ObamaCare: What you need to know...

On January 1, 2014, all Americans will be required to purchase health insurance or pay a penalty. With the deadline less than a month away, it's natural that ObamaCare (officially known as the Affordable Care Act) has been much in the news. On top of the many questions that are to be expected with rolling out such a program, the nation has lived through a government shutdown and the train wreck known as HealthCare.gov.

Despite all the hullabaloo, and at the end of the day, Americans are still left with the task of figuring out what to do. As I began my journey to figure out what to do about ObamaCare, I first wanted to see what the ObamaCare plans entailed. How much did they cost? What did they cover? How did they work?

Answering those questions is not necessarily straight-forward... particularly when you're dealing with a broken government website. Two websites purport to provide basic information about the plans available to you under ObamaCare: HealthSherpa.com and ValuePengiun.com. They seem to be stable, and they're a pleasure to use. Unfortunately, however, I simply don't trust either site to give me completely accurate information. You can look around for yourself, but I have read anecdotal evidence that the information about particular healthcare plans listed on either site are simply not accurate.

So, if you want to know how much health insurance will cost you under ObamaCare, my first suggestion is to speak with a health insurance broker in your area. Here in Bloomington, a number of us have spoken to a very friendly and helpful broker at the May Agency. If you're in the area, let me know, and I'll put you in touch (ldweeks@gmail.com).

Your other option, of course, is to simply brave the HealthCare.gov website. I was able to successfully fill out an application and begin to browse through the plans. HealthCare.gov works by having you submit your health insurance application first, and then showing you your available plans. And you had better take good notes as you fill out the application. I discovered that after you submit your application, you are no longer able to go back and review, let alone change, your previously submitted application. To view or change a previously submitted application, you must call 1-800-318-2596.

So, then, what do we see when the curtain on the ObamaCare plans is lifted?

It depends. It's very important to remember that the Affordable Care Act (aka ObamaCare) did not actually create any health insurance plans. Instead, it simply regulates plans that health insurance companies are willing to offer. That means that the plans you see when you browse your options are not "government plans" per se, but are the plans that insurance providers are making available that follow all the Affordable Care Act guidelines. Consequently, the plans will vary depending on the insurance companies in your area and what they've decided to offer.

In Bloomington, Indiana, you have two health insurance companies to pick from: Anthem and MDWise. You'll need to do your own research for options outside of Bloomington, but be careful! The company you pick will determine where you get your healthcare. For instance, many women in our church choose to deliver their babies at Bloomington Hospital. However, Bloomington Hospital is not "in-network" if you choose an Anthem plan. Although Anthem used to have an expansive network, under the affordable care act this is no longer the case. Anyone in our church who enrolls on an Anthem plan, and then needs to deliver a baby, will be told that they will have to pay out of pocket if they elect to deliver the baby at Bloomington Hospital.

To make matters worse, in this particular case, the other closest hospital in the Anthem network is Monroe Hospital, which does not have a maternity wing. The next closest hospital in the Anthem network is Greene County General Hospital, a distance of about 30 miles. Greene County General is a small hospital, with only two OBGYN doctors with admitting privileges. The next closest hospital in-network is 40 miles away.

A friend of mine who lives outside of Bloomington, just over the county line, with his wife and family is expecting another baby in the summer. They do not have access to the MDWise plans, and must choose an Anthem plan. All other insurance providers have been driven out of the market by Obamacare. They have no choice at all.

Rather than travel 20 minutes (a distance of about 12 miles) to Bloomington Hospital to deliver the baby, they are facing the very real possibility of having to travel over an hour one way (50 miles) to a hospital near Indianapolis, for every single maternity visit, not to mention to deliver their baby.

Not to state the obvious, but when the government forces a couple to drive over an hour to deliver their baby, when there is a good hospital nearby, with doctors that they prefer, it isn't an improvement in health care. It is hurting both mother and child.

This is the Affordable Care Act in all its splendor.

Lucas Weeks

Lucas serves as an assistant pastor at Clearnote Church in Bloomington, Indiana. Although he pines for the warm, tropical weather that was familiar to him growing up in west and central Africa, he has since made peace with the harsher climates of North America.

Want to get in touch? Send Lucas an email!

Comments

Have you also looked into different health sharing ministries like Samaritan Ministries, Medi-share, and Christian Healthcare Ministries? My wife and I (and several of our friends) have joined and all three of them (with a few state-specific exceptions) qualify for an exemption from getting health insurance. Each of them have their quirks (if you'd like me to specify which we use, I'd be happy to do so.)

-joe

Stuff like this all over.  Almost all hospitals in southern Minnesota --at least from Mankato eastward and from New Prague south--are in the Mayo system, which accepts only Blue Cross.    We are talking about distances that make 50 miles look like a short drive to get to the Twin Cities, LaCrosse, or Cedar Rapids.

