(or alternative title: What’s in it for me and why it’s affordable)
Marcy Wheeler over at FireDogLake has done a couple of great posts illustrating what costs for insurance might be for different income levels. Her numbers are solid and argue for subsidies based on something that comes closer to the real-life experience those of us in the middle class live. Her latest hits on the costs for middle-income families toward the 300-400% Federal Poverty Limit levels.
Example #1 is pretty close to our situation before I was laid off. Now we’d move to around the 200% line, but I’ll use her numbers for this post.
In Marcy’s example, a family earning 301% of the poverty level would spend $14,477 (maximum) under the Senate plan between premiums and cost-sharing, after subsidies, leaving $13,620 for education, clothing, debt service, transportation.
I am grateful beyond words that we do not have any outstanding credit cards, our car is paid for and our home will be paid off in the next 7 years due to accelerating our mortgage. A comparison of Marcy’s numbers to our own situation yields an opposite conclusion from hers, even with our lower income stream right now. What Marcy illustrates is that insurance is absolutely affordable, and if we could get it, we would.
Under the Senate bill, our premium costs would be $542/month. Cost-sharing would be a maximum of $719/month, assuming the maximums were reached, or $1,261/month.
We currently pay $750/month for medications and supplies just for the diabetes. We pay an additional $275/month for doctor visits. This is for one person in our family. That’s $1,025/month, which is less than the $1,261.
What do I get for that additional $236/month? Here are some things:
- If my husband feels chest discomfort, he can go to the doctor and get a physical, including a stress test, a non-stress test, and cholesterol tests for free.
- My daughter and I can see an OB/GYN without extra cost.
- If my husband has a heart attack and needs bypass surgery, we can get that surgery without paying more than the maximum of $1261/month or $14,477.00
- Our son could receive treatment from an endocrinologist and dermatologist to manage the effects of two conditions that leave him better, but less than 100%
- I could get a mammogram. If they found a lump, I could get it diagnosed and treated. As it stands today, I haven’t done that because we would have to sell our home and use the after-tax proceeds to pay for medical care.
- Our out-of-pocket for medications drops to about $125/month which counts toward the cost-sharing maximum.
Those are the benefits I get for that extra $236/month. They are not insignificant.
What that $236 buys us is the security that we won’t lose our home, and we won’t be dropped because we got sick, and that for the next few years until both of us are eligible for Medicare we have a safety net.
That’s not unaffordable. It’s essential.
Bonus: A list of immediate goodies for all of us when it passes here.
