Channel 19

Todd Dills

Obamacare case analysis: Stick with the wife’s insurance

| October 14, 2013
This image greets visitors to the HealthCare.gov central portal for applications for insurance purchased through the public exchanges mandated by the Affordable Care Act, or "Obamacare." Best estimates of the cost of coverage for your particular situations, without going most of the way through the application process, can be found via the Kaiser Family Foundation's costs/subsidy calculator, though only Silver-level plans are estimated there.
This image greets visitors to the HealthCare.gov central portal for applications for insurance purchased through the public exchanges mandated by the Affordable Care Act, or “Obamacare.” Best estimates of the cost of coverage for your particular situation, without going most of the way through the application process, can be found via the Kaiser Family Foundation’s costs/subsidy calculator, though only Silver-level plans are estimated there.

Michigan resident Michael Wright was looking to newly re-mint his owner-operator business after a year driving a company truck with a partner working the North Dakota oil and gas fields hauling a tanker this fall. When I talked to him a day after the Affordable Care Act’s health-insurance exchanges opened, with no shortage of reported problems, Wright was in the process of purchasing a 2005 Western Star 4900 series with a 68-inch sleeper, powered by a 490-hp Detroit and a 13 speed transmission.

He was fairly certain everything would go forward as expected re: the loan for purchase, and following that, he and his business partner planned to run the rig, hauling fracking fluids in a tanker owned by the company he’ll be contracting with there. What he wasn’t certain about at that time: whether or not the 48-year-old’s health insurance would be available at the same rate – about $400 a month out of pocket, secured via his wife’s membership in a group plan offered by her employer, which pays for 50 percent of the premium for an overall cost of $800 or so. “She’s been there 25 years,” says Wright. “We’ve been informed it’s going up 130-plus percent this month. If that’s true, it’s going to be painful.”

Related: Obamacare exchanges open, drivers sound off

In such a scenario, the couple would be looking at monthly out-of-pocket premium expenses well over $900 monthly to continue to participate in the company plan – Wright has been exploring other options. He says he searched plans available for himself using this calculator at a government site in Michigan. Inputting the basics of his and his wife’s ages, place of residence and income in that calculator yields a range of “gold” level plans, comparable to what the Wrights have now with 80/20 coinsurance, yields a $721-$1,634 range in potential monthly premiums. Wright, however, is a smoker – the Michigan calculator estimates an 18 percent surcharge for smokers, but the ACA itself allows as much as a 50 percent surcharge. What the surcharge would be depends on the insurer and plan, ultimately.

That $721-$1,634 range boosted by 18 percent: $851-$1,928

By 50 percent: $1,082-$2,451 

Poll: How is Obamacare affecting your 2014 health insurance preparations?

Under that calculation, Wright’s likely better off sticking with his wife’s company plan even with increases that come, such as they may be, though given overall costs, if the lower half of the estimated range is in fact equivalent to what his wife’s employer is offering, it’s tempting to see an incentive for employers to flee from company-provided group coverage. Keep in mind, for those with access to employer-provided coverage, there’s unlikely to be any subsidy/tax credit available to directly reduce premiums. And besides, the Wrights make too much yearly to qualify for subsidized premium reduction, likely to be the case for most in this audience.

Other calculators get into more exact calculations, such as that at the site of the Kaiser Family Foundation’s, endorsed by HealthCare.gov, the ACA exchanges’ official hub. However, that calculator only shows estimates for Silver (70/30 coinsurance) and Bronze (60/40) level plans. Inputting Wright’s information there yields an estimate of $8,801 in annual premiums for a silver-level plan, or $734 per month, $6,595 for a Bronze plan, or $549 a month. Coverage levels with both plans are not equal to what Wright has currently, however. Assuming a more costly Gold level plan, he’s likely better off sticking with is wife’s employer-provided coverage from the premium pricing perspective. 

What’s your case look like? Have you seen success or had trouble attempting to enroll via the public exchanges, which some tech experts are reportedly considering calling the “highest-profile and most complete failure on a major web launch” ever, given widespread technical problems… Tell us here or email me at tdills@randallreilly.com. 

  • Roy

    Give all the numbers, not just if and buts.

  • Todd Dills

    These are all the numbers, Roy, for this case. Problem with all this stuff is you don’t know what the final outcome will be until you go through the application process officially. I see why it’s frustrating for users, computer glitches or not. More on that later. In terms of missing numbers, as you suggest, what do you want to know and I’ll see if I can find it?

