What To Do If You Absolutely Can’t Afford Health Insurance 2015

What To Do If You Absolutely Can’t Afford Health Insurance is one of the most popular articles that I’ve written on this website. But it was written back in 2012, and my family and I have had to make significant changes in our health insurance during that time. I’d like to take this opportunity to share what we’ve learned. Herewith, What to do if You Absolutely Can’t Afford Health Insurance 2015.

Also, that time frame has seen the rollout of Obamacare, and that’s resulted in more than a few changes to the whole health insurance system. Speaking of which, wasn’t Obamacare supposed to ensure that all Americans would have health insurance?

Hardly. And that’s another major reason why it’s time for an update on this topic.

What To Do If You Absolutely Can’t Afford Health Insurance 2015
What To Do If You Absolutely Can’t Afford Health Insurance 2015

According to Obamacare Facts, 16.4 million people have signed up for health insurance through the Obamacare health insurance exchanges through March 15, 2015. Close to 10 million of these sign-ups have obtained coverage through Medicaid, while some 5.7 million represent 19-25 year olds who have been able to stay on their parents policies as a result of changes in the healthcare law that were part of Obamacare.

That means two things:

  1. Since Medicaid and young adults staying on their parents polices make up nearly all of the people who “got coverage” as a result of Obamacare, only a few hundred thousand actually purchased private coverage on the exchanges, and
  2. Since there were some 50 million people going without health insurance prior to Obamacare, and 16.4 million now have it as a result, that still leaves at least 33.6 million people who are still uninsured – despite the penalties for not having coverage. In fact, the Gallup organization confirms that 11.9% of the adult population in the US are still uninsured.

Health Insurance Hardfact #1: Obamacare did nothing to address the issue of health insurance affordability. Unless you’re at or near the impossibly low poverty line for your state. That’s left most of the middle class no better off than they were before – except for the penalties for not having coverage, which means most are actually worse off.

If you’re one of the 33 million still uninsured – or afraid of becoming one of them – this article is written for you.

Here’s what I’ve learned about health insurance over the past year. Hopefully some of these strategies will be useful for you as well.

Part-time Jobs With Health Insurance

This is another health insurance topic that I covered way back when, mostly as a theory just in case I needed it for my family. Well it turns out that here in 2015, that theory became our reality. This is why I wrote an updated post on this topic as well, 20 Part-Time Jobs With Health Insurance. This is not a theory suggestion, but one my wife and I are currently part of, so please consider it seriously.

When my family and I moved from Georgia to New Hampshire last November, we also gave up the health insurance coverage that we had through my wife’s full-time job. But in late January, she landed a part-time job with a credit union here in New Hampshire that includes health insurance coverage. We’ve been on this plan since February 1st.

Based on my research on this topic, there are quite a few employers who offer part-time jobs with health insurance. If you’re unable to get health insurance in any other affordable way, this is an option that’s well worth investigating. Please see my post for more details. I’m encouraged by the results of the research, and it is our reality right now.

Obamacare – Take the Cheapest Plan Possible/Get Your Kids Covered

Earlier this year we actually did take a deep foray into the Obamacare health insurance exchanges and decided to pass on the coverage. It wasn’t nearly as affordable as the official hype indicated. The best we came up with was $741 per month for me and my wife, and that’s with a $6,000 deductible. And that didn’t include coverage for our kids, who are considered to be “separate households” because each have an income and file an income tax return.

My suggestion is to get the least expensive policy that you can find, since even bad health insurance is usually better than having none at all. And even if you can’t afford it for your whole family, at least get coverage for your children. The health insurance exchanges are seriously complicated, and I am not even aware if you can get coverage for your children only. If you can, the coverage should be fairly inexpensive, since age is a factor in determining premium rates. One of the limits of course, is that you can only get coverage during the open enrollment period, that runs from Nov. 15 to Feb. 15, though it’s been extended through April 30 this year for certain situations.

Medicaid

One of the good things that has come out of Obamacare is that Medicaid has been greatly expanded. And based on the statistics, close to two thirds of the people who have obtained coverage through the exchanges did so through Medicaid.

I did some unintentional research on Medicaid, since my kids were each covered by it for all of about two weeks before being disqualified based on verified income. It’s actually a pretty good program that covers just about everything. There are little or no co-pays, and there are no premiums to pay.

The problem with Medicaid is income qualification. The income numbers are pretty low. As an example, here in New Hampshire, an income that exceeds $1,300 per month will disqualify you from the program, and that’s for a single person (that was how my kids got booted off, and they’re only 20 and 19 and holding part-time jobs.)

