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Affordable Healthcare insurance

Unbiased facts about healthcare insurance market in america

America has now entered the age of affordable healthcare insurance for all its citizens with no regard for pre-existing conditions. How has the ACA legislation changed the American landscape since Obamacare has been implemented? Regardless of your health everyone now has access to health insurance. Getting to this point involved quite a bit of effort especially by those who believed that access to healthcare was a "constitutional right" of every resident and not just for those who could afford it. 

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On that basis there were two camps that developed and people quickly took sides.

In the one camp you have those with a more liberal mindset who believed that it was the governments responsibility to take over the health industry from the greedy insurance companies to insure that those who were denied health insurance would have access. In the other camp were those that believed the health insurance market was in desperate need of improvement but didn't agree that the government should take control of such a huge segment of the American economy.

There were several issues being debated;

  • the governments ability to effectively improve the quality of affordable healthcare and insurance for the general population
  • was health insurance indeed  a basic right to be insured
  • how would healthcare providers be impacted

results of the OBamacare rollout

healthcare in america

President Obama tried to alleviate these concerns by crisscrossing the country to speak to the crowds and assure them that first, the ACA would reduce costs. On May 13, 2009, President Obama said, after meeting with House Democrats that Obamacare could save families $2500 (per year).

Second, if they liked their doctor they could keep him, and finally if they liked their current policy they could keep it as well. In other words Americans could expect a seemless transition into this new era of healthcare.

Unfortunately for the Obama administration the roll-out was filled with gaffs. To start off, a lot of taxpayer money was spent setting up the government website,  healthcare.gov, to handle enrollment. There were nothing but problems to say the least with this website. Once again, the inability of the government to play an effective role in the marketplace was sorely evident.

The recent enrollment period of November 2014 turned out to be a shocker for many American families who were already insured. They were hit with several rude facts; many doctors were now refusing to see patients who were covered by an Obamacare plan, deductibles increased significantly and premiums began to increase rapidly.

In other words, the Obamacare option would not be generating the promised savings or improvement in quality for this now affordable healthcare.

I should mention that millions of Americans who couldn't afford healthcare now had the healthcare they needed. Most of these families were able to afford this benefit as a result of the generous government subsidies provided to offset the cost of the new premiums.

Where are we now with affordable healthcare insurance?

The topic is still being hotly debated among politicians as of January 2015. The idea of affordable healthcare insurance for America is one that is still on the minds of many American families. One group of Americans that are still searching for a viable solution to their affordable healthcare insurance needs are the self-employed and small business owners.

Their situation is unique in that they don't have access to group insurance. Shopping for their affordable healthcare insurance as well as for their employees is never fun or easy. The ACA has not simplified their lives although you think that it would. Why?

Many of them sincerely care about their employees and are concerned about the quality of coverage that is available from the exchanges as well as the actual out of pocket liability each employee and their family will be liable for. With little time to spend searching and evaluating their insurance options they tend to go with the premium that fits their budget. 

The downside to picking a plan this way is that the employee and his family don't always get a plan that is suited for their particular life situation.

The majority of Americans will now be part of an employer group plan that is being scaled back to keep costs in line. What is happening more often is that many employers are now offering coverage for employees and their children but not the spouse. In lieu of a complete family plan they are offering a stipend and telling the employee to shop on their own for affordable healthcare insurance.

What many experts are anticipating is the elimination of group plans completely. The responsibility of finding affordable healthcare insurance will fall squarely on the shoulders of the individual employee and his/her family. That's one of the reasons the healthcare exchanges were set up. They are supposed to be an better option than the plans offered by the traditional providers like Blue Cross and CIGNA.

what to do while waiting for the next open enrollment period

You do have an option for affordable healthcare insurance if you missed the open enrollment period. Don't panic. You can still get great coverage by shopping for what's called Short Term Medical coverage.

A short term medical plan is a major medical plan that has a termination period date, therefore reducing the risk to the carrier. It also has several "knockout" underwriting questions. The purpose for these questions is to weed out the riskier applicants. In other words, short term medical plans are not "guaranteed issue" plans. You have to qualify for them.

The majority of Americans can qualify for these plans and they are usually  a much more affordable plan then what you can find through the Obamacare exchanges. If the short term medical plan expires you can get a guaranteed issue Obamacare plan as long as its during the open enrollment period.

