Wendy’s story: Obamacare costs are unaffordable


My husband helped found a small software company in 2004. We were in the individual market for about six months that year, in between his job and when the company really got off the ground. Our premiums for a family of four (including some dental) were $371 a month. At that time, insurance was very affordable because we could tailor the plan to meet our needs and budget.

Once the company was established, we provided an excellent, affordable plan to our employees and ourselves. We never had any complaints from our employees about the plan. But after the Affordable Care Act kicked in, the costs for the plans we wanted to provide became, ironically, unaffordable. We (and our employees) were forced to switch plans, companies, and doctors several times as the plans we chose were dropped by the insurance companies.

In 2015, my husband left his company and started a consulting company. We were forced into the individual market in South Carolina. As far as I can tell, we had one choice outside of Obamacare. That is BlueChoice healthcare.  For a health family of four with a $7,700 deductible, here is what we have paid: (Please note, this plan DOES NOT cover dental at all)

2015:     $ 745/month

2016:     $ 986/month

2017:     $1,394/month

2018:     $1,539/month

As you can see, the cost keeps going up every year for seemingly no reason. Keep in mind that we are forced to buy coverage for things that we don’t need and will never use. Thank God, we are all healthy people with not much more than routine well visits and the occasional sick visit for an antibiotic, etc.

Now I am left with two bad options: Paying premiums that are out of control, OR having no insurance at all.

Imagine if we could buy a catastrophic plan to cover unexpected expensive illnesses or injuries, and then self-insure with the $26,168 (that’s premiums + deductible) that we pay out of pocket anyway.

We cannot continue on this trajectory, and I refuse to live off of my neighbor and get a subsidy. I just want the freedom to choose what is best for my own family.

How our plan would help:

Wendy’s story reflects the predicament of millions of Americans:  She is faced with too few choices, and the cost of her insurance is soaring beyond her reach.  Too many people feel they will have to drop their insurance as it gets more and more expensive.

Under our plan: 

  • States would have the flexibility to approve a much broader range of plans, giving Wendy more choices of coverage that meets her family’s needs.
  • One of the reasons health insurance is so expensive is that everyone is forced to pay higher premiums to cover the costs a few very expensive patients. Under our plan, states would have resources to help to cover the costs of the small number of people with the greatest expenses.  States could revive high risk pools, create reinsurance programs, or otherwise provide separate funding.  This, in turn, would reduce the ever-upward pressure on premium cost that Wendy experienced.
  • And our plan would give Wendy more options to put money aside in a Health Savings Account. She could buy a higher-deductible policy that costs less that would cover her family in the event of an accident or illness, and she could use the money in her HSA to cover routine expenses or sign up for innovative programs, such as enrolling in a Direct Primary Care practice.