Still it’s worth looking into Medicaid if you believe you qualify based on the income limits. But I am almost certain that you must apply through the insurance exchanges, which will then refer you to Medicaid if it looks like you qualify. Otherwise you will be offered a private plan through the exchange.

Auto Insurance Medical Rider

My family had no health insurance coverage back in December. But since we had moved to New Hampshire in November, we switched our car insurance in December.

Under our Georgia policy we had a $1,000 medical rider, that will cover medical costs that are uncovered by your health insurance, or apply if you have no health insurance at all. Since we had no health insurance at the time, I increased the medical rider to $10,000.

It resulted in only a very small increase in the monthly auto insurance premium. And I don’t remember for certain, but I think that the medical benefit can be substantially higher. No, it’s not comprehensive medical coverage, but it will offer medical benefits in the event of an auto accident. That’s actually one of the most common reasons for needing medical coverage in the first place.

Create a Cash Flow and Dedicate it to Paying for Health Insurance

Despite Obamacare, cost continues to be a major obstacle for the uninsured. It may be necessary to create a cash flow that is specifically dedicated to paying for health insurance. That can mean taking a part-time job or creating a side business and using the income strictly to pay your health insurance premiums.

Having health insurance coverage is sufficiently important to warrant finding extra income to pay for it. And one of the side benefits of this could be that the part-time job or side business could actually grow into something a lot more substantial in the future. It’s worth considering.

Non-Prescription Medications

If you think that the co-payments on prescription medications have gotten expensive, you should try buying them without the benefit of a prescription drug plan. That $40 co-pay will look pretty small compared to the $300 full price of the meds.

We’ve had experience with this in the past as well. The best strategy if you don’t have prescription drug coverage, is to ask the pharmacist for a non-prescription substitute.

These are actually much more common than the average person realizes. A certain drug will be on the market as prescription only for several years, but it’s often lowered to nonprescription status later on. Two prominent examples of this process are Prilosec and Prevacid. Both were once prescription only, and now both are over-the-counter.

The difference between prescription and over-the-counter could be the difference between, say $200 and $20. You can save a lot of money just by asking a question. Naturally, if the medication is of the life-saving variety and your doctor specifically disallows substitutions, including generics, you must take the drug prescribed. But for any prescription that doesn’t rise to that level, you should see if you can go the over-the-counter route.

Mini Clinics

These have sprung up all over the place, in chain pharmacies and even in grocery stores. If you have not use them in the past, you should if you have no health insurance coverage.

We have used them at different times in the past, but most recently in January. My daughter needed to go to a doctor, and we had no health insurance. My wife took her to a mini clinic at Walgreen, and the cost was $45 for the office visit, and $71 for the prescription – $126 altogether. And yes, her condition was fully remedied as a result of the visit and the prescription.

Now even if we had coverage, we would probably be looking at a $40 co-pay on a doctor’s visit, and another $40 on the prescription, for a total of $80 out-of-pocket. So in truth, the cost of using the mini clinic was only $46 ($126, less the $80 that we would have paid even with a plan).

That’s not a bad arrangement, if you consider that having a family plan will easily of cost over $1,000 per month. Obviously, mini clinics won’t help in the case of a serious medical issue, and certainly not for a medical catastrophe. But they’re perfect for those routine doctor visits for colds, flu, ear infections and minor injuries.

Take REALLY Good Care of Your Health

If you don’t have health insurance, it’s more important than ever that you take care of your health. Ignoring your health and going without health insurance is a double risk, and it will be just a question of time before it becomes a real problem.

You don’t necessarily have to do anything extraordinary here, but you should adopt better habits. Some of those include:

  • Slow down when you’re driving, and pay close attention to other traffic on the road
  • Wear your seat belts, even if it isn’t required by law
  • Avoid dangerous activities, those likely to result in injuries
  • Lose a few pounds, it can make a difference
  • Start a regular exercise program, even walking a couple of miles a day can make a positive difference
  • Quit smoking, especially if health insurance looks unaffordable for the foreseeable future
  • Avoid excess alcohol consumption, especially when driving
  • Make healthier eating choices wherever possible
  • Do your best to control your stress levels

I realize that this is standard medical advice for the entire population, but its even more important if you don’t have health insurance.

Check Out Some Websites Dedicated to the Uninsured

This is a single article dealing with what to do when you absolutely can’t afford health insurance. But there are entire websites that offer a wealth of information, and usually much more specific information at that.

