Not long before the new Affordable Care Act, aka Obamacare, website (www.healthcare.gov) was supposed to go online I wrote a column with some practical advice on this new program.
The column elicited a considerable reader response and some strong opinions were expressed. My point then, as it is now, is love it or hate it the law and program is here. I would have added “to stay” to this statement but after actually working with the program, or attempting to, I believe it will inevitably at least continue to be tweaked, perhaps even more than tweaked. At this point, however, the coverage deadline is looming and it’s time to understand this program.
To pre-address some of the response. I believe the farther any point of service gets from the end user, the lower the customer experience and ultimate satisfaction becomes for the user. While big business and even centralized government has its role to play, seldom do individuals go away dealing with these large entities feeling totally fulfilled.
This opinion is being validated with my Obamacare experience. First let’s talk pricing, which is impossible to discuss without considering the liberal premium subsidies associated with program. As I’ve said before, I think the Obamacare program is most potentially attractive for early retirees between the ages of 58 and 65.
This group has traditionally found it difficult or overly expensive to obtain health coverage, and in its base form Obamacare does not change this. But when subsidies are considered, a couple with income of up to $5,170 per month can receive a premium subsidy of about $7,500 per year. This puts the net premium for a middle of the road plan at around $550 per month.
$5,170 is a functional retirement income in Northwest Indiana, and when considering the health care cost reduction I believe with a little planning the plan has the potential to make a positive impact on many people in this demographic.
Similar subsidies apply throughout the family spectrum with a family of four able to receive subsides with monthly income of $7,850. So while I have no idea how these types of entitlements can be fiscally sustainable, the potential to make a positive difference is apparent.
On the flip side of the coin, engaging the system is a disaster. Anyone I know who has attempted to use www.healthcare.gov has gone away frustrated and even households I consider to be extremely capable have simply given up.
My experience thus far is that people who have chosen to engage the program by using traditional local health insurance agents have been more successful. And as a heads up, I’ve reviewed the scope of the local health care provider lists for the exchange plan PPOs, and at this point it’s limited. I would expect, however, the local provider network to be somewhat enhanced as more people begin using these plans.