The trick is to get a plan that doesn't expire prior to the open enrollment as to prevent a gap in coverage. These plans are also referred to as a "bridge plan".

The ideal candidate for the STM plan is a young healthy couple with two or three kids. The result is a more affordable plan. The typical premium for an STM plan is 40% to 60% less than an ACA plan and usually has better coverage with less PPO restrictions and penalties. Even when you factor in the penalty for not carrying a "qualified" ACA plan, consumers still save thousands of dollars per year."

If your affordable healthcare insurance agent provides you coverage under an STM plan and you remain relatively healthy then you can "re-qualify" for another STM plan. These plans are not for what I call "unhealthy" people.

If you experience a sickness or accident the STM plan will pay the claim. If you become ineligible to "re-qualify" for another STM plan because of a change in your health status then you can ask your affordable healthcare insurance agent to sign you up for an ACA plan during the next open enrollment period.

do aca plans really offer good coverage and a better value?

health spending

Well it all depends on your pocket book and the condition of your health. For those of you who are healthy and your family doesn't have a history of critical illnesses and you don't live a risky lifestyle then you won't see any value in these plans.

The exception would be if you don't make much money and fall below the federal poverty level then you would qualify for the federal subsidies. The following amounts are 2015 numbers and used for calculating eligibility for Medicaid :

  • $11770 for individuals
  • $15930 for a family of two
  • $28410 for a family of five
  • Be forewarned, there's an excellent chance that the federal subsidies will soon be phased out. Follow the link above for more details

If you're one of those liberals that never sees anything wrong with any program implemented by liberal politicians and you thought that the ACA would provide you with affordable healthcare insurance then you're in for a rude awakening.

The following is a list of the premium increases being requested by insurance companies in certain states;

  • Alabama: 28%
  • Alaska: 38.7%
  • Connecticut: 32.9%
  • Iowa: 28.7%
  • Maryland: 30.4%
  • Missouri: 22.8%
  • New Jersey: 30.3%
  • North Carolina: 26%
  • Oregon: 42.7%
  • Tennessee: 36.3%

There's no telling if that they'll get approval for these increases. But that's a moot point. Simple economics will be the driving factor. If any carriers can't make a decent profit then they'll simply close shop, put their money into  a more profitable venture and leave thousands without coverage. Let's not forget the doctors who will be dealing with an even lower reimbursement rate.

If you're on Obama supporter then you should have seen this coming. Even Jonathan Gruber admmitted that Obamacare had NO COST CONTROLS. According to Gruuber, though, this wasn't a bad thing: "Because this bill is about coverage, which is good". He went on to say, "Why should we hold 48 million uninsured people hostage to the fact that we don't yet know how to control costs in a politically acceptable way? Let's get the people covered and then let's do cost control". His statement obviously shows his lack of concern for consequences.

As was expected, cost control has never come about and it probable never will and now the people who had affordable healthcare insurance are now stuck with unaffordable healthcare insurance.

is there a positive flipside?

tax act

The first positive I can think of is that the issue of affordable healthcare insurance is receiving the attention it deserves. Yes, this country needs to do something to curb the runaway cost of healthcare since it takes up such a big chunk of a families expenditures each month, not to mention the federal budget.

One way to assure that we as consumers get something better than we have now is to first realize and not meddle with what actually works well within our current healthcare system. Government needs to not try to fix what they're not qualified to meddle with. That means leave it to the free market (yes, I know you hate the idea) but work with the providers, not the insurance companies, to create legislation that will enhance the markets ability to provide what's needed by everyone. These insurance companies agreed to Obamacare simply because they couldn't lose. It was a win-win for them.

Let's stop hating on the "rich" and stop trying to find ways to get more of their money to fund an ever growing greedy government. My suggestion is to force our legislators to seriously consider the Fair Tax by having town hall meetings throughout the nation to educate everyone about the details and merits of this plan. This would allow legislators to hear what their constituents think of this  possible solution and then take appropriate action without fear of unwanted repercussions.

If approved this could provide even more needed revenue that is not generated as a penalty for being successful. It also would eliminate the income tax that is often used as a political tool. Tax revenue would be generated from all possible sources without being a burden to anyone.

Finally, allow a qualified affordable healthcare representative to walk you through all your options. Most of us would seek the counsel of a realtor before buying a piece of property. Consumers should do the same with regard to their affordable healthcare insurance. 

Don't Be Overwhelmed with Choosing The Best Health Insurance

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