I strongly recommend you become a regular reader of Sean Parnell’s The Self-Pay Patient. The site has many articles discussing cash-only medical providers, and the amount of money that you’ll save going that route. There’s also plenty of articles covering other topics related to the uninsured. Obamacare is causing new trends to develop in healthcare, and you need to know what’s going on.

If you don’t have health insurance, you do have to begin developing contingency plans for what you will do if you have a major medical event. Some research now can save you a mad scramble later, when emotions may be clouding your judgment. As the saying goes, knowledge is power, and that applies when it comes to healthcare and health insurance as well.

I’m not recommending that anyone use any of these strategies as a replacement for traditional health insurance coverage. If you can get affordable coverage, then you absolutely should. But if not, these are methods that me and my family have used successfully both now and at different times in the past. The first, best option is always to have a good health insurance plan. But if you don’t, I hope you will find some benefit or inspiration from this article.

Do you have any other suggestions for what a person who absolutely can’t afford health insurance can do as an alternative, or a set of alternatives? If you’re currently going without health insurance, what are you doing to pay for medical treatment when necessary?

( Photo by COD Newsroom )

45 Responses to What To Do If You Absolutely Can’t Afford Health Insurance 2015

  1. Hi Kevin,I guess I will be one of the first to respond. I agree it is not affordable health care for the middle class and it needs another fix or it will falll apart…I guess president obama tried to correct this but just could not make it affordable for the middle class..I agree people will go to pay as you go cash as that is the route i also will be taking..I find it unfair that countries can protect their citizens health but not the u.s.a.,I thank you for this informing article and look foward for more of your research and comments in future ones….p.s. hope your family gets the true coverage they deserve as an american citizen in the near future…take care and good health..Jon Walker

  2. Hi Jon – Thanks for your comments. I agree, I think Obamacare is already on life support (really bad pun!). But there doesn’t seem to be any consensus on how to fix it. Everybody wants the care that it provides, but at a cheaper cost. No one in Washington is serious about cost containment. Other countries can provide affordable coverage because they created comprehensive systems before prices got out of control. Back in the 70s and 80s it wasn’t so bad here either, but we chose to continue on the same route.

    I know everyone claims that a single payer system is socialism, but one thing it would do is to turn costs into a national debate. The current hybrid system that we have is so complex that it’s virtually self-protective. No one dares question why healthcare costs so much, and the entire debate focuses on creating increased funding. It’s really a bubble of the highest order.

  3. I am 59 yrs old after all my monthly debts are paid I have 370 left to buy gas food clothing ect. But nooo I em expected to give 292 towards health insurance. Which leaves me only 78 a month to live on. How is that affordable health insurance? Why am I forced to live in poverty. Yet I don’t qualify for the benefits of the poverished?

  4. Hi Faith – It’s unfortunate, but they’ve billed Obamacare as the solution to people not having health insurance, but it does little to help people of limited means. The premiums are high, and the tax subsidies strike me as something of a hoax. I already know of one person who is having to repay some of the subsidy and she isn’t making much money. Other than the people who have qualified to be shifted over to Medicaid, it doesn’t seem as if healthcare reform has helped a whole lot of people.

  5. I am 69 years old, so I have medicare and carry a supplement through AARP. I feel blessed to have insurance. Before I turned 65, I was self employed. The turn down in the economy forced me to give up my health insurance. Then I had a heart attack, and a triple bypass. I owned my home, and had a few dollars in the bank, so I did not qualify for assistance. After working with the hospitals for almost a year, I had to sell my home and pay $57,000 medical bills out of pocket. I went from owning a nice retirement home to being almost broke. I feel sorry for all the hard working middle class people in America. The American dream use to be home ownership, now It’s being able to afford healthcare premiums which cost more than rent or house payments. Obamacare is a joke unless you are getting a free ride. I have friends that work for a living, and they can no longer afford the premiums. Does it seem fair to penalize the people that cannot afford to pay such ridiculously high premiums? I do not understand how the supreme court ruled this to be constitutional? Really?

  6. Hi Steve – I couldn’t have said it better. Here’s my take…Just as the government bailed out the banks back in 2008 – while the banks were foreclosing on millions of people – Obamacare has been established to prop up the healthcare industry. Like housing in the early 2000s, healthcare is now is a protected industry. The government considers it too big to fail. Obamacare is designed to bring in more health insurance premiums to keep the industry humming. That’s why it’s so expensive, and why it has penalties for non-payment.