  • cincar

    obama is crazy no body have money four trush

  • safetygirl

    I looked.
    Right now insurance is going to cost me $1200-$1400 for a family of 3. I will pay about half if my employer continues to subsidize the family coverage and not just mine (which they arent required to do and may quit doing because of the cost increases) If I quit my job I can get family coverage for under $200.
    I know I am not the only one facing this scenario. I manage our plan at work and see a number of people who buy insurance for a domestic partner or partner and children. Those people will probably go off their partners plan and apply for the subsidy as an individual without income or much income.
    We have another economic group of people 60ish looking at retirement but they keep working because they need the insuance. They will no longer have a reason to stay in the workforce if they are the spouse working just to keep medical coverage.
    We have a lot fewer young people who refuse coverage that will suddenly take it, and of those even fewer who will consider the consequences to their taxes at the end of the year if they don’t take it. They mostly live in the moment.. thats why they don’t have any medical insurance.
    From the looks of things this is going to be a national disaster.

  • safetygirl

    I think you should add another answer to your Obamacare poll;
    Yes, in light of the comparison between my employer plan costs and the available subsidy if I dont work, I’m going to quit my job and buy throught the exchanges so I can qualify for a subsidy.

  • Trucker Wife

    no one is really going to honestly answer the smoking question – in Maryland they’re not even bothering to ask because they know everyone will lie. I work for an insurance broker and have seen the new plans – for most people with insurance already, they’ll be taking a step down in coverage. And unless you qualify for a subsidy, you’ll also pay more. There is nothing affordable about “affordable care” – unless you’re getting something for nothing, which guarantees you’ll continue to vote the party line and the rest of us will continue to see increases in taxes everywhere to pay for someone else’s benefits. Maybe one day the overtaxed working class will say “enough.”

  • Anna Lowdermilk

    We’re still waiting on identity verification. Healthcare.gov wouldn’t verify identity online so we had to submit documentation. That’s been about a week ago. It took until then for us to get that far in the process!

  • C.L. White

    Who cares if people stick with the health insurance they already have. Obama are does not force anyone to drop wha,t the,y already have. It’s a non issue and a phony issue.All you boycotted Obama haters need to get a life.The billionaires are the ones screwing us all.Damon fools.

  • Stormy

    I quit social media because of all the spying. I am going backwards on technology and refuse to use any online services or the cloud. I limit phone calls and no longer send personal emails Technology was great but it is now a weapon being used to take away our right to privacy. AND they want me to enter the most private information about myself into a non -working computer system so my information can be hacked and shared with anybody that decides they want to see it I don’t think so. I am sure they put as much attention to security as they did to having a reliable website. With all the problems how do you even know you are on the right link and haven’t been directed to a mirrored website? I am sure the administration would be outraged and somebody would be held accountable…. well, at least until the next crisis that causes outrage throws this outrage into all the previous outrages. Sorry, not today and probably not tomorrow either.

  • Phil

    C.L. – You’re exactly right. But this is Overdrive and they are here to stir up the Obama hate and talk down affordable health care. If it’s not Todd Dills, it’s Wendy Ride-A-Long. The owner operators need this most since they don’t usually have a company health care option. But what’s really telling are all the people signing up and flooding the healthcare.gov website. Guess the Obama haters don’t hate him TOO much. And if you look at the stats that have been compiled so far, a majority of the people signing up are coming from the red states whose people/politicians voted against it. I’ve already talked to friends (drivers and non-drivers) who have gone through the application process and discovered they’ll be paying less. And like you said, if you want to stay with your current care, you can. But I guess these people think the billionaires need more help.

  • lyndapeace

    What about people who don’t have coverage at all? Is it affordable? Or is it cheaper to pay the penalty. What if you are a divorced owner operator w/kids and you don’t have a current plan from work or a partner who has a plan that you and your kids can ride on? What about those of us who need insurance will it help us?

  • bigred

    Hey C.L.,,,what does Obamacare mean to you??some billionaire or our Muslim president, you dumass.

  • bigred

    And for CL and the rest of you dumbass Obama lovers. I am an owner OP with my own authority. I am grandfathered in with BCBS in TN. My NEW Insurance with just me will run me 328 bucks a month with a 6k deductible and instead of 80/20 coverage it goes to 100% coverage. Stick that in your OBAMACARE pipe and smoke it. I can afford this, can you afford your OBUMMERCARE plan?????

  • bigred

    This is to PHIL>>>NOt one sole in the TN> red state has signed up so far and very few anywhere according to the stats but you better read on, this initial price goes up every few years and all you will do is pay for the people that can`t afford insurance. It`s a tax, you idiots, period.

