- A Review of My Life Under The Health Insurance Marketplace
- November 26th, 2013
With so much being discussed about the mess in the rollout of Obamacare, I have been spending some time reflecting on my experiences with the health insurance market from a 22 year old healthy young married man with no children to a 66 year old man with a prior heart attack now on Medicare. What a ride this has been. I will briefly out line to you this 44 year experience.
I got married as a senior in college and for the first time in my life became uncovered because I had become married. I was able to buy a very cheap plan for both my wife and I through the University which required all of our treatment at the college hospital and clinic. If I had had a car wreck on the way home and had to be taken to a different hospital, I would have been uninsured. This coverage continued until I graduated from law school in 1973 at the age of 25. My wife delivered our first child at the University hospital for very little expense to me. Following this I went to work as an Assistant District Attorney and received insurance through the State of Texas at no expense to me and at a very reasonable premium for my wife and child (it seemed like a lot to me at the time, but in retrospect it was reasonable.)
At age 30, I left the State employment and went into private practice where I remain today. I bought a policy for myself, my wife, and now two children at a reasonable rate. The only exception in our policy was my left knee because of an old football injury. If I had had any problem from that old injury it would not have been covered. It was our only preexisting condition. The premium was around $300/month which seemed very high to me at the time. The next 5 years was when I discovered insurance pools and how it affected my family and I. The insurance premium kept going up every year. In about 5years it had increased to about $650/month for my family. I talked to my agent and he said it was time to move to a new pool since I didn't have any preexisting condition. In other words, I hadn't cost my insurance company a dime during these 5yrs. He moved me into a different pool and my premiums dropped back down to about about $400/month. Again this premium started increasing every year. At age 39 I added my 3rd child to the policy. At age 40 my premium had risen to abou$700/month so I went to my agent again. He couldn't move me out of the pool because I now had high blood pressure and my oldest son had some other medical problems which had caused him to be in the hospital for about 3 days. Our family now had preexisting conditions.
Every year I watched my premiums go up and up despite me increasing my deductible to keep the rise under some type of control. By the time I had my Heart attack at age 57, I was paying $1,500/month with a $5,000 deductible for just myself, my wife and my youngest son. My other 2 children had obtained their own insurance. The first thing the hospital asked from my wife was a $5,000 check. After 10 days in the hospital after bypass surgery, my share of the bills excluding the deductible was around $20,000. The policy was a 80/20 co-pay with a maximum, but there were a lot of charges not covered.
With the loss of income, these charges, and the loss of that much from my savings along with college for the kids I was having a hard time paying the monthly premiums of my policy which kept going up and up. My wife had to take a job at the county paying just $10.00 per hour which she hated for the insurance. Hers was free and mine only cost $380/month. My wife and I now have gone on Medicare, With Medicare parts A,B,&D and Supplemental coverage our total cost now is $500/month for us both and my wife was able to tell her stupid boss "Take this job and shove it."
In retrospect, the best and cheapest insurance we had was when I worked for the State, my wife worked for the county or Medicare. All provided by a governmental agency. My wife knew first hand what it meant to be a health insurance slave.
My life would have been very different if Obamacare would have existed during these 44 years. I firmly believe that the experiences of a young 22 year old couple today will be very different in the next 44 years. Many times I wonder what I would have done if I had had a preexisting condition when I wanted to go into private practice. I don't thing I could have done it. So many people were tied to their employment because of preexisting conditions.