Obamacare and me

by H.B. Koplowitz

Twenty years ago I started bleeding from my butt. It creeped me out, but at the time I was a freelance writer and couldn’t afford health insurance, so I let it go on until I found a job I hated but that had benefits. As soon as the insurance kicked in I got a colonoscopy and had a pre-cancerous polyp removed. To prevent colon cancer in the future, every few years I’d have to get another “Roto-Rooter.”

After eight years I left the job I hated and moved to Hollywood, where I tried to freelance again. At that point I could afford health insurance but couldn’t get it because my polyp was considered a pre-existing condition. I had to find another job with benefits, and thankfully it was one I loved. Like a lot of people, I figured that because I was ineligible for individual health insurance, I’d be working for someone else for the rest of my life.

Around the time I turned 60, I once again decided to become an “entrepreneur,” which is a fancy word for “be my own boss.” To paraphrase comedian Louis C.K., I was no longer going to let a health insurance policy get between me and my dreams. So I moved to Florida, where I live frugally on sales of my self-published books and e-books, but mostly on Social Security.

At this point in my life, as I struggle to establish myself as a writer, I could neither qualify for nor afford to buy private health insurance, were it not for Obamacare, which prohibits denying coverage for pre-existing conditions. And when I went on the Affordable Care website, I was pleased to find that I qualified for subsidies that brought down the cost of a policy to several hundred dollars a year, with maximum out-of-pocket costs under $3,000. Plus a free colonoscopy. I certainly couldn’t complain about that, although I could have qualified for the virtually free expanded Medicaid program, had Florida’s Republican-controlled Legislature not turned it down.

Like many fans of President Barack Obama, I grudgingly supported the Affordable Care Act, although I would have preferred some version of single-pay, Medicare for all, or at least for folks over 60, even a public option. Obamacare is a major step forward, but it’s still not “the same insurance Congress gets.” The federal and state insurance exchanges offer pretty much the same crappy insurance that existed before Obamacare, plus a free colonoscopy. The same confusing mishmash of premiums, deductibles, co-pays, HMOs, PPOs and medical groups, at a discount for some and a premium for others.

Unlike Medicaid or Medicare, Obamacare comes in four — make that five, no, four again — flavors: Platinum, which is the most costly and covers 90 percent of medical bills; Gold, which is less expensive but covers only 80 percent; Silver, less expensive, 70 percent of expenses; Bronze, 60 percent; and at one point Catastrophic, or If You Like Your Crummy Insurance You Can Keep It, which was the cheapest but covered less than 60 percent of medical costs and has since disappeared from the federal exchange. The bottom line is that those who can’t afford the more expensive policies will have to pay more out of their own pockets for medical expenses, keeping in place the same rationing of healthcare based on ability to pay.

This year I won’t be participating in Obamacare, because Palm Beach County has a program to fund “free” healthcare (paid for with taxes) for “indigents” (which, luckily and unluckily, I qualify for). No premium, no deductible, no co-pay. Even the drugs are free. It’s a vision of what national healthcare could be like for everyone.

Thanks to my county’s healthcare program and federal Social Security, I can do in my old age what I wanted to do in my 20s. Obamacare will also make it easier for others to strike out on their own without worrying about medical expenses. Call me a freeloader or communist if you like, but I think government-funded healthcare is part of life, liberty and the pursuit of happiness, the American dream.

© H.B. Koplowitz 12/11/13

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