How to Explain Obamacare to the Average Person Upset With Costs


Why are health premiums and deductibles so high?

How to Explain ObamaCare to Someone Upset With Costs

Explaining ObamaCare to the average person who is upset with costs is really hard, but an honest approach sends the right message..

To someone who wants to do research, i’d simply point them at the cost controlling measures and how they are working, the expansion of women’s rights, the expansion of Medicaid, the less than $100 a month most are paying with cost assistance, our cost page, the subsidies page, our facts page, and our summary of every provision in the PPACA. Spend a few hours with those and you’ll start to gasp the moving parts of the law, how they are working, and why they are important from a 3,000 foot view of American Democracy. You’ll also start to spot the sticking points that many supporters of healthcare reform know well.

You’ll get it, but you’ll be left with the same question as Hillary, Bernie, Obama, me, and the rest of us: “How do we boil a 1,000 pages of legislation, 1,000 days of it working, and 100,000 days fighting for reform into an honest talking point?”

This concept comes up, because on one hand, middle-class Americans really are struggling with costs (not a political thing, it is really happening), and on the other hand, due to a recent QA with Hillary Clinton about ObamaCare (as displayed in the following video).

CNN Ohio Town Hall 3/13/16: Hillary Clinton asked about ACA Premiums.

As said by the woman in the video:

“Hello, I voted for Obama, but then my health insurance skyrocketed, from $490 a month to $1,081 a month, for a family of 4. I know Obama told us that we’d be paying a little more, but doubling…more than doubling our health insurance costs has not been a “little” more. It has been difficult to come up with that kind of payment every month. I would like to vote Democratic, but it’s cost me a lot of money, and I’m just wondering if Democrats really realize how difficult it’s been on working-class Americans to finance Obamacare.”

TIP: Check out Charles Gaba’s excellent explainer on this for another angle.

NOTE: This message is written from a Democrat to a Democrat, I would phrase it differently if talking to a conservative. Not that I’d change my views, but I’d likely focus on different issues such as how specific tax and regulatory mechanisms worked.

My personal explainer:

Some regions are more expensive than others for coverage, and many can get cost assistance or coverage for the first time due to preexisting conditions, but that aside, there is truly no justification for a family paying $1,000 plus a month, no justification aside the base cost of healthcare and ironing out the kinks in a relativity new law that gets so much right. This is a problem we face as a country, and this is a problem that we can solve with more healthcare reform solutions that build on what the foundation of the ACA.

ObamaCare fixed a lot about the healthcare system, but it didn’t fix everything, partially because of the way government works. So here is how government works, we (we being elected officials, working in tandem with and representing, we the people) can regulate, subsidize, and tax. In order to do that we have to pass laws through, and with the support of, Congress. Republicans in Congress and cooperations (you know, lobbyists, that is real, especially with our friends the Republicans pushing Citizens United) have fought healthcare reform since Johnson and FDR made the last two great updates. Despite opposition, we, under President Obama, finally passed the Patient Protection and Affordable Care Act ensuring healthcare for our all classes, not just for you, but for your children and their children.

The ACA fixed preexisting conditions (which if you know someone who has been sick in the past, is a BIG deal), addressed the lack of Medicaid eligibility (in states that didn’t reject Medicaid expansion at least), it fixed about 900 different things actually and that is part of the problem. The ACA is a really long and complex law, and 99% of the provisions are working and no one even talks about them. The ACA did a lot, but the one thing it didn’t do was tell insurers what they could charge, because America operates on (regulated) free-market principles.

But now we get to THE sticking point, what you don’t like about ObamaCare is “the amount of money private insurers are charging you” and “the fact that you can only buy insurance during open enrollment, meaning you have to keep it all year (which protects the insurers and tax payers from people cheating the system, by the way)”. You also don’t like that, at this price, you are asked to buy insurance or pay a fee, and that IS on ObamaCare. But at the end of the day, its not access to healthcare for your family, it is out-of-pocket and premium costs which now create an extra barrier to care. That is not OK.

We know Medicaid expansion and subsidies solve the sticking point for tens of millions, making their costs truly affordable, but for some of the middle class in that right tax bracket with other costs like child care, student loans, and mortgages, the ACA didn’t go far enough. The truth is, “fixing” healthcare, one of America’s biggest industries and one of America’s biggest annual debts, is going to take a village. The ACA fixed a lot of longterm spending issues, but there is more work to be done economically in regards to healthcare, both as a country and as individuals.

