Obamacare — November 18, 2013

I’m the story Obamacare’s opponents don’t want you to hear


I’ve officially enrolled in coverage through the marketplace. It was easier than I expected — and will save me about $10,000 a year.

I just got covered under Obamacare. I already had insurance, but it was breaking my piggy bank. Now I have coverage with almost identical benefits, for less than half the price I’m paying right now.

Even better, my coverage can’t be canceled or limited if I get sick, and I could choose any plan I wanted, despite living with type 2 diabetes. That’s all thanks to the Affordable Care Act or, if you prefer, Obamacare.

Under my current insurance plan, I’m paying $1,400 a month for coverage. Yes, it’s comprehensive. At that price, it had better be. But my rates had been going up by $100 a month annually in the last few years and, as a self-employed woman with a pre-existing condition, I didn’t have a lot of choices.

Starting January 1, I’ll be paying $530 a month for almost identical coverage. Actually, my annual deductible is less — $150 instead of $250. My prescription co-pay will be just a tad higher, but that still won’t bring me anywhere near what I’m paying per month now. The cost to see a doctor is just about the same if I stay in-network, and the nationwide network is huge. All the other benefits are comparable, with the added bonus of programs to help me better manage my diabetes. Plus, I can keep every single one of my doctors.

This is what I call winning.

Was using HealthCare.gov cumbersome? Well, yes, at first. But I was patient. I started the enrollment process in mid-October. Knowing they were working on the website, I waited a couple of weeks to check back. I logged in just four or five times to get through the entire process, and every time I did the site was working better. It took me a total of about four hours to complete my enrollment, including comparing plans to find the best one for me.

There were plans on the Obamacare marketplace that cost even less than I paid, but as someone with a pre-existing condition I want as much of my care covered by my premium as possible. This plan covers about 80 percent of all my medical costs. In Michigan, plans start at $161 a month (there are even less expensive catastrophic coverage plans). There’s a plan and a price that’s right for everyone, and they all have to cover 10 essential health benefits that “junk” insurance plans being phased out under the Affordable Care Act don’t offer.

I could not be happier, both with my coverage and the help I got through HealthCare.gov’s live chat and phone representatives. I also got assistance from my new insurer when I called to check that my blood glucose test supplies would be covered. They will be, at an even better rate than they are now.

Everyone was well-informed and able to answer my questions promptly. When HealthCare.gov froze at the point where it should have confirmed my enrollment, a HealthCare.gov phone rep was able to verify that their database showed I had, indeed, selected a plan. Earlier, the insurance company rep had told me I could always call them directly and provide the name of the plan I wanted, and they’d take care of the application and enrollment process over the phone. I ended up doing just that, a process that took less than 10 minutes.

Everything I needed was accessible from HealthCare.gov, including a brochure about my new plan and the phone number to contact the insurer. Which happens to be the same insurer I have now. But I never would have gotten a plan like this on my own without Obamacare.

If you’re still trying to enroll, keep trying back and use all the resources they offer. Be sure to consider not only premium costs, but co-pays, co-insurance and deductibles. Buying insurance through the Obamacare marketplace isn’t anything like buying insurance used to be. It’s better.

For me, and millions of other Americans, that’s a very, very good thing.

[CC image credit: Will O’Neill | Flickr.]

  • Congratulations, Amy. And thank you for sharing your story. These success stories need to be out there as counters to all the baloney. Sharing.

    • Amy Lynn Smith

      Thanks, Ramona!

    • Teddi

      You leftist nutters disgust me. Obamacare had nothing to do with real healthcare reform – it was all about govt control. The result will be a significant lowering of the quality and access to healthcare. But those on the left never think through the consequences of the policies.

      Govt intervention (regulations) into the private has crushed the economy permanently, thus destroying opportunity for generations. Your social engineering has destroyed the country’s morale compass and the list goes on…

      But you will reap what you sow on the healthcare front.

      • You are so adorable. Thanks for stopping by.

      • toptwome

        Vomitous creep. The Affordable Care Act is helping people and it will be saving lives in spite of the ignorance of stupid people like you.

