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>ACA is horrendous, unless you're receiving a government subsidy. I'm curious as to why you say "the ACA is horrendous" rather than "The income cutoffs for the ACA subsidies are way too low" - I mean, it seems obvious to me that if you make a median salary and have a family of four that you need some sort of health insurance subsidy, but I don't know where the ACA subsidy lines are, or even if they vary per state or not. I personally am in favor of just expanding medicare or medicade so that everyone can use them to get minimal health care if they need it. I mean, sure, if you have money, you probably still want private insurance on top of that, just like retirees today, but we've got a reasonable system for giving everyone over 65 a minimal level of care, and healthcare for younger people is a lot cheaper than healthcare for old people, so it seems like a big rich country like ours should be able to cover that bill. but I don't think that is politically possible. I think this last election was in some ways a referendum on the ACA, and I would interpret the results as saying that many, if not most Americans think that you should only get healthcare if you can pay for it. Which seems weird to me, because as you point out, if you make anything like average money, healthcare for a family for three or four is impossible to pay for without a subsidy. >I'm seriously considering returning to wage employment for health care benefits. In the days before the ACA, I'd just get a full time job every time COBRA and CAL-COBRA ran out, because I couldn't get a plan at all without. I mean, I was happy paying $6K/year just for me, and that's what I'd pay under COBRA or CAL-COBRA but, once that ran out, nobody would sell to me. Maybe I wasn't asking the right people, but it wasn't like they came back with high numbers, they just said they couldn't cover me. It was weird, because while I did have a chronic condition or two, none of them were particularly dangerous or unusual. |
In 2016, I decided to take off from work and travel outside the US. I did what I thought was the responsible thing and purchased a travel insurance plan. In total, I was gone for a year...I had an amazing trip.
When I got home, I wanted to sign up for insurance again. But since it wasn't a life event, I wasn't eligible to enroll until the open enrollment period. And when that time rolled around, I wasn't eligible for the subsidized plans because I hadn't gotten a job yet and my monthly salary was $0/mo. Nevermind that I'd done enough contracting work during my trip such that if you divided my annual earnings by 12 to arrive at a monthly earning, it would've easily qualified me for a subsidy to stay on a plan that let me see my previous doctor. But I did eventually get signed up for Medicaid for the month between open enrollment and when I found a job, so...yay?
Then tax time rolls around and, it turns out, you need to be out of the country for 11 out of 12 calendar months to qualify as a non-resident. Since my trip didn't start on Jan 1st, despite being out of the country for an entire year, I didn't qualify as a non-resident for either 2016 or 2017 and had to pay the ACA penalty for the entire time I was gone because I didn't buy health coverage that would've only been useful in a country I wasn't present in. And adding insult to "please don't let me get injured", I had to pay a penalty for the time I was uninsured between when I got home and open enrollment.
In short, I feel like the ACA was rushed and they never seriously considered what was right for people not working a 9-5 job getting regular pay checks. By deciding to opt out of the workforce and do my own thing for a while, even doing it responsibly, the ACA cost me thousands because I somehow managed to find corner cases that were simply not considered or poorly handled by those writing the bill.