If you think the way to solve the new cost crisis is a repeal of access to healthcare and patient rights, vote Republican, if you want to see real change, give the Democrats the support they need. If there is one thing that is for sure, either Hillary or Bernie will be addressing premiums and out-of-pocket costs with fixes, this is the primary planck of the Democratic party in regards to healthcare: fix the ACA and make Obama’s namesake something all Americans can be proud of on every level. The Republicans will address our issues by dismantling assistance programs and related rights, times aren’t easy, and the middle class is struggling, but we can’t fix new problems by going backwards, we fix new problems by going forward. By making progress i.e. being progressive. That doesn’t mean helping our poorest at the expense of the middle class, that means helping all Americans, of all classes, at the expense only of those who stand in the way of America and progress.

My question to you reader: How do you explain to someone struggling with the costs of the ACA that it is worth sticking it out and supporting further reform? How do you show that Democrats don’t just care about the rich and poor, but also about the middle class and small business? Or, if you support Republican solutions, why is that the best solution for those with low incomes or who were sick in the past, and our longterm spending issues with healthcare?

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a...

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My husband and I have annual income above what qualifies for any subsidy at over 60K housefold for 2. So I am one of those people now spending $20,000 per year for my husband and I BEFORE we receive any assistance with medical costs. ($1100 per month premium and $5600 Deductible with $11,000 annual out of pocket max)
Well isn’t that absolutely fair and wonderful?
Did anyone notice that the rate structure for medical insurance is based on age? BLATANT AGE DISCRIMINATION?
Yes, I am being screwed by my government. And if I don’t like how that feels and don’t buy insurance I will be “fined” for that too.
I have never been without medical insurance in my entire adult life. I either had it through my employer while working, or paid out of pocket being self employed. I am now a victim of the ACA. Who can afford this system? I agree with Bill Clinton that this the “craziest thing he’s ever heard of…”
We can’t afford to pay premiums and actually go to the doctor so we don’t go unless its an emergency. And then when the new year starts you have to start over with your annual deductible and out of pocket. This is only Catastrophic insurance…

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I am one of those people now spending $20,000 per year for my husband and I BEFORE we receive any assistance with medical costs. ($1100 per month premium and $5600 Deductible with $11,000 annual out of pocket max)
Well isn’t that absolutely fair and wonderful?
Did anyone notice that the rate structure for medical insurance is based on age? BLATANT AGE DISCRIMINATION?
Yes, I am being screwed by my government. And if I don’t like how that feels and don’t buy insurance I will be “fined” for that too.
I have never been without medical insurance in my entire adult life. I either got it while working, or paid out of pocket, but I am now a victim of the ACA. Our government has found a way to take my retirement income away from me too.
We can’t afford to pay premiums and actually go to the doctor so we don’t go unless its an emergency. Am I living in a 3rd world country?
Nope – this our great USA under the current administration.

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If you think the way to solve the new cost crisis is a repeal of access to healthcare and patient rights, vote Republican, if you want to see real change, give the Democrats the support they need.
Huh? 8 years of hell hasn’t been enough? Who ever wrote this should be stoned to death. This was FORCED on us. Did you explain if you took Obamacare and used the federal funding you get screwed on your tax return? Now they want to take away the funding, and then who the hell is paying for it then? ME! I’m middle class and can’t even afford to use my insurance. Private insurance, pay out the @@@, $500 deductible, one trip for a swollen foot, ultrasound, $5000. Cat scan $5000. Shit I should be thankful when I had a MRI it was only $2500. One issue, $500 deductible, then supposed 80-20, I’m out of pocket $2000. I’ll give you a clue. Say I make $20/hour. Just had the riding lawnmower fixed, $200. So you worked 10 hours to pay for it. NO! Taxes! I had to work about 26 hours to pay the taxes to shell out $200, So when the guy that fixed it pays sales tax, tax on the income he made, by the time $1 changes hand twice it’s been taxed to the point it’s worth 30 cents until it gets back to the bank and recirculated. If you want to equate this to a Republican/Democrat issue, you’re an idiot. The middle class has always been screwed. It’s not a Republican/Democrat issue, it’s what’s been decided. This country needs fixing, if you can buy our asses back from China. “Hillary or Bernie will be addressing premiums and out-of-pocket costs with fixes” Bullshit, tax the middle class some more. How’s this, get rid of the electoral votes. Get who the American people want as president as a start. We don’t need any more puppets. Hire an outside source to see if Obamaabortion is even feasible to save. It’s not rocket science. If you think any “politician” is going to solve our problems, Think again.