  • judyms9

    Just listened to a discussion of the ACA status on the Diane Rehm show on NPR. The rightwing panel member and callers came across as snortily petulant, including the man who complained about the exchanges while he lives in Florida where the state legislature has already skewed Floridians’ opinions of the ACA.
    Thank you for this report because it shows the way for others. Regarding the federal exchange, I hold to my CT that those who want to see the ACA fail probably jammed up traffic on the website in order to discourage its use. I base this on the expanding proof that principled behavior is in short supply over there. (Think emergency manager legislation after the proposed legislation was roundly defeated by the electorate.)

    • Amy Lynn Smith

      Thanks! I agree there have been more than a few attempts at sabotage, as I wrote about last week. But the truth will eventually triumph. I have faith in that.

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  • Rogue203

    I “had” a plan that was far from Junk. $250 deductible, no copay for doctor visits and prescription coverage of $30 no matter the medicine! My wife is a cancer survivor so we needed to be in a more expensive group plan however. I understand the frustration of being denied less expensive coverage for pre-existing conditions. It happened to us!! However that being said, I was canceled from my policy and put into another and my president lied to my face saying that would not happen on many occasions! I was automatically enrolled in a “comparable” Plan which is costing me $400 more a month, $2500 deductible $50 copay for doctor visits AFTER I reach my deductible and a horrible prescription plan! I am a 47 year old very health conscious male, I do have to say my plan was “JUNK” due to the fact that now I can get a free mammogram annually and maternity coverage! I could care less if the website works or not! I got SCREWED!!!!!!!!!

    • Amy Lynn Smith

      You should not have to be auto-enrolled in a plan. If your insurer did that to you, you should fight that. You have the right to shop around now — a right I never had before.

      • Rogue203

        They did. But I cancelled it. But there is NOTHING better offered on the exchange in CT. Almost exactly the same as the policy I just got put into. High deductibles etc. I am not eligible for subsidies so I am in big trouble! I cannot afford $400 more a month for worse health insurance. If it is down to paying my mortgage of health insurance. Which would you pick??

        • Amy Lynn Smith

          When my rates were sky-high high, I had to make some tough choices, too. I get it. You might try working with an in-person ACA navigator (info is on Healthcare.gov) or see how you fare going direct to an insurer or broker.

          • Rogue203

            My rates were ALREADY sky high! I was in the same boat as you! My wife has had Cancer twice! But now my insurance went up MORE!!! We were in a group plan, because an individual one wouldn’t touch us! But now its way worse.

          • Amy Lynn Smith

            I sincerely urge you to keep shopping. The point of the ACA is to make insurers compete for your business. That will ultimately drive prices down for everyone.

          • Rogue203

            Im glad you got a good deal Amy, But you dont know what you are talking about! You cant fight the black and white #’s You did good, I didnt! There are about 7 Million Americans that lost there insurance. Im one of them. Enjoy your free Dental exam!!

          • Amy Lynn Smith

            I’m not getting anything for free. I’m well aware that people lost their coverage. But insurance companies dropped people because they didn’t want to offer plans that provide basic health benefits required under the law. Those are the facts, for those who may be interested.

          • sandra350

            I don’t think Rogue203 is interested in the facts, Amy.

          • Rogue203

            The FACT is I got my insurance cancelled!! Wanna see the letter smartass?

          • Watch it. Name calling gets you banned from commenting. First and last warning. Read my comment policy if you have any questions.

          • LJB

            Yes, basic benefits like maternity and prenatal care. I’m 58, been surgically fixed and don’t want or need what THEY say I need. I thought all the liberals were pro choice? They take that away with their forced upon us plan. Why should I pay for some else’s birth control? I always paid for my own or no play, simple but it works.

          • Carlos

            Oh yes you are getting more than what you are paying in, if your pre-existing conditions costs are more than your premium. We are interested in facts but not propaganda.

          • Rogue203

            I never said you were getting anything for free! But the exchange in CT is garbage!!! No Platinum plans! only gold. Lowest deductible is $1500. You think im lying?!? Check it out for yourself!

          • Amy Lynn Smith

            I never said you lied. But I’m not getting free dental care.

          • Rogue203

            You get 1 free preventative dental exam a year. If your a insurance “Expert” you would know that! Well its not free its in your plan though.

          • Amy Lynn Smith

            No, I don’t. Only kids get free preventive dental care under the ACA. I’m paying a slightly higher premium for benefits including one dental exam a year.

