Real talk. I was pissed when the Affordable Care Act was implemented. I was. I recall my liberal friends rejoicing while I rolled my eyes when they turned around. I wanted to feel their same optimism that our country was trying to crack the universal healthcare nut, I did. But I didn't.
While the ACA was being poked and prodded, I ditched working for the man to put up my shingle. Up to that point, I had been purchasing my health insurance on the open market.
I was in excellent health, and I knew that I wasn't planning on having children. I was going to the doctor once a year if that. I needed emergency insurance. My premium was lean, and I was grateful given how little money I was making at the get-go.
I was the one who the ACA bullied with its grandiose formula. I didn't want nor need any of the extras it sought to provide.
Because of that, I was able to find an insurance plan that offered everything except maternity care which brought my premium down about $600 annually. I loved it, especially someone new to covering my benefits.
I never thought about what it wasn’t covering nor what I would do should I need said care.
When the ACA was rolled out, and I shopped my first round of insurance, there were fewer plans and way higher premiums. The base plan increased my premium by $1800 a year. And I was forced to carry maternity care.
My immediate followup thoughts went something like this: so now I'm paying for other people's babies and men's treatment for prostate cancer because they were too macho to get their annual check-up? What if I were menopausal or was unable to birth a child? And what about people who go to the doctor for things that nutrition and some supplements would clear up instead of costly meds?
Maddening. I resented my premium increase. I resented supporting others. I hated the ACA.
I have signed up every year since, with bitterness in my fingertips. I still needed medical care, and I’m a rule follower. Heaven forbid, I get slapped with a fine for no coverage.
My formula has been the same since. I opted in for the most inexpensive base plan (aka Bronze) and maxed out my HSA contribution every year. I figured if I was going to be forced to carry the darn plan, I should at least reap the benefits of the tax advantage.
Fast forward a few years, and I now realize the wisdom of the ACA and my short-sightedness. During last year’s open enrollment, I upped myself to the Gold plan, knowing that I needed to access more services this year.
I have coverage for things that I didn't know I would eventually need that are guaranteed by the ACA. For example, just this year alone, if I had the same insurance that I had before the ACA, I would not have guaranteed access to the many things I have needed to-date.
I received an exam, crutches, x-rays after a ski accident in Utah (not my home state). I received followup exams and physical therapy. There's a lot of cancer in my family. I have been screened for everything this year and given directions and timelines for all the preventive measures I should take. Those tests revealed vitamin and mineral deficiencies. I took a few supplements and the lethargy I had been experiencing for years, gone. I've been to the doc multiple times since for physicals and strange moles. I also decided since I was turning 40 years old this year, it was probably time I get my mental health checked out before I started to lose my memory. As it turns out, I needed a few extra appointments.
Since I had made the maximum contribution to my HSA every year and did not use my funds, I have been able to pay for all these things with tax-free money, which also happens to earn interest since it is an investment account.
In 2017 alone, I have accessed over $20k in preventive care and immediate medical care. I wonder how that translates into future savings for not only myself but our economy as a whole. Preventive care, mental health care, physical care are vital to my individual contribution to a healthy, safe economy.
I couldn’t see beyond myself in my early years nor predict what I was going to need, but the ACA did. Even more, I didn’t take time to understand the architecture nor the premise of the ACA.
Like everything in life, it’s complicated.
For the majority of the business owners I speak to, they have limited understanding of the design and the formula. They mostly will just tell me about the cost it is to them and their business. It is difficult to have to think beyond our small ecosystems. I get it.
Change is hard. But what if we look beyond the immediate impact of our businesses and dive into the long-term benefits of proper healthcare and all that means? I hear the concern, and I want to push back. We must figure out how to philosophically wrap our minds around this investment in our country, no matter your political party.
For myself, I can cover my health insurance premium. I could pretend like it is a burden and while sometimes it certainly feels that way, I can cover it. And I am grateful.
When I have a talk with myself about my values system, this is what I say: I believe fundamental to a healthy country and a healthy economy are healthy people. We must think about the future and how to secure the health of the future. Therefore, the collective investment in healthcare continues to be a good investment. And it needs to be equitable.
I know that is easier said than done and President Obama did it despite a lot of opposition. He did it with brute force, and at the time, I scoffed at him. At the same time, I appreciate that he made it happen. He forced us to start somewhere. He forced me to think beyond myself. He forced me to engage, even if it got my hackles up.
It now begs the question, as childish and dangerous as it is, is Trump’s about-face on ending the supplemental payments doing the same thing and forcing a fix to the parts that are broken?
It pains me to ask the question. Believe you, me. But have a think. I know I am.
More to chew on: