ACA Worth vs. Cost If I ever want to start a political argument, there is the fuel. I went into the Illinois HealthCare Marketplace to to price coverage, making the assumption that I will earn $30K as an annual salary in 2016. There were policies available for as little as $213/month for bargain basement HMO…but let’s assume like me that you are sort of old and relatively screwed up….so you are going to hit your deductibles. Here is the bargain basement:
Now let’s go to the other extreme….a Gold PPO policy…
So the Gold policy costs roughly $8,000 more if you stay healthy and don’t just pay premiums…and if you get really sick and blow through all of the deductibles the difference shrinks to $5,000. What to you get for the $5K difference……
- A PPO Plan where you get to pick your doctor, and can self refer to specialists without playing tug of war with you Primary Care Physician [“PCP”]
- Your choice of facilities [hint: there is a pretty good reason why every single one of my healthcare providers in Chicago is at Northwestern Memorial….it’s this here
So…no big deal eh? Well….having been in the position, when its YOU that they are going to be cutting open, sawing in half and spreading your ribs apart with a crowbar to play with your ticker….all of a sudden it matters alot, unless you a blithering idiot.
Now for the shocker….let’s change my income to $300,000 instead of $30,000 same policy, same coverage guess what happens to the cost……it increases the premium by $117/month which is the value of the ACA credit. So earn 10X as much spend an additional $1,400 for the year on health insurance.
There is a message to be had here “BIG TIME”.
ACA is WORKING the way it was INTENDED to in year two.. If you want good coverage, you are going to pay for it…if you want crappy coverage and you can get that two. Once you are earning $30K which is $15/hour if you need to do the math, the subsidy is only worth $1,400/year.
If you earn substantially less than $15/hour the subsidy is much bigger as it should be. However, if are are earning $15/hour, there is coverage available in Illinois for a 54 year old non-smoker for < $250/month which anyone with a brain would have a difficult time arguing is excessive.
Fine point – assuming that no Net Investment Income tax applies – all compensation.