Another holiday approaches and, with it, another presidential request to nag friends and family about Obamacare.
“Christmas is around the corner,” notes Barack Obama’s official Twitter account, “time to #GetTalking with your family” about Obamacare.
A photo of a cozy-looking hipster accompanies another @BarackObama tweet: “How do you plan to spend the cold days of December? Wear pajamas. Drink hot chocolate. Talk about getting health insurance.”
Thus continues a “Health Care for the Holidays” push that began before Thanksgiving. Some people complain Obama is politicizing a cherished time of year. But I say: Remember, ‘tis better to give than to receive.
Should you get cornered by a well-meaning relative who took the president’s advice, here are some points to keep at hand:
1. Ask for a raise. Employers got a one-year reprieve before their Obamacare mandate takes effect. Individuals, not so much. If your company doesn't provide health benefits and you buy your own plan, chances are good you must trade it for a new, pricier one.
Subsidies are granted on a gradual scale up to four times the federal poverty level — though possibly not in Georgia, pending the outcome of a lawsuit challenging subsidies in states using the federal exchange. The upper income limit for subsidies next year is $45,960 for a single person. But even if you earn substantially less, you could wind up paying more for even subsidized insurance than for many pre-Obamacare plans.
Oh, and the cheapest Obamacare plans available, the “bronze” level, tend to have high deductibles. Many people stand to pay thousands of dollars for premiums and treatment before receiving much in the way of benefits.
To adapt a line from another horror show: You’re gonna need a bigger paycheck.
2. That goes double if you're young and/or relatively healthy. Above all, Obamacare is yet another federal program shifting money from young people, who tend to be lower-paid, to older people, who tend to be better off.
Before, young people could get health insurance relatively cheaply because they typically don’t consume much health care. Obamacare significantly restricts insurers’ ability to base their premiums on age. The effect is to raise prices for 20-somethings and lower them for 50-somethings. Ditto for the healthy versus the sickly.
Perhaps, 30 years from now, today’s young adults will be glad they spent decades paying more. In the meantime … you’re gonna need a bigger paycheck.
3. That doesn't mean you're OK if you are 50-something. Especially if your income is relatively low.
Under Obamacare, if your income is below 100 percent of the federal poverty level, you are not eligible for subsidies. That’s because lawmakers assumed you would be covered by Medicaid. But it’s still true even if your state, like Georgia, didn’t expand its Medicaid program.
In states that did expand Medicaid, an applicant’s assets, such as a home, car or other property, are not counted. So if you’re a 60-year-old who paid off your home, retired early but have to buy your own insurance, you might qualify for Medicaid now in some states. But if so, here’s the catch: The feds can place liens on your assets and seize them when you die. For these people, Obamacare turns Uncle Sam into a loan shark.
4. Either way, be prepared to look for a new doctor. One way insurers are meeting Obamacare's coverage mandates without sending premiums even higher is by working with fewer doctors and hospitals. (Of course, some providers are making the choice for them, by dropping out of their networks.)
Remember when Obamacare proponents scoffed at the notion people with acute diseases could or should be bothered to shop for the best price, as a more market-driven reform might dictate? Well, the law they pushed to passage is now causing many such people, after being treated by the same doctors for months and even years, to interrupt their care and seek a new doctor from a smaller provider network.
Ideally, we’ll all be able to celebrate Christmas and ring in 2014 without these kinds of debates. But if a pajama-clad, cocoa-sipping relative won’t let it go, be glad for the chance to #GetTalking.
