Reader shares views on Obamacare

Letter to the Editor regarding Obamacare--

I am a local business man and we have about six employees. I am 61 years old. When the Affordable Care Act (Obamacare) was passed I said, "this will never help me." I did not think I would ever really benefit from it. About a year before Obamacare was passed I found myself without insurance. I had an insurance salesman that had been bugging me to buy insurance with him. He insisted that he could save me a pile of money. I was with Missouri Blue Cross (Anthem) and paying over $1000.00 per month. He insisted he could get my rate down to about $700.00 a month. I finally agreed to try it when my premium came due. We filled out the application and sent it in. My premium was due for the old insurance and I decided not to pay it because I would have the new policy. While I waited to hear from the new Insurance Company my old policy lapsed. When I finally did hear from the new company they denied my coverage. When I was refused I tried to pay the premium for my old policy. They said I had pre-existing conditions and they did not have insurance. My sister sent me an article that said one of the provisions of Obamacare was the "Federal High Risk Pool." This program was a Federal Program that was administered by the states. If you had been denied insurance and been without insurance for six months or more you could apply. I applied as soon as it started. I got a notice that I was approved and my premium would be $835.00 a month. They said I could not pay more than $5,000 a year out of pocket and everything would be covered, unlike my old policy that had pre-existing conditions that were not covered. One of the provisions of Obamacare was that the insurance company that administered the program could not keep more than 20% for administrative costs. So 80% had to go to pay for actual healthcare or the premium would be lowered. My premium has dropped now to $605.00 per month. That is saving me over $2700.00 a year.

In July this year I found a strange looking mole on my body. I went to the doctor and had the mole shaved off and a biopsy done. The mole turned out to be cancer (Melanoma). Since then I have had surgery to removed the mole, the surrounding tissue and some lymph nodes removed for testing. The good news is they think they got all the cancer. Meanwhile, the many trips to the doctors, the surgery at Barnes Hospital and the adjuvant treatments cost about $26,000.00 so far. Since I was told I would not pay more than $5,000.00 per calendar year, I expected to be billed for the $5,000.00 right off the top. That is the way old insurance company did it. To my surprise I have only been billed for about $2500.00 to date. That $26,000.00 bill could have really hurt me if I did not have this insurance through Obamacare. This is a much better deal than my old insurance and is pays for everything.

A few months ago more of the Obamacare provisions have "kicked in." Now ALL insurance companies have to spend 80% of all premiums collected on healthcare or refund the difference to policy holders. I know many people that have gotten rebate checks from their insurance companies over the last couple months. One guy I know got over $2,000.00 back. This is great for the insured. The problem had become that insurance companies were denying claims and putting the money in their pockets. Now if they can only keep 20% of the premiums collected there is less incentive to deny legitimate claims, because they can not just keep the money. Many of us have already taken advantage of the other provisions of Obamacare that have begun. Our children now stay on our policies until age 26. Starting in about 14 months many of the parts will begin like the following: Insurers are prohibited from discriminating against or charging higher rates for any individuals based on gender or pre-existing medical conditions; Insurers are prohibited from establishing annual spending caps; For employer sponsored plans, set a maximum of $2,000 annual deductible for a plan covering a single individual or $4,000 annual deductible for any other plan and several over provision that are phased in until 2020.

Missouri residents will on Nov. 6 decide on whether to allow the governor to establish exchanges for us to buy insurance. Do not be fooled by all the hype out there, it is not in our best interest to vote against the Affordable Care Act. First of all it is a Federal program and we will be taxed on our Federal Income taxes no matter is we use the program or not. Opting out of the exchanges will not save us a dime in taxes. We do not want to pay for the program and then not use it. That makes no sense at all.

Lets recap: my insurance premiums have dropped by 40%; there are no more pre-existing conditions on my policy; my out-of-pocket expenses have been cut in half.

Don't be fooled by all the propaganda, The Affordable Care Act was good for me and will be good for Missouri!

Regards,

Bill Aronson

Doniphan, Mo.