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I am an insurane broket in Arizona. The woman who spoke to Hillsry about het health insurance ssid she had paid $490 per month for coverage for four people. From my experience, that health insurance she had must hsbe bern terrible. Probably hafpd a $10,000 deductible and no co-pays. Real healthbinsurance gor a familybof four costs $1,000 per month. But she mow has real coverage. And of course Hillay knows nothing about how health insurance works. She should have asked if the woman applied for a subsidy. The woman said she and her husband had been unemployed and that would probably mean they would get help with their premium. They would love Obamacare if they got help with their premium.

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justanothetaxpayer

As an insurance broker, your spelling needs some work as credibility in your attempt to debunk someone gets lost. Actually, for about $400-500/mo prior to Healthcare Reform I had insurance that insured my family of 5 with a $1000 deductible and $20 co-pays to see the doctor. My out of pocket maximum was also low and I don’t recall what the split was on prescriptions however it was a feasible rate. So in total I paid around $6000 per year (premiums plus deductible) – and add in maybe another thousand or so with doctor visits mess etc on a high end for roughly around $7-8000 per year. With the coverage available now – just for myself alone the premiums on the bronze plans (lowest) is $200/mo and minimum essential coverage plans around $100/mo (higher plans are sometimes up to nearly $4-500 in monthly premiums for myself ALONE – however we will just run with the lower number). So just in premiums I would be paying between $1200- 2400/ year. Then there is a $6000 deductible for which plan pays NOTHING – UNTIL this is met. Copay doesn’t exist until the $6000 is met. So right there is $7200-8400 paid for NOTHING except to be a memeber. Then doctor visit is $150 where I’m located – except for my preventive check up (which was also covered under my other plan) I have to pay $150. Plus cost of med school etc. In that case why have it – I am relatively healthy and don’t have to go to the doctor often. Why not keep the $7-8k in my own pocket to pay the things I need to pay and/or enjoy as I would like since I earned it? Even after the penalty I still keep several thousand in my pocket verses giving to an insurance company to do nothing more than send me a bill every month. Even paying the doctor visits and medications out of pocket I still come out ahead. THAT is a problem and is not what the affordable care act was about. My previous insurance by the way was through one of the top insurance companies out there. I was very excited about the Healthcare Reform and while the idea is much needed – correcting the obvious errors needs to be addressed quickly. I’m sorry but when a person avoids the insurance all together and/purchases yet avoids going to the doctor then you still haven’t covered everyone and I honestly see a lot of insurance companies making good money while the average working person ends up with nothing but a bill. That’s a problem. I used to do medical insurance billing so I look at the policies a little closer than most. A person should NOT be paying into an insurance plan and not able to see their physician when ill nor obtain needed medications. There should be co-pays that exist prior to the deductible being met so one can afford to go to the doctor. There should be a Copay on prescriptions prior to a deductible being met. Such things prevent a large deductible and essentially a larger cost for patient and insurance company alike. I know many people who do have these plans to meet the requirements yet don’t go to the doctor as needed because they can’t afford it or search alternative methods to obtain prescriptions because they can’t afford them.

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justanothetaxpayer

*cost of meds not med school

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justanothetaxpayer

*doctor visits/meds not mess
*and/or purchases insurance yet avoids going to the doctor

(wish there was an edit function to correct missed typing errors – sorry)

Even with basic coverage if one is not able to see a doctor when needed or afford their medication without first meeting an outrageous deductible then then goal of the Healthcare Reform Act has not been met. It was to allow the people the ability with to access appropriate Healthcare. It didn’t change what was occurring before – it just changed which portion of the population it affected. I do believe if our Representatives were held to the same standards of insurance the public is they would move a little quicker to fix the obvious problems. Easy to say you’ll “fix it later” when it has no effect on you or your pocket book.

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