    Our country is now about protecting systems, not citizens. I see no way out of this in the current scheme of things. My suspicion is that after a surge of people going on Medicaid with the roll out of Obamacare, the number of uninsured is likely to begin rising to levels never expected. Maybe then we’ll get real reform. But just keep this in mind – REAL reform will involve cutbacks in both price levels and services. No one will like the service cutbacks, and that’s when we’ll see how serious We The People are about reform. I suspect most of us see reform as unlimited healthcare at discount prices. That’s not going to happen.

  7. The one good thing about obamacare is that companies cannot deny you health insurance if you have pre-existing conditions, otherwise I would be completely screwed. But you’re right, it hadn’t done anything to make it more affordable unless you are very poor.

  8. You’re right Tryan – that’s one of two things it got right, guaranteeing coverage for everyone regardless of health condition, and not rating people for higher premiums due to health conditions. But on the price side, it’s done nothing. I’m increasingly of the thinking that the primary purpose of Obamacare was to save the health insurance companies (thru mandatory consumer participation) and not the consumer.

  9. I recently found out my plan from last year ($150 deductible and $60/month) is now going to a minimum $4500 deductible and $190/month. Even after browsing other companies, the cheapest plan I can find for a healthy 30 year old woman is $6500 deductible for $98/month. It’s insane. I am in the category of not being poor enough to get on State/Federal assistance, but don’t make enough to pay my bills, especially grossly inflated deductibles and premiums. If something tragic happens, I will pay out a total of $7,700 for medical expenses/premiums – that’s over a 1/3 of my income. It’s depressing to try and be a responsible adult, contributing to society and doing the right thing only to be constantly kicked down when you get a glimmer of hope. Things really need to change.

  10. Hi Christine – This is why I wrote this article, to suggest ways to get health insurance if the exchange plans prove inadequate, too expensive or both. Unfortunately, that’s very typical and it falls most heavily on people in your situation. Not that it helps your situation any, but our plan through my wife’s part-time job has a $4,000 deductible. Deductibles are being raised everywhere to offset the health care price spiral. There are no easy solutions, other than to muddle through with the best plans that are available. With a $6,500 deductible, you’re really looking at a catastrophic plan. It WILL help in a medical catastrophe, but not for anything less.

  11. Im too poor to pay anything. I get a couple hundred a week or less and half goes to rent. The rest goes to food. I dont qualify for anything because the “household” makes too much but im just renting a room. I wnt have to pay the insurance tax because it has to be 8%. Im starting to worry about my health after showing serious complications. Is there anything i could do besides trying to save what little i can for a doctors visit i know i cant afford?

  12. Hi Deno – Can you do something with a part-time job? I’m thinking either a part-time job with health insurance, or a part-time job where you dedicate the additional income to pay for health insurance. An extra $300 per month in income should be enough to buy yourself some sort of coverage. Also, check out The Self-Pay Patient site listed in the last section of the article. If you’re worried about serious health issues, you should have some sort of coverage, even if it isn’t perfect.

  13. Here is how I see it
    I Am
    Too young for Medicare
    Too poor for Obamacare
    Too rich for Medicaid
    All I qualify for is a Federal Fine…

    If I purchased the very cheapest plan (not that I can afford any) I would never see a doctor again because I could not afford the co-pay. Then as soon as my prescriptions ran out I’d be fast tracked to die anyhow as I could not afford the medication co-pays either. I suppose that would of course resolve the health insurance issue completely…

    I have to also say this was the understatement of a lifetime
    “No one in Washington is serious about cost containment.”

  14. Hi Nancy – I’d love to say that your comment is an exaggeration, but it’s closer to the truth than most want to admit. Healthcare in America has turned into a fiasco, and the squeeze is mostly on the middle class and on the working poor. When people talk about the death/hollowing out of the middle class, healthcare affordability is one of the main causes.

    Cost containment is our only hope, but there’s no constituency behind the concept. That’s basically what’s given us Obamacare in the first place. Healthcare is now something like 18% of the total economy of the US, and no one wants to weaken it.

  15. You say to get a part time job so I have to work my 45 hours a week plus a part time job that would have to be 39 hours and I still wouldn’t be making enuf your crazy if you think so because I do and nope still can’t afford it America sucks

  16. Hi Josh – I’m not crazy because my wife got us both covered with a part-time job at 20 hrs per week. I’ve made several suggestions as to what to do, and I’m sorry if none will work for you, but they will work for others. It all depends on what your situation is. And for what it’s worth, you don’t need a 39 hour per week job to qualify.

  17. Kevin – your wife is extremely lucky to have a part-time job that offers insurance. Throughout my work history, any employer I worked for required you to work 32 hours a week to be eligible for health insurance. Even getting insurance through your employer is not a fix, their premiums and deductibles are just as astronomically high as the marketplace or individual plans. I’ve done it all, and you usually fall into the category as described by another commenter – too poor to afford it, too rich to get assistance, screwed if you get sick,

    You have listed a lot of great resources, but unfortunately I don’t think they help the majority of us that are searching for any options. I thank you all the same!

  18. You’re welcome Christine! You might bookmark the article though. We’ve used most of these at different times, and you never know when your circumstances might change, and one might come into play. I have to agree with you, where healthcare/insurance is concerned, there are few good options. The deck is most definitely stacked against the middle class where this is concerned. That said, we’ve done well on this front, despite job/career changes, self-employment and geographic moves. I don’t know where you’re at spiritually, but my wife and I really think that it’s a “God thing”.

  19. I work 9 hrs a day 5 days a week, I absolutely refuse to work on my days off to buy UN AFFORDABLE insurance.
    I pay enough federal taxes as it is. $190.00 a pay check,
    I have decided that I’m just not doing it.
    No More.
    Not filing taxes either.
    With what I pay out the Gov owes me a refund of $354.00
    And they will fond a way to take that. So.
    NO MORE

  20. One problem with exemptions is getting one.
    I filed for one earlier this year, then months later got a call stating that there was affordable health insurance in NH and that I had a subsidy (yeah a subsidy that would not cover even half of the cheapest plan offered to me). Now I’m waiting for a letter that will tell me when my phone hearing will be – they could not even give me a small clue as to when they might be planning to do that.
    No scheduling letter yet and its been more than a month. For all I know I’ll be paying the fine before I get my ‘hearing’.
    The fine is still way less than what it would cost me to buy insurance but I sure could use that money to pay medical bills instead.
    Some helpful person in the NH government did tell me if I just wasn’t married I’d qualify for all sorts of things…

  21. Hi Nancy – They do seem to have put us into a conundrum with this exchange set-up. It’s like on one hand it’s voluntary, but on the other it has the force of law behind it (“do what we say, or else…”). When we tried to set it up early this year, one of the reasons we opted not to do it was that it was way too complicated. We would have had to get a policy for my wife and I, then a separate policy for each of our kids. The cost would have been way over $1,000 per month for the four of us, and we didn’t qualify for the subsidy.

    Fortunately we got covered by the plan at my wife’s part time job, but we had already decided we wouldn’t take the exchange plan. One of the complications was that you have to report income changes throughout the year because it can affect the subsidy. It smacked of having a parole officer to report to – no benefit, but we still had to report regularly. I’d rather go without the coverage, pay the penalty, and not have to report regularly.

  22. Of course Nancy, unless you’re a single, helpless, and useless member of society, you don’t get the free handouts. Instead you’re forced to sacrifice and saving for emergencies or a better life and to work your butt off for nothing in return. Sad but true.

  23. Hi Krystal – As much as I hate to admit it, you’re right about that. Millions of people who might best be defined as “working poor” (living wage income, but no savings) are kept in a position of dangling just above desperation. Unless you come under a number threshold or you meet certain demographic criteria, there will be no help available.

    A couple of weeks ago I met a guy, probably in his late 50s, who had recently had a stroke, but also had a degenerative disease, diabetes and a couple of other chronic conditions. He applied for disability, and was turned down. I don’t know what more he’d have to have go wrong in order to qualify, but apparently the good folks at SSDI thought he could continue to earn a living with all those problems. He doesn’t fit within the income threshold or the demographic to qualify (skilled tradesman, homeowner, married, etc), and they probably much prefer that he continue to work (until the day he drops) to pay into the system for the benefit of those who fit the desired demographic.

    Meanwhile I see people in their 20s and 30s who are physically capable of working, but fit within some sort of recognized mental or emotional disturbance, who get SSDI and other perks. I don’t get it, and no longer waste valuable brain power trying to figure it out. The answer is that the system is screwed up, and past the point of being able to fix itself.

    I realize that none of my comments help Nancy’s situation, but maybe they’ll provide some perspective on her situation. The problem isn’t Nancy, or anyone else in a similar situation, it’s the system, and it’s a major mess. In the end, decent, productive people are always on their own, while the spoils of the system are had by those who know how to play the game.

  24. Jason, this article is NOT about the big-picture, political aspects of Obamacare. That’s a separate discussion, and I don’t want to get sidetracked by it. The article was written to make suggestions on how to survive what is generally an unworkable federal law. The system sucks, but we still need healthcare of some sort. A single major health event could land even a prosperous person in bankruptcy court. What do we do about that?

    And for what it’s worth, a large part of why I emphasize personal strategies is that when I look at the political landscape, I don’t see any consensus in the masses as to what Obamacare will be replaced with. The public wants MORE health benefits for LESS money. That’s not even rational! We can’t build a replacement system as long as we’re collectively living in fantasyland, and that’s exactly where we’re at. Translation: there is no political solution on the horizon.

    Keeping that in mind, I’ll continue addressing the issue in the manner that I have so far.

  25. You said “My suggestion is to get the least expensive policy that you can find, since even bad health insurance is usually better than having none at all.” and “Having health insurance coverage is sufficiently important to warrant finding extra income to pay for it”. Both of those prove your complete paid off bias and make you completely ignorant to what’s actually happening with obamacare.

    Take the least expensive with a deductible you’ll never be able to meet, so therefore the plan will never pay thing toward your healthcare, only take your money in premiums.

    Find extra income? How do you do that when you already have 2 jobs and can’t afford obamacare? Like extra income is just laying around waiting to be picked up and used.

    Please get a clue before you write anything else.

  26. Death sentence for the working poor..Governments idea of euthanasia. If your not one of the chosen few you die! How constitutional is that?

  27. Hi Jason – “Paid off bias”? I don’t like the healthcare situation in the US any more than you do. But what do you suggest we do – dig a six foot hole, throw ourselves into it, then declare that we’re checking out? That isn’t a strategy.

    I believe that the US healthcare system is heading for a major crisis point, but until we get there, I’ll continue making constructive suggestions to anyone who asks. Your implication of somehow dropping out won’t help anyone (I’m assuming as much since you don’t counter propose better ideas, you just criticize mine).

    Not every suggestion made here will work for everyone, but we should be bouncing ideas in the hope that one or more will apply to at least some people. For some people, I fully agree, there is no workable solution. But let’s continue to explore ideas that may benefit at least some people under what are admittedly very adverse conditions. Giving up is never a viable solution.

    So what are your constructive suggestions Jason??? You have an open forum here to make them, so what have you got?

  28. FWIW I was denied an exemption. Reason was ‘subsidy was correctly calculated’ something I never contested.
    But my accountant found that as my state did not go full Medicaid I got an exemption for that reason (not that I would qualify if they did it was just the legit excuse the accountant used).
    New solution (not really just saying this is another ugly truth) become a heroin addict and overdose to get free healthcare as long as you get the narcan in time of course…

  29. Hi Nancy – You have a good accountant! In this environment, squeezed between cost and complexity, sometimes you have to improvise to get what you need. That’s what healthcare has become in recent years, a desperate attempt to hang onto coverage a little bit longer in the hope that the system will one day be fixed into something we can actually live with.

  30. Hi Sue – Depressing outlook, but it’s easy to see why you’ve come to that conclusion. Millions are still without coverage because Obamacare isn’t the plan it was billed to be.

  31. First, let me put your assumptions to rest, because you know what they say about assumptions and you’re full on sporting that saying to a tee.

    First and foremost base the income guidelines on your actual net income. What you truly do get as a paycheck and have in your account to pay bills. Using gross income calculations is completely wrong to begin with and the most inaccurate in a real life situation, like when you actually pay the bills with the money you have and not the gross figure on your check you never see.

    Then actually take into consideration what expenses someone has before saying they can afford something and making them pay a fine if they don’t buy it. Right now it looks at your gross income, says you can afford it and leaves it at that. Very little is considered when making that very broad sweeping decision.

    And assistance is also denied because by those same guidelines saying you make too much money. They don’t care what your housing costs are. They don’t care what your others bills even are or how much they are. Car payment, food, clothing, nothing like that is actually considered. Your gross is $2,000 and a plan is $500, you can afford it. Child support is looked at and a few other things that tend to apply to only a select few. Where car, food, clothing apply to everyone.

    Also don’t offer plans that are to say the least criminal. A $500+ a month premium with a $13,7000 deductible is a joke. You’d have to spend $3,000 or more a month on health care costs, covering 100% of the cost yourself to meet the deductible within a 4-5 month period to get the plan to pay anything toward your care. And that’s on a net income of maybe $1,800 a month or less. In other words you pay more than you make on ONLY health care and nothing on living expenses to get the policy to ever pay out anything. Don’t pay any rent, or for a car, on food, nothing. Only on healthcare to ever meet that deductible which is far beyond your monthly income anyhow.

    Back to the criminal part. If a private company sold you a plan like that, one that would NEVER payoff anything toward your care the government would step in, call it fraud and sue them. Get your money back and they’d face criminal proceedings. But the government does it and it’s lauded as a wonderful plan and the answer to America’s health care needs.

    Make the exemption process actually work. I filed for one last year in January. Never got a answer. Called them all year. Literally every other week. Still have no answer. Filed again this year in January. Still waiting to hear back. I’ve been calling every other week again. Still nothing but “it’s being processed”.

    Your suggestion to get the least expensive policy that you can find, since even bad health insurance is usually better than having none at all is just as criminal. No it’s not better than none at all. Look at the example above, a $500+ a month premium with a $13,7000 deductible. No copay or anything until the deductible is met. Having the money you save in premiums on a plan like that is better than that plan, it’s better than nothing at all. Having a monthly money drain of a premium on a “fraud” of a plan is worse. That’s practically a criminal suggestion in itself and hence my paid off bias comment. Because that’s just what it sounds like. Hey, just buy one, it’s better than not buying one. Wink wink.

    And that’s the very bottom level bronze plan available to me. $500 premium, $13,700 and nothing else. No copay, no Rx, nothing. Only after the $13,700 deductible is met does it pay anything. And then I’m still stuck with 20%.

    Your “Not every suggestion made here will work for everyone” is also the root of the problem. ACA was made to fit exactly that mold. It doesn’t work for everyone but we’ll hammer that round peg into the square hole until it does. And if it doesn’t work for you… oh well. Now pay up.

    What’s actually needed is the attitude that the ACA is made to help, but if it doesn’t help then you’re free from it. Not you’re a prisoner of it and if it doesn’t work for you then it’s penalty time. Their exemption process is a joke of an out that also doesn’t work for everyone, and if it doesn’t… oh well. Now pay up.

  32. Jason, I don’t know why you’re making this look like a conflict as if I’m complicit in Obamacare. If you read the original article, I indicated that we applied for coverage and decided not to proceed due to cost, deductible and complexity. We then used a different strategy. I fail to see why that generates the need for a challenge from you.

    I get that your angry, we all are to some degree, but some of us prefer to channel out anger/dissatisfaction/unhappiness in ways that are reasonably constructive. I don’t have a perfect answer to this healthcare mess, but you’ve provided even less for anyone to go on. Please consider the tone of what you’ve written in two very lengthy comments, and consider whether you have any kind of workable strategies to add to the conversation.

  33. I’m not writing this with any kind of anger at all. I’m more laughing in disbelief than anything. As for a challenge to you. I’m giving my opinion that you seem to only have suggestions that trade a bad situation for a slightly less bad situation and do not address the real problems with the system. They are only band-aid like answers to squeak by in a manner that is really just as impractical as the ACA itself. Making your immediate situation seem a bit better but offering little to no insight on how to actually fix the issue in the long run. Which is what people need to understand more than how to save a few dollar while still being stuck under a very broken system.

    That’s what I gave. Options that need to be considered to fixing the underlying problems. To really having a solution to make this mess work. Not to side step the problems with “better than nothing” answers. And until those key points are understood and voters act upon them with their representatives we will be at the mercy of a completely failed system and settling for slightly less worse will be all we’ll ever have.

    Your squeak by solution will be counted in the “ACA works” column because with the ACA as is and using your suggestions, no changes are needed. The system works. That’s not the reality of it but that’s how politicians will view it, spin it and how their decisions will be made on it. That’s what you fail to address at all in this. You gave a small picture save a buck view but not a solve the problem and make it work view.

    Along with your suggestions you really need to address this part of it as well. So people understand why it’s broke and not working for them. Not just that it is broke.

  34. And people claim to not understand why voters are furious with the current mess in Washington…
    This all brings to mind for me that movie phrase I’m mad as H*** and I’m not going to take it anymore.
    The only thing I can see Obama care accomplishing is making insurance companies richer than ever.
    Hmm I wonder if we took all the premiums paid and simply paid doctors and nurses and maintenance etc to run clinics and hospitals if it would be cheaper in the long run. Of course that would probably crumble the economy if the insurance companies health divisions ceased to exist.

  35. I agree Nancy, Obamacare’s primary purpose is propping up the healthcare/health insurance cartel. Healthcare is now 18% of the US economy, and seen politically as “too big to fail”. We can suppose that politicians see economic disaster unless the bubble is allowed to continue inflating.

    I often think about that quote “I’m as mad as Hell and I’m not going to take it any more” – it was from the 1970s movie “Network”. Unfortunately, I don’t think we’re at that point, collectively. People aren’t nearly as angry about the system as they are at the feeling that it isn’t providing the benefits that they think they deserve. That’s a very different mindset, and not the kind that leads to constructive change. In fact, it’s a recipe for “more of the same, but make it work this time” – which of course can’t happen for all the same reasons it doesn’t work in the first place.

    My feeling is that the system is the problem, but the citizenry are too scattered/distracted to rally around an alternative. It’s not surprising. A few months ago I was at Logan Airport waiting for my daughter to return from a trip to Atlanta. There were more than 100 people waiting at the gate, but the room was nearly silent. Why? Nearly everyone had their faces buried in their smart phones.

    This is the distraction that I’m referring to. People will put up with any amount of distress as long as they’re constantly entertained or engaged in distraction. That’s pretty much where we’re at, and why a disaster like Obamacare continues despite its obvious failure.

    Getting back to my last response to Jason, I don’t see this being fixed politically, and our only option is to cope as best we can. No solution we can come up with will be permanent, but we have to keep our ears and eyes open and be ready to act.

  36. Nice article. However, this seems to be a fix for two parent homes. I’m a single mom of one child (16) and a co-parent of another child (6). The younger son is covered on his dad’s plan, so, he’s covered. The issue is, I work full-time and go to college full-time. I make under $50k ($3400/month)a year and rent in Phoenix is ridiculous! Obamacare wants $700/month for the two of us. My open enrollment at work (a contract job) is asking for $1000/month. With rent and utilities right over $1000/month, car insurance and bill, we’ve nothing left for insurance. 2016 will be the first year I’ll be penalized for not having insurance. But now open enrollment is upon us again! This can’t possibly be the same song and verses from now on. I wish I could get a second job, but something about sleeping. I don’t feel that I should stop everything I’m doing and begin living off the government. That is not an option for us at all. Plus, I’m trying everything I can to get out of debt and start saving for a house. How do you get ahead with this nonsense?
    -Concerned for her sanity, Phoenix, AZ

  37. I wish I could tell you that there’s some magic provision that could help someone in your situation, but there isn’t. That’s the problem. There are millions of people like you who aren’t covered at work, don’t have enough income to buy coverage on the exchanges, but earn too much to qualify for Medicaid. There is no answer, which is why millions are going without healthcare. These penalties are ridiculous because they punish the people in your situation. As we will likely have another Democrat in the White House for the next four years I don’t see this situation getting materially better.

    That said, is there any way you can get your 16 year old on a plan alone? At 16 the premium should be a lot lower. Then at least one of you will be covered.

    I know that isn’t a good solution but that’s the point – there aren’t any.

  38. I’m not sure if I can insure just the older son. That is certainly something to look into. Thank you so much for your advice and opinions!!

  39. I’m not sure you can either. My own experience on the exchange wasn’t positive. But right now you have no coverage for either of you. If you could get it for your son, it would be a step forward, even though it isn’t a perfect solution. It’s kind of a divide-and-conquer strategy – you get him covered, then you can focus on you.

    And you never know what’s coming around the next bend. It could be a job with coverage. We usually assume that the unknown is dark and dangerous, but just as often it presents new opportunities. All any of us can do is move forward in the best way possible (at the time) then trust the future and our instincts to find positive outcomes. They often come from unexpected directions.

    Can you check back with an update on what you find out about coverage for your son?

  40. Listen, ACA is nothing but wealth redistribution. It provides full health coverage for people who don’t work, afforded by money paid by people who have worked all their lives, but cannot afford to pay for their own insurance. If anyone thought ACA was a good idea, they are too stupid for their opinion to matter.

  41. Hi Hillary – I think you’re painting with a very broad brush. People supported ACA because it offered the hope of change for the old system, which itself was incredibly dysfunctional. That system sucked wealth from the average person, and siphoned it up to the health insurers and providers. ACA has merely added its own negative affect to the mix. I’m not sure where we go from here, since no one will like a truly affordable health insurance plan, since it would lower benefits. This is a serious problem with no simple solutions.

  42. my daughter makes $11000 and is going back to school in January. she is 26 and can’t get medicaid – Tennessee. Medical insurance is $150 minimum a month. how is she supposed to live on $11000 and pay this insurance? Where can we get insurance that is cheap as heck in order to keep this young woman out of trouble with the IRS. Can she get an exemption number.

  43. Hi Vivian – I don’t know if it will be much less expensive, but if you’re a practicing Christian, you can look into Christian health sharing ministries. They work like pre-ACA health insurance, which means they’re better for young people. They’re also “ACA compliant”, which will get you around the IRS penalty.

Leave a reply