Yeah, that's what I want when my wife is in labor.  An hour's drive....what could possibly go wrong? And I bet the situation is far, far worse in states like the Dakotas and Wyoming.  Could be lethal, quite frankly.

Just some extra information to help people make decisions about signing up for Obamacare. I am numbering them out of convenience, not in order of importance.

1. All plans in America that are Obamacare compliant, no matter how they come to you, through an exchange or employer, fund abortions and contraceptives for other insurance customers. The only people who can get around this are church workers, and even then, Obama has narrowly defined what a church is, so that fewer and fewer will qualify for this exemption. A Christian ministry probably doesn't qualify, and neither does a Christian school.

2. There are a number of lawsuits out there, most notably by Hobby Lobby, that are taking up the issue of business owners funding abortions and other contraceptives through employee health plans.

3. One does not need to go through an exchange to purchase an Obamacare compliant health plan. Many of these same plans are available directly through the insurance companies themselves, and the signup may be easier and more private. You may have more choices for networks if you find other providers who sell on the individual market but do not have a presence on the exchanges.

4. Obamacare plans are significantly more expensive than they have to be, and there will be sticker shock for most shoppers. One reason they are expensive is that they offer coverage for procedures that people don't need. For example, maternity care for men. The other reason is that there is no exclusion for pre-existing conditions. This latter issue is a helpful change for many people, but could have been handled in a different manner than harnessing 330 million people to find a solution for such a small percentage of Americans.

5. Monthly premiums are higher than they need to be due to cost sharing with other customers, but deductibles are high too. A common deductible is $5,000. This means you pay for most everything until you reach that amount. In other words, these are catastrophic plans that are masquerading as everyday coverage.

6. There is little to distinguish between one plan and the next. In effect, these are all the same plans, with different premiums and deductibles, all feeding off the same underlying actuarial numbers, and offering the same benefits, no matter the supplier. Only the networks differ.

7. The only reason to use the exchange is if you feel you can get a subsidy. The numbers are out there to help you figure that out in advance. In many states, you don't qualify if your income is in the mid-20s.

8. There is a marriage penalty built into the system. In a marriage, both partners will be penalized by an income level that disqualifies both for subsidies. If divorced, the non-wage earner would get practically free insurance.

9. Expats are free from Obamacare. If you want to reconnect with American freedom, you'll have to find it in Canada.

10. Obamacare will soon fail. It wasn't meant to succeed. Since private and group coverage will be destroyed, single-payer will be only other option.

As for me, my cobra coverage costing around $400 monthly with a $750 deductible will soon end. I will share exact amounts that Cigna recently offered to me. The first number is the deductible, the second is the premium:

5100/473
2750/518
1250/617

I have personal issues with the new system, mainly due to the abortion issue, and how it promotes government control. I don't know what to do, and I am looking to Christian leaders for advice. You really can't control accidents or illness. I could easily trust God to protect me from something that I can't pay out of pocket. Where will this take me?

I have spent 36 years in the health insurance consulting field and I can tell you our current system is monopolistic and broken. The new system has problems, but is in many ways better than the old system. Hospitals will join when consumers join, they will have to. Go to http://kff.org/interactive/subsidy-calculator/ to find out an approximate price---most secular folks are not having kids and will subsidize many of us...

@Denver,

Thanks very much for that great information! As for what to do, I hope to follow-up this post with one (or more) about what I plan to do and why. I have already contacted Joe Helt, above, about working with me to discuss the various Christian sharing ministries out there. Stay tuned.

 "Monopolistic and broken" are codewords for Marxists and socialists. You forgot to mention the 1% and villainous corporations. You can keep Obamacare, and I'll just pay cash. By the way, if anyone wants to join me in Denver for the fastfood strike day this Thursday, I'll be the one holding up the sign that says "I believe in free market answers to economic problems." 

Being in Texas, a state that has chosen to NOT expand Medicaid, we don't make enough money to qualify for a subsidy. Yet, we don't make little enough to qualify for Medicaid either. The decision my husband and I are left with (for this year at least): pay the fine or enroll in a "bronze" plan (the minimum allowed to meet "Obamacare" (PPACA) requirements -- basically a "catastrophic" policy) for a premium of $3,760 per year and a $12,700 out-of-pocket deductible. We'll have to pay the fine, save whatever we can into an emergency savings, and pray that God will protect us from something that we cannot pay out-of-pocket or on some kind of payment plan. From what I've read, most Christian sharing ministries will not meet the PPACA requirements -- will be anxious to hear more! 

Hi Jessica,

At least one of the Christian sharing ministries does meet the PPACA requirements. See this link: http://samaritanministries.org/healthreform/

I don't have time to check out the others, but hope this helps.

I have been reading a blog at theselfpaypatient.com and it talks all about the ins and outs of Obamacare alternatives. While promoting the idea of self-pay (and doing research on how to get the best price when you do), he also leans toward the share ministries and short term coverage. He does suggest that going without an alternative to regular insurance has its risks.

Add new comment