Have changes been made in the last year or so that make getting health insurance any easier?

January 7, 2011 5:30 AM

Have changes been made in the last year or so that make getting health insurance any easier?

I'm self-employed and have an outrageously expensive Aetna insurance plan for my business. The premiums are increasing to a seemingly astronomical $1,650/month for my family of four. While I'm fortunate to have health insurance at all, the plan stinks and the prices are putting the hurt on us.

Degree of difficulty: Wife and son have some prior medical conditions and have typically been tough to insure. We are in Florida, our ages are 39(me), 44(mrs neilkod), and 2 sons 7 & 11.

I haven't been paying too much to the Obamacare and related initiatives but I figured I'd do some research before committing to renewing.

posted by neilkod to law & government (8 answers total)

None of the changes in the Health Care Reform law have kicked in any substantial way that would make it easier for you.

I do have one suggestion though - it sounds like you own your own business, right? Do you take a regular salary? If so, you might look into getting a pay-roll company. The pay-roll company will take a small percentage of your total pay-roll (about 3%) - but then you are part of a large pool of workers, and getting health care becomes cheaper and easier. The money spent on a pay-roll company might be worth the savings in health care.
posted by Flood at 5:40 AM on January 7, 2011

I sympathize. We, too, are saddled with a four-figure monthly premium. As well as four-figure individual deductibles.

As far as I can tell, there is language in the healthcare reform that says insurers cannot refuse you coverage due to pre-existing conditions. Unfortunately, there isn't any sort actual control over what the insurers can charge you for the coverage. There's language that vaguely implies insurers should keep premiums reasonable, but, as far as I can tell, there are no actual limits or numbers defined. I'd welcome anyone more knowledgeable about this to jump in here.

And, can we please stop calling the thing Obamacare, as if he wrote it? It's more like "Tons-of-compromises-made-to-get-both-insurers-and-some-conservatives-on-board-Care"
posted by Thorzdad at 5:42 AM on January 7, 2011 [1 favorite]

"None of the changes in the Health Care Reform law have kicked in any substantial way that would make it easier for you."

This. More kicks in in 2012 and 2013.
posted by thatguyjeff at 6:54 AM on January 7, 2011

None of the changes in the Health Care Reform law have kicked in any substantial way that would make it easier for you.

Well, like Thorzdad says, if the OP wants to switch providers, they can't give his wife and son trouble for pre-existing conditions. So there's that. The OP might want to watch this to see if there's anything else. Yes, it's a cartoon, but people who have been talking about health care reform for years think it's well-done and informative.

And, can we please stop calling the thing Obamacare, as if he wrote it? It's more like "Tons-of-compromises-made-to-get-both-insurers-and-some-conservatives-on-board-Care"

Agreed. I just call it ACA (Affordable Care Act), but we're not the only ones annoyed by the term "Obamacare."
posted by zombieflanders at 7:43 AM on January 7, 2011

According to those hippies at Forbes, the Health Care tax credit seems to working quite nicely for some small businesses. So the answer is 'Yes, they made getting health care easier."

I don't know if/how that would help you personally, but that's the compromise we accepted going away from "Heath Care Reform" and going instead for "Health Insurance Reform".
posted by anti social order at 8:07 AM on January 7, 2011

Getting your son insured should be easier now; preexisting condition exclusions for children are prohibited now, but the prohibition on preexisting condition exclusions for adults don't take effect until 2014. The other significant changes that would help you are not in effect and won't be for some time (rolling in from 2012-2017).

And, can we please stop calling the thing Obamacare, as if he wrote it? It's more like "Tons-of-compromises-made-to-get-both-insurers-and-some-conservatives-on-board-Care"

Agreed. I just call it ACA (Affordable Care Act), but we're not the only ones annoyed by the term "Obamacare."

Thirded.
posted by mchorn at 8:13 AM on January 7, 2011

You should shop around to other insurers. Aetna is pulling out of many markets that it does not find profitable and rapidly raising rates to encourage people to drop out. You might try Blue Cross/Blue Shield. As others said, you should not be hit by pre-existing conditions as long as you have less than a 60-day gap between insurers.

Also, since you are self-employed you should be able to deduct 100% of health insurance premiums from your income. This reduces the sting somewhat.
posted by JackFlash at 8:58 AM on January 7, 2011

The federal government's heathcare reform site has an interactive timeline showing when the different provisions of PPACA go into effect. (PPACA how I've usually heard it called in the legal academy, but I do kind of giggle at the pronunciation.)

As mchorn said, part of the prohibition on pre-existing condition exclusions has already gone into effect, for people under the age of 19, but the rest of the prohibition doesn't go into effect until 2014. There is a state-run Pre-existing Condition Insurance Plan that will provide coverage if someone can't currently get health insurance due to pre-existing conditions. According to Utah's HIPAA information site, the federal 63-day prohibition on rejection for pre-existing conditions (which is part of HIPAA) only applies if you're moving from or to a group plan, not from an individual plan to another individual plan, as far as I've been able to tell. That's federal, though - the state law could be different, and, although the Utah site doesn't say anything about the state law, they do give the phone number for the State Insurance Commissioner's office, at least.
posted by Madame Psychosis at 5:05 PM on January 7, 2011