Not all states have chosen to reject the Obamacare medicaid expansion, so I'd suggest searching to check.
My previous health insurance costs me $191.95 per month (or $2,303.40 per year) in premiums, which includes $50k in life insurance coverage at $15.23 per month. If you subtract life insurance, I'm paying $2,120.64 per year. I didn't choose to have any extras so I paid out of pocket for the recent birth of my son, but that cost less than $1500 since we used a mid-wife at home.
The Obamacare exchange rates are specifically subsidized in an attempt to bridge the gap between private health insurance plans and the Medicaid expansion. I just received a pay raise so I'm at 266 percent of the federal poverty level. But, since a family of four can make $94,000 and still qualify for the Obamacare exchange, it's not like the marketplace is limited to only low income individuals or families.
Obamacare Plans ComparedThe Obamacare marketplace splits your options into labels like Bronze, Silver, Gold and Platinum, which are split into actuarial values of 60 percent, 70 percent, 80 percent, and 90 percent, respectively. As such, my Bronze plan would pay 60 percent of all costs (Silver pays 70 percent), with the remaining 40 percent consisting of my out-of-pocket costs in the form of deductibles, coinsurance payments (which kick in after the deductible is exceeded), and co-payments (which don't count toward the deductible and are typically for doctor's visits and the like). The coinsurance payments and co-payments are cheaper if you purchase a plan with a higher premium like Platinum.
There's also alternatives, including a catastrophic coverage plan limited to people under age 30, which is probably the best option for lower income workers. Based upon the prior Obamacare pros and cons listed, it should be obvious this will not be an apples to apples comparison. But I will attempt to get them as close as possible by choosing a Bronze plan.
After the Obamacare subsidies are included, my marketplace Bronze plan gives me a premium of $2,388 per year after ACA subsidies knock off $2,010. As a comparison, the Silver plan is $4,431 per year. Interestingly enough, if I don't list my recently born son, the marketplace says I don't get any subsidies and the price is more expensive at $4,889 for the Silver plan.
Fortunately, for this comparison the Obamacare deductibles are in the same league as my current insurance plan ($5,000 per person, $10,000 per family). But my co-payment is $35 and my coinsurance rate is 70 percent with a max of $5,000.
Research is key since Obamacare bronze plans can be all over the map for these options and depending on where you live, the premium may be the same. There's also different versions of plans from the same companies in the marketplace. For example, Silver Plan A offers a high $2,000 deductible and a low 15% coinsurance while Silver Plan B has a lower $250 deductible, but a higher 30% coinsurance payment. As it is, the 2014 deductibles limits are $6,350 for individuals and $12,700 for families, for all plans.
Conclusion: Are the Obamacare Exchange Rates A Good Deal?In the end, the Obamacare Bronze plan is very similar to my current insurance plan which costs $2,120.64 per year. If I did more shopping I could probably find a company offering options exactly like my current plan. So it's possible the extra money in the $2,388 might be a better deal overall.
My original health insurance plan has some negatives in comparison, but in 2014 all insurance plans will have to accept pre-existing conditions. But it's possible that once my Obamacare application reaches the underwriters the prices I'm being quoted will skyrocket. I'm also uncertain whether my premiums will go up regardless of whether I change plans or not.
But I do have to question what it took to reach this price point. I currently have a health insurance plan that costs $2,120.64 without the $2,010 in Obamacare subsidies. That money comes from billions of dollars in taxes each year.
So, all in all, since I'm an American taxpayer, I'm uncertain whether the Obamacare exchange rates are any good after you take into account how much everyone is paying for the Affordable Care Act. What do you think?