          • toptwome

            No one gets any dental coverage with the ACA. I don’t know why people act as though they would. We have a dental policy for that very reason. I was afraid my husband was headed for serious trouble when infection caused him to lose a couple of teeth. I read in one of the doctor pamphlets that I got a couple of years ago that if you make a paste of baking soda and peroxide for your gums that it can help. Since he has been doing that his gums have improved and no more worry about losing any more teeth.

          • I think you’re right. It’s not him. I banned his IP address which is totally different than this idiot.

          • Carlos

            That is a myth. Nobody has to compete for your business if it is mandatory. With no provisions to control cost, there is no reason to believe that prices will come down. Insurance companies have to cover all the costs of last year, more for new policy holders that never had insurance, and make 20% profit that ACA allows them to do.

    • toptwome

      Whine away right wingers.

  • Keith

    I also had my plan cancelled. After spending over 8 hours on the website and phone I have my new family rates. My option in Northern Wisconsin is only one insurer. At least it is the same as my current. My current plan is a HSA with a $3000 max for the family. The closest I could get is a HSA with a $6000 max for the family. The new plan has no prescription benefits until the deductible is met, the old plan had a 20% copay prescription benefit. I currently pay $850 per month, the new plan will be $1020. I end up paying 20% more for poorer coverage. Being my wife and I are upper 40’s we don’t need the maternity care or want to pay for it. We also will pay for our own birth control, thank you. And this is shoved down our throat. Amy, at least you see a better option but keep in mind the rest of us are paying for your gain.

    • Rogue203

      I have to admit I was all for the ACA. Bringing affordable health care to Americans would be a good thing! And if it didn’t effect me? Great! But no matter how you slice it, I was lied to from the beginning! “If You like your plan, you can keep it” Sound familiar anyone?? Democrats are shoving this down my throat and I dont like it I pay my bills, Taxes AND I vote! I am voting republican across the board next election and this law is the sole reason! How much more am I expected to pay? I would be better off unemployed!

      • red rover

        come on, admit it… You’ve always voted GOP.

        • Rogue203

          Nope, I always tried to vote based on common sense, Im not a fan of the Tea Party Wack jobs. OR Conservative Republicans, but Liberal Democrats are just as dangerous! Moderates on both sides are this countries only hope! OOps! Gotta go, just saw a pig fly past my window!

    • Amy Lynn Smith

      Keith, I’m surprised you only had one plan to choose from. In Michigan there are 50 available plans. No one is paying for my gain. I am simply no longer forced to pay exorbitant rates available from the one insurer I could choose because of a pre-existing condition — coverage that included many things I didn’t want or need. You don’t have to enroll through the ACA if you don’t like it. You can buy direct from an insurer or broker. Plus, we’ll all be relieved of the burden of paying for the uninsured who seek ER treatment once they have coverage.

      • Carlos

        If you need the subsidy to pay for the premium now, you have no choice but to enroll into ACA. Stop spreading non-sense. There will be still uninsured people after everything is done and they will go to ER and you will still be paying for it. All the ACA policies are offering coverage you don’t need, such as maternity care for 50+ year olds. With these kind of claims, your entire post is very much suspect.

    • toptwome

      Republican governors have been working to make sure that the ACA is not successful. Even in right wing Louisiana we have three insurance plans to choose from.

  • Gman

    Another Paid for Advertisement care of Obama White House.

    • Amy Lynn Smith

      The White House didn’t pay me to write this.

      • Carlos

        Are you sure?

  • j2muw

    The only people who are benefiting or liking Obama care are those with pre-existing medical conditions, since caring for their medical needs costs more.

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  • nepatriots36

    I am sorry that you have diabetes. It like every sickness is unfortunate that anyone is afflicted. Me being a “healthy young person” who helped Obama get elected; and who’s demographic is experiencing record high unemployment will pay (subsidize) the rest of the money so that you can have this “affordable care”. Because in Socialist America it is my responsibility to do this for a complete stranger.

    • I call bullshit on this comment. You didn’t “Obama get elected” only to turn around and call him a socialist when he did what he campaigned on.

      • nepatriots36

        You clearly missed the irony that my demographic “young healthy people”voted predominately for Obama only to face high unemployment and now being force to buy more expensive health insurance to subsidize others.

        • Which is incoherent. Unemployed people and people paying for their own insurance are disjoint groups, whatever their ages. Also, young people who are in the individual coverage market are still able to get catastrophic coverage that is much less expensive than the comprehensive coverage.

          But ultimately, yes: luckier, healthier, and younger people with health insurance tend to pay more in premiums than they get in coverage. THIS HAS ALWAYS BEEN TRUE. It’s the nature of any form of insurance: pooled risk gets covered by everyone in the pool. For decades we have covered the risk of the inadequately insured via haphazard indirect mechanisms that have worked poorly and helped fuel health care inflation. Fixing that broken system had to including pulling everyone into the pool. Anyone paying attention to Obama in 2008 would know that.

      • nepatriots36

        By the way he also campaigned on the fact that if you like your insurance you can keep it. We know how that promise went.

        • toptwome

          President Obama campaigned on providing the country with better health care. He did not campaign on what insurance companies would do. He thought that insurance companies would honor what he was saying, but they used it as an opportunity to drop people they were paying a lot on.

  • JenRN

    You nailed it when you said you are “THE story the Obamacare’s opponents don’t want you to hear” because you are the literally the ONLY positive experience I have read about.

    • sandra350

      that’s because you’re only listening to sources that confirm your own prejudices.

      • Carlos

        Sandra, Math never made sense under ACA. I don’t “listen” to one source or the other. I collect all facts and try to make my own conclusions. With an Engineering degree, I am very comfortable with Math. There is too much incorrect info from both sides and so you have to do your figuring out. Dismissing people who know cases where the insurance premiums have doubled is also a prejudice. My own insurance went up by 33% from last year to this year for identical coverage. That is a fact.

    • toptwome

      I have read several very positive stories. One was particularly good. The young man would only be paying $40.00 a month.

  • Katniss

    I could have written this article myself. I had a very similar experience and am thrilled to FINALLY get affordable coverage for my family. Both my daughter and I have pre-existing chronic illnesses and were laying exorbitant rates beforehand with no choices in coverage. Now we’ll pay half for better coverage. The news needs to cover all of these success stories. Thanks, Obamacare!

  • Marilyn
  • Marilyn

    I would guess there are trolls/liars on this page.

    • Carlos

      Including the author.

  • Carlos

    You had me believing you until you said your deductible is 150$. That makes no sense at all. All the plans I have ever seen in all my life for over 25 years are a lot more than that (in thousands), and it makes no sense for any insurance company to offer that low a deductible.
    Also, you undermined yourself by saying “junk” insurance plans that are being phased out. You clearly have no reason or proof to believe that all the plans being phased out are junk.

    • Amy Lynn Smith

      The details of my plan are accurate. My experience doesn’t have to meet your criteria to be true.

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  • bsfurg

    then why isnt the entire country on your insurance?

    • For the same reason not everyone owns the same television set.

  • Alice Lapin

    All you people complaining about covering pregnancy and childbirth got born. Don’t you think your mom deserved this insurance? What about your sister, daughter, friends?
    Everyone who has insurance is covering things we won’t use, and many of those have almost no social benefit. But we all pay the cost of poor prenatal care, in terms of more premature babies, etc.
    Even if you hate women, the cold financial return on providing insurance for pregnancy and childbirth should be convincing.

  • bobsmom88

    You people are swooning over the word of a professional political strategist and media spokeswoman who has worked for the Obama campaign? No wonder our nation is in the dire straights that is. It’s unavoidable when sheep like you are allowed to vote.

    • Amy Lynn Smith

      What I do for a living is irrelevant to my personal experience with the ACA. But you skipped the fact that I’ve been writing about healthcare and insurance for 10+ years.

    • There’s no need for anyone to make their own judgments of what the policies and prices are based on who is stating them. Anyone can go to healthcare.gov and verify Michigan plan options and base (unsubsidized) prices. I haven’t looked at all of the options because I’m not in the individual market, but the $530/month she states is consistent with what I saw there last week for an individual “Gold” plan. You can also find pricing for many plans on insurer sites now as well (e.g. hap.org) since the ACA has made it feasible for them to do so.

      • Amy Lynn Smith

        The Gold plan you mentioned is exactly the one I got, Bill. Thanks.

      • Just Wondering

        Instead of ignorant trash running there mouths…. GOTO Healthcare.gov and find out who is telling the truth…. PUT UP OR SHUT UP

  • IDSprout

    And how much of your premium is subsidized by the rest of us?

    • Amy Lynn Smith

      I am not getting any subsidies to offset my premium cost.

    • bomber

      Foolish question really. All insurance policies are “subsidized” by all the members of the group. fi

  • greatadgirl

    I didn’t have the same experience. My coverage is less, my doctors aren’t in the network and now I have to wait until I am 50 for a breast exam. Since breast cancer is in my family I don’t feel comfortable waiting 10 years for my exam.

    • toptwome

      You can go to the doctor any time to get a breast exam.

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  • It is useful to understand that positive and negative stories of the ACA are not contradictory and have behind them factors that the ACA failed to address. In Michigan, we have a pre-existing health insurance market with major non-profit players like BCBS-MI and HAP that have never had the driving force of shareholder returns encouraging them to participate in health care price inflation. We also have a history of large unionized employers paying the lion’s share of the cost of health care for their workers, playing the market role of well-informed dispassionate consumers willing and able to fight inflation. The individual market here has had problems, but it is an adjunct to a group market that runs relatively efficiently and the BCBS-MI 50% market share combined with their coverage mandate meant that our system already had most risk covered. Contrast this with states like CT where the for-profit insurance industry has dominated the market and captured regulators. Their group market is more fragmented, allowing for inflation of health care costs that has ultimately meant more money per patient flowing through insurers, who have in the past been able to keep rates for individuals artificially low by not covering risky individuals. They are having more market disruption and an influx of risk into a higher-priced market, so people with individual coverage in the past stand a strong chance of seeing increases.

    The state-based structure of health insurance is one of the major flaws in our healthcare system not really addressed by the ACA. It is completely irrational in the modern US to have this patchwork mess. Maybe our kids will be able to fix it…

    • bomber

      A single payer system as Medicare would have removed the mess. Hopefully this will morph into that…

  • Cory S

    ACA is a success! I mean, at least one person got signed up, right?

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  • David Asset

    I had virtually the same good experience with Obamacare. My current plan costs us $1K a month for a family of two. It has a high family deductible of $8K and high co-pays. It’s virtually worthless except for something catastrophic. I enrolled in a much better plan through Obamacare which will cost us $475 a month with NO deductibles and co- pays that are 50% lower. I guess I won’t be interviewed on FOX News because the Republican noise machine only presents negative stories about Obamacare to discourage people from even signing up.

    • Amy Lynn Smith

      Glad to hear it, David! I’m being told of more and more success stories every day. It’s important that people share them, and thank you for sharing yours.

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  • JD

    I consider myself to be a moderate republican. I disagree with the left on many subjects and find the attitude of neo liberals to often be offputting

    With that said, I have to admit that, obamacare helped me. I have health insurance for the first time in over a decade. The tax credit obamacare gave me took a 183 dollar plan down to 19 dollars a month which was finally affordable for me

    Thanks obama (seriously)

    • Amy Lynn Smith

      Thanks so much for sharing your story, JD. I’m delighted to hear you have had a genuinely positive experience.

  • TransitDave

    Nice going Amy. I couldn’t get on the Obeymecare website at all. But now I’m boycotting it out of principal. Sure a few people are getting a great deal on coverage. Lots more are getting cancelled, or huge increases in premiums, with huge deductibles. Now tell me how a high deductible policy is any better than the catastrophic policy I had before Obeymecare outlawed it?
    I choose my kids college fund over insurance. But Mistress Mona below is going to punish me for my choice…….Maybe it won’t be so bad…………

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  • Steve Shane Lester

    So glad to hear your premium went down from $1400 a month to $530… I too am self-employed, and mine went up from $597 to $1167. Just in case you were wondering who was picking up your tab… Oh, and that’s with a $5,000 deductible, per individual.

  • jessica

    i want to use this media to say big thank you to dr obantala for helping bring back my husband after two years he left me and my kids for another woman. i saw a testimony about him online and i decided to give it a trial he gave me his word and i did all that was required by me. you won’t believe it in 48hours my my husband came back begging. Thank you once more dr obantala you are so true and real. You can also contact him for any kind of problem on his mail [email protected] or his personal number +2348063297200

  • toptwome

    Thumbs up for you and everyone else that the Affordable Care Act helps and saves their lives and money for.