New Jersey mother tilting at Obamacare windmill; read her story and weep (PART 1)

The author: 'I want to keep my plan.' Photo by Sunny Kam

The author: ‘I want to keep my plan.’ Photo by Sunny Kam

By Jen Furer

My husband and I have four children, ages 13 to 24. Since 1995, we have been paying for a family health insurance plan, and since we have our own business, we were eligible for the Small Business group plan.

We’ve always had HMO Plus policy with no deductibles. Every year I took time to speak to our insurance broker. I went over various health insurance options that could save us money but still provided the coverage that we needed.

In 2013, our health insurance premiums cost us about $17,000 a year. We didn’t have any deductible and was covered 100 percent for services such as our preventive care, pediatric immunizations, mammogram, and outpatient laboratory pathology. We paid $25 co-pay for primary care services and $50 for specialists. We didn’t need referral to see a specialist. For routine eye exams twice a year, the co-pay was $50. For hospital stay, the co-payment was $100 and $250 for outpatient surgery. Our prescription plan was $10 for generic brand.

As you can see, we have a high-quality health care plan.

On November 2013, as I was going through the monthly paper work that was on my desk, I noticed the renewal letter from our insurance provider, AmeriHealth New Jersey, that stated “More Value” and offering an alternative insurance plan that “most closely matches your current option.” I felt the rush of blood flowing through my veins and into my heart. It felt like my eyeballs jumped out of my eyes socket. I couldn’t believe the substantial increase in the cost of my health insurance premium.

My current annual premium was $16,500. The recommended coverage that matched my existing health plan was with AmeriHealth NJ Premium Regional Preferred Gold HMO Plus. The deductibles are the same as my current plan except that the new prescription plan has a 50 percent coverage up to $125 as opposed to the $10/$40/$60 co-payments that we used to have. My eyes couldn’t fathom the new annual premium of $33,000, a 100 percent increase!

Needless to say, I lost my composure. Still shaking with anger, I logged on to Facebook and updated my status: We’re screwed!…What happens to “if you like your private insurance you can continue to keep it? I was OK with a 10 percent increase but 100 percent? If this keeps up, my family will be on welfare soon!”

On March 23, 2010, President Obama signed the Affordable Care Act (ACA aka ‘Obamacare’), purporting to make health insurance within reach of the average American. The U.S. Census Bureau has estimated that 48.6 million Americans (15.7 percent of the population) are uninsured. Proponents of ACA want that number to be zero or close to that as possible.

Despite my busy schedule as a community advocate, book author, television talk show host and mother of four, I made a resolve to learn more about ACA. I’d like to know how they arrived at that computation of our family’s insurance rates, and if that is the case, how ordinary Americans can afford insurance at all!

At first, I read the newspapers and soaked in all the arguments from both sides. I couldn’t get a vivid picture because the Republicans and the Democrats both had opposing arguments that did not quite answer my questions. All I remember was what Obama has said about “keeping your plan if you like it.” I like my current plan, but the steep raise in rates will make it impossible for my family to keep it.

I got hold of the full text of the law, all 11,000 pages of it, and downloaded it on my computer. I wasn’t even sure if there was one politician who voted for the bill who actually read – and understood — what they put into that legislation. But there I was, time permitting, reading the law page by page waiting to find that provision that applies to my family’s situation. I couldn’t comprehend all the legal jargon. Maybe former Speaker Nancy Pelosi was correct when she said, “We have to pass the [health care ] bill so that you can find out what is in it.”

I am still reading the law.

But I am also getting educated by talking to health care experts and insurance providers, listening to webinars, browsing the revised and improved website, and reading anything I knew would help me understand ACA. I also got to meet families like mine who saw sharp increases in their rates. I compared notes with them.

As the effectivity date neared, the debate over Obamacare escalated. My Conservative family and friends warned me that our premiums would skyrocket, the quality of health care degraded and that ACA was another big government’s plan on infringing on our freedom. My Liberal family and friends insisted that ACA would extend health insurance to all including those with pre-existing conditions, would benefit women and the elderly and would hold insurance companies accountable. I find myself dumbfounded by the stark differences. There are people on both sides of this debate that want the best for all Americans but the facts in my case are very clear. My cost did not go down, they went up. My benefits did not go up, they went down. The only reasonable statement of my personal situation is that I’ve been profoundly injured by this law.

A few of my Facebook friends chimed in:

“probably to help pay costs of insurance of those on welfare…so sad for those working their a– off”

“The entire middle class will be on Medicaid. The problem with Medicaid is that the doctors don’t accept it! No insurance, no doctors, and opening ourselves up to identity fraud when you put your personal information into the website – when that is working, just to be able to compare plans. Take this to the polls in November”

“Wow. Next thing you know, you’ll get penalized for not having one. Tsk.”

“This is outrageous!”

Clearly everyone was confused, anxious and in need of facts.

NEXT: Talking to a navigator

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