Over here in Massachusetts, we have government mandated private insurance. Just like the proposed national plan, we have subsidies available to lower & moderate income levels. If you don't meet these levels, you are on your own to buy your own insurance from the state group pools that are suppossed to offer 'affordable' insurance choices.
Well, I just went to the site in Massachusetts that helps uninsured families find and enroll in these plans. I typed in my income was above the 54,936.00 limit for assistance for a family of three and choose to find plans for a family of three of the following ages - 38, 41, & 14.
Here are the results:
Low premium. Most have deductibles and co-payments. Prescription drug coverage included. 4 plans $836.84 - $952.45/mo
- Okay, there is your first option....for between 836.84 - 952.45, you can buy a family plan with high premiums, deductibles, and co-payments. Now if you make 55,000 dollars a year, you and choose this plan, you would be paying 19.63 percent of your income for health insurance that DOES NOT FULLY COVER YOU, CAN DENY CLAIMS, & WILL COST YOU MARKEDLY MORE IF YOU ACTUALLY USE IT....(I used 900 dollars a month as a mid-way figure between the costs presented for purchasing this plan). It may be slightly more or slightly less.
Looking closer, I went into the program and looked at some of the deductibles. One plan the deductible is 2000.00 per family member up to 4,000 dollars total before they pay for hospital stays. Prescription drug copayments could be as high as 180.00 co-pays for some prescriptions. There is a 250.00 dollar fee for emergency room visits. The cheapest plan had a deductible of 35% for hospital stays.
Okay...moving on to the next one....
Moderate co-payments. Some have no deductible. Prescription drug coverage included. 6 plans $1,037.26 - $1,343.15/mo
Okay...so let's first figure out the percentage of GROSS income you will be paying for this plan - again, I choose a mid-way number, 1150.00 from the price range offered. At this price, you are paying a full 25 percent of your income for health insurance and it still has copayments! A quarter of all the hours you work and you STILL are not fully covered. Let's look more closely at one of these plans. First, I found that you had to pay 1,250 dollars a month for a plan with no deductibles (however you still had to pay 500 dollars per hospital admission, so I don't see how that isn't a deductible, but moving on)...Prescription drugs co-payments range from 15 dollars to 1/2 the cost of the drug AFTER the prescription drug deductible is met!
Wow, this is shaping up to be an inspriing model for a national health insurance plan! Alright, on to the 'cadillac' programs...(cadillac meaning that they may actually cover more of the cost, if you need care...maybe because remember, they can still DENY care)
Low co-payments. No deductible. Prescription drug coverage included. 4 plans $1,493.62 - $1,739.38/mo
Whew, I am getting sticker shock at this point. Okay, let's start with the mid-level range for one of these plans, say 1,600 bucks a month. Or, to put it another way, for a mere 34.9 percent of your income you can have nearly full coverage health insurance that still can be denied, but it may cover a lot of if you ever need to use it. Fingers crossed.
Looking at a plan that matches the price I choose, the maximum out of pocket expenses is 2000.00. You STILL HAVE out of pocket expenses with the most expensive plan. Co-payments for meds were as high as 90.00 dollars per script. Durable medical equipment costs were 1,500 dollars before they pay a dime.
There you have it! That is the reality of health insurance costs for a family that makes too much to get government subsidies. And, from what I am reading about the national plan, the income rate for subsidies will be much lower. Also, you might want to know that the MA plan is becoming financially insolvent and they have been paying for the subsidies for purchasing health insurance by cutting benefits to lower income people...the poor sacrificing for the slightly better off. A reality that will be happening to people on Medicare and Medicaid across the country, if this current plan passes.
Here is the link to the site -
https://www.mahealthconnector.org/portal/site/connector/My conclusion: SINGLE PAYER INSURANCE NOW - because nothing else will WORK
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