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One Cobble at a Time

Ala Carte Health Care

Sandra Tayler's Journal

responsible woman

A cobble by itself is just a small stone, but when many of them lay together they create a path . My life is made up of many discrete parts. I have to find ways to fit them all into place so that I can continue to journey where I desire to go. This journal records some of the cobbles that create my path.

Ala Carte Health Care

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responsible woman

Prior to Obamacare we had health insurance with a deductible of $10,000 per person per year. The only thing it provided to us was a vague reassurance that if something catastrophic happened, we would have help for all the expenses between $10,000 and 2 million dollars. Mental health was not covered. Maternity was not covered. Birth control was not covered. Dental and vision, not covered. Also my premiums went up every year like clockwork.

We made the switch to Obamacare the second year it was offered. I watched that first year to see if it actually worked for people I knew, and it did. On Obamacare my premiums were about the same as they had been on my old plan, but my deductible per person came down to $3000, and there was a $7000 cap per family. Suddenly a catastrophe which affected my entire family would put me out $7000 instead of $60,000. And there was no upper limit on how much the insurance would spend. Mental health, maternity, birth control, annual check ups, and vision check ups for my kids were all covered. True I still had to pay out of pocket for these things, but all those payments counted toward a my deductible rather than being unrelated to it.

I would have loved to have all those things covered in my earlier plan, but adding things like Maternity care were called riders. They cost more money. Not only that, but you couldn’t add a maternity rider to your plan if you were already pregnant. You had to add it several months before you got pregnant in order for the insurance company to agree to pay for anything. Mental health care wasn’t offered at all, not even as an expensive rider. I suppose that there were people whose coverage was provided by their employers who had coverage for mental health stuff, but I didn’t know any.

That is what the newly-proposed ala carte model for health care means. It means that those who have health needs, like maternity care, will have to pay more than those who don’t have needs. Guess which person will have less ability to work to cover the cost of their health care? Ala carte means that some things won’t be covered at all, or will only be covered at rates which are so high no one who has the issue can afford to purchase coverage for it. I suspect I’d be back to out of pocket for my family’s mental health care.

It is true that year after year I saw increases in my premiums for Obamacare. This past year my monthly premium went up by $600, an increase of almost 60%. That was alarming and has put a serious strain on my budget. I had to drop down to a plan with a $7000 deductible per person and a $13,000 deductible for my entire family. Yet those deductibles are still lower than the ones I had before Obamacare. And visits to mental health professionals count toward those deductibles. Also, I believe that my premiums would have skyrocketed anyway. There are other things driving the increase in medical costs than just giving coverage to more people.

There were definitely things to fix, but prioritizing the profits of insurance companies is not how to help people. Ala carte may help a few healthy people lower their premiums, but it will cost everyone else more.

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