  • Todd Dills

    I’m not trying to stir up Obama hate, Phil — sorry you think so. This is just one case. I’d love to talk to others who’ve gone through the entire application process if you might be able to refer me to some others. Here’s my email if you might help me connect: tdills@randallreilly.com.

  • Todd Dills

    C.L., This is just one case, and I’m no “Obama-hater”, as you say. However, some existing plans, such as the quite common catastrophic-type, low-premium, high-deductible plan purchased on the individual market, are not going to be sufficient to satisfy the whole “minimum essential benefits” portion of what the ACA requires of plans to satisfy the requirements of the individual mandate. Folks who remain on such plans, in some cases, have been told they’ll still have to pay the penalty, for instances. Purchasing on the exchanges, they’ll be getting better, more robust coverage, but it may well cost them, depending on their income. Again, just an example of a particular kind of case. So much of this depends on individuals’ situation.

  • Marc Ballard

    Folks, I’m an insurance broker that works with MC’s and their OO’s and our research(backed by ATBS)shows somewhere between 40-60% of owner ops WILL qualify for subsidies on the marketplaces. This case study went the other way because his spouse worked. For those of you that have a non-working spouse or even a working spouse, you should do yourself a favor and at least determine your best route. We’re finding many oo’s don’t think they’ll qualify for subsidized rates because they make too much. Note- subsidy eligibility is based on your families modified adjusted gross income(MAGI) and NOT your gross income. A family of 4(that makes 50K MAGI) can get a decent plan for somewhere around $250/mo. I bleed “red”, but do think it’s important to get facts out there…especially for the drivers that have tried for years to get a medical policy and because of their health history have settled on limited medical plans offered by their carrier. We work with fleets all over the US in trying to educate on the law and help their OO’s know what’s best for them….and at no cost. Amazingly, we’ve had several MC’s slam the door in our face as they viewed us as cheer leaders for Obamacare….and said all their guys would rather pay the penalty or make too much money.
    Questions on our service or need help with the law marcb@healthytruck.org

  • safetygirl

    “When the people find that they can vote themselves money, that will herald the end of the republic.”
    My father used to quote this and attribute it to Ben Franklin. I have since heard it attributed to Alexander Tyler.

  • g

    Obama has “Nationalized” health care….plain and simple. It Was free enterprise capitalism, free market…The American Way…..NOW it is a “Utility”…..monitored from top to bottom and every American Citizen MUST answer to the BEAST.
    It is NOT a free market…AND you WILL PAY if you dont participate……….hardly THE AMERICAN WAY.

  • g

    Oh you will PAY allright…or go to debtors Prison..which will be the logical extension of this Hitler Plan. Americans are FORCED to particpate……obama knows best…….Wow…this is a severe erosion of FREEDOM of choice….and this is just the Beginning. Americans need to join the TRUCKING business if the want to see MORE total dominance, control, and ABUSE!!!

  • g

    If Obama had a SON……he would sign up right away and declare his Low Income and pay nothing……this is another FRRE RIDE fo dee po…………and stick it to the Working Folks to PAY and PAY and PAY……once they initiate this crap and get Corp hands around our collective Throats the Premiums will go UP and UP and UP……just like the GAS and DIESEL prices….this is the “arab oil embargo” of 1973 all over again…..just the begininning of the PINCH.

  • g

    Americans are being “prepped” like the truckers have been for years…..OBEY! CONFORM! COMPLY!
    You WILL do as the Gov. Orders you to do…..You WILL purchase this CRAP!!!!!!! You have NO CHOICE in the matter!!!! OBEY!!!!!! Total Dominion!!!!!! Welcome to
    Hitler Tyranny!!!!! OBEY!!!!!! JAILS will need to house those who do Not COMPLY!!!!!!!

  • guest

    Theycould have floated this “program” for a year or so where we could investigate and determine if it will work in our benefit…then bring it to a National vote..intead they rammed it to us insisting THIS is what we want and need and THAT is un AMERICAN. We have lived a long time without Obama and his “brilliant” ideas…..he needs to CONSULT the AMERICAN PEOPLE whom he was elected to REPRESENT not DOMINATE! People are STLL trying to get ONLINE to “browse” and investigate and Obamas “brainchild” in Non Functional……Obama knows best?? Do we need a Babysitter???

  • guest

    I agree….the premium will Increase you can bet on that….this lowball price is just to slip this bad puppy over our heads….the Working Man will PAY or Get Taxed and the Poor Folks will pay Nothing..as usual..so we are Paying for Health Welfare…..AