Paid Back the ACA Subsidy – Story

I am 64. My wife is 59. Last year we signed up with a local healthinsurance provider but obtained the policy through the federal marketplace. Our anticipated income qualified us for a subsidy of $7356. Our monthly premiums for a $5000 deductible plan were only $224.62. Hooray for the ACA, I thought.

During 2015, we received a lump sum Social Security Disability amount that, although not income-taxable, did increase the “Modified” Adjusted Gross Income required under the ACA. This put us over 401% of poverty level, and we had to pay the subsidy back, $7,356. Total premiums for 2015, $10,051.44. It was nice that with the lumo sum we could afford to pay it back.

The 2015-16 federal poverty level for two married persons is $15,930. Any couple making over 401% ($63,720) of that number does not qualify for premium relief under the ACA. Premiums this year for the least expensive $5000 deductible plan where I live are $894/month, $10,728/year, or 16.8% of that total income. My plan from last year is $990/month (to allow for more doctor choices, the only difference), or 18.6% of total income. For most who fall into this demographic, those premium amounts are not doable, not to mention that up to $10,000 in deductibles may apply if the couple is in poor health.

Some say premiums have NOT gone up under Obamacare. Those two policies I mentioned cost about $350/month a few short years ago. The insurance company is sympathetic, however, they say that the Obamacare requirements and mandatory coverages are driving premium costs higher (all plans include materity and childhood dental, and other required coverages). The exhorbitant premium costs are driving couples like us to decide to “take a chance” that we won’t get sick, and skip the insurance in favor of self insuring and government penalties. What an awful choice to have to make.

Shame on this country and shame on those who extoll the virtues of Obamacare, who say premiums are not going up, and who refuse to run the numbers or believe them. I grant that it is good for many who are struggling, but at the same time, it pushes a larger middle-middle-class population into a much worse situation.

For my demographic, middle-class, the income range is about $35K to $100K, and it is said that there are about 120 million Americans in the homes of this group (adults and children). I can’t calculate how many 2-person families earn between $63000 and $70000, those hardest hit with premium realities, but it is likely a fair number. It would be interesting to have Hillary Clinton interview those couples and inform them that she intends to perpetuate this plan.

I am a registered republican, but I do have some streaks of democrat in me, mostly having to do with income disparity. My empathy does not lie with the rich. About 71% of Americans made less than $50,000 last year. I can’t verify the following facts, but your blood should boil.

35 soul-crushing facts about American income inequality

There is a workable solution in there somewhere.