My Obamacare (Non-) Nightmare, Part 2


Yesterday, I shared my experience with Kaiser Permanente and the ACA. In a nutshell: I currently have a  policy purchased on the individual market before the ACA was passed; Kaiser informed me back in 2010 that my policy was grandfathered; Kaiser told me in 2013 that I could purchase an ACA-compliant plan or keep my existing plan. Fact is, the story isn’t very interesting because nothing went wrong.

However, you’d never guess that “nothing went wrong” was an option if you only listened to complaints about the ACA. Apart from the rollout of (which was badly and inexcusably botched), the other big complaint I’ve heard is that people were losing individual policies that they liked because they didn’t comply with the ACA. I have to conclude, based on my experience, that either 1) people in that situation didn’t have their plans in place before the ACA was passed, or 2) that their insurance companies had chosen not to continue offering their non-complying plans. (Another possibility, I guess, is that Kaiser made a huge mistake when it told me I can keep my current plan. Based on this article, that may be the case.)

But my overall conclusion based on all of these scenarios is roughly the same—and pretty boring: Insurance companies make business decisions. Yes, those decisions are influenced by legislation, including the ACA and the individual states’ laws and regulations regarding its implementation. Because we’ve chosen to base our healthcare system on private insurers rather than a government plan, the insurers have a right not to participate. But that was their right before the law, too.

Two things insurers can’t do now, if they choose to participate, are cancel a policy when someone gets sick, or deny a policy to a person based on a preexisting condition. The tradeoff for those two conditions is that the insurers will have more people in the insurance pool—including healthy young people who don’t use their services very much—and thereby spread the risk around. And the tradeoff we, as a society, get for having mandated insurance is that our fellow citizens won’t be bankrupted by illness. (And we hope people won’t wait until a crisis to see a doctor because they’re afraid of the cost.)

To me, those are fair tradeoffs, even if they mean my own costs go up.

To those who think the whole ACA should be junked because its rollout has been slow and troubled, I offer a comparison to the technology industry: Some people like to be the first to try a new technology or product, and are willing to endure challenges to do so. (The phrase “bleeding edge” is so common that we sometimes forget that it’s a pun.) There are others—I’m one of them—who like to wait a while after a new technology drops before trying and adopting it. We like to wait a while for the kinks to be worked out. Was anybody honestly surprised that the rollout had glitches? As many people pointed out, Google’s Gmail service was in beta for five years.

Fact is, health insurance isn’t a simple or easy business for the buyer or the seller. Six in ten Americans get health coverage through their employers (though that number is dropping; another business decision, perhaps). Most of us are sheltered from the real costs and complications of our healthcare decisions. Consider: A recent survey by Colonial Life found that 55% of Americans were willing to spend a week or more in choosing a car, but only 38% were willing to spend that much time deciding on an insurance plan.

Yesterday’s post also promised an unexpected ending to this story, and here it is: Earlier this month my wife took a full-time job that includes health benefits. I’m soon to be enrolled on her health plan, so I won’t have to navigate the system or even get to the bottom of my questions. I’m both relieved and disappointed.

Image by LaDawna Howard