Obamacare Is a Lifesaver. Sign Me Up

By Sadhbh Walshe, Guardian UK

03 October 13

Until now, I've had to trust tofu and yoga will keep me healthy. The ACA is a game-changer for millions of Americans like me.

t's not easy being a hypochondriac, especially when you don't have health insurance.

I'm the sort of person for whom a bad headache can never just be a bad headache; it must be the onset of a brain tumor. If a new cluster of freckles appears, I will automatically assume it's skin cancer and not just the natural outcome of having spent some time in the sun. I'm not sure if these irrational concerns, which are invariably unfounded, have anything to do with the fact that I've lived most of my adult life in a country where healthcare is treated as a luxury that, more often than not, I can't afford. I do know that I was incredibly relieved on the morning of 1 October, when, despite congressional Republicans desperate and pathetic attempts to stop it, the Affordable Care Act (ACA) exchanges went live, and for the first time since I became self-employed, I can actually partake in the basic human right that healthcare is, without driving myself over my own fiscal cliff.

Don't get me wrong, I live a comfortable enough existence and if I gave up all the yoga classes I do and spent a little less money on organic kale and spirulina and high-grade vegan protein powder and other super nutrients, which get loaded into my juicer of a morning in the ongoing effort to stave off illness, I could at least afford one of those "catastrophic" policies on offer that kick in (allegedly) when disaster strikes. To get proper health insurance, however, which would actually mean I could visit a doctor when I needed to and get any necessary medication, the lowest price I've been quoted is around $1,000 a month. That's simply more than I'm willing, or indeed able, to pay.

No wonder then, I've been waiting with baited breath for the ACA to kick in and to see if it lives up to its name. So far, the news is pretty good.

In between website crashes on Tuesday morning, I learned from the New York state exchanges that, for around $300 a month, I could get a bronze-level plan. This would have high-ish deductibles but would still cover around 60% of my healthcare costs. For $500 a month, I could get the silver plan that would have much lower deductibles and basically would offer the same level of care for which insurers have been asking $1,000 or more for until now. It's not exactly a giveaway, but it's a much bigger reduction that I expected, frankly. It's an amount I can afford to pay and still have some money left over to spend on things that keep me healthy.

So, it looks as though, in the very near future, once I work out all the options, I'll be back in the health insurance game. This is good news for me, obviously, but it's also good news for insurers because I'm exactly the kind of person they should want on their books. Despite my hypochondriacal tendencies (or perhaps because of them), I'm pretty healthy. I've never been hospitalized, have never broken any bones and have never been diagnosed with any illness more serious than a routine chest infection. Even during the periods in my life when I have had the luxury of employer based health insurance, I rarely visited a doctor more than once a year (apart from one Woody Allen-esque moment a few years ago when I discovered a lump that was eventually dismissed as mere scar tissue - but only after two ultrasounds and a mammogram).

All told, getting me to sign up under the Affordable Care Act's "individual mandate" was never going to be a hard sell. The question is, will the "invincibles" - the healthy twentysomethings, who have not yet had any brush with mortality - be nearly as willing?

Throughout the day on Tuesday, there were reports of exchanges crashing across the country, which would suggest that there are quite a few Americans interested in what the ACA might have to offer them. It's too early to say how many of the estimated 17 million uninsured young adults were among those helping to bring down the system. The signs are, however, that the very young are not as indifferent to healthcare as many people seem to believe.

A study released in August by the nonpartisan Commonwealth Fund came to the rather interesting conclusion that if the so-called invincibles shun the new law, it will be because the plans cost more than they think they can afford and not because they feel that they are above needing healthcare coverage. That being the case, there is every reason to hope that young people will sign up because if they take the trouble to check out the exchanges, they are likely to discover that the less money they have, the better the deal the ACA has to offer them.

Prices vary from state to state, but on average, a person earning $20,000 a year will be able to buy for just $85 a month the same sort of plan that's going to cost me $500 a month. The price drops to $25 a month for people earning $15,000 a year or less. I understand that even $25 can be a lot of money to set aside for someone earning such a low salary, but those are still some pretty sweet deals for comprehensive healthcare. If the pricing incentives don't manage to win over skeptics, however, the ACA has a built-in stick element that might do the trick. Individuals who don't sign up will pay a modest financial penalty in 2014 of $95 (per adult), or 1% of household income, whichever is greater. By 2016, the penalty will rise to 2.5% of household income or $695 per adult.

Only time will tell how this is all going to play out, but the Affordable Care Act can count on one convert at least. The "tofu and yoga health plan" that's been my default for so long has its merits, but it will it be of little use the day one is run over by the proverbial bus. No one should have to live with that kind of stress just because insurers were able to get away with pricing so many of us out of the healthcare market for so long.

Despite its shortcomings, by making insurance at least somewhat affordable, the ACA has the potential to be a game-changer for millions of Americans. Let's hope that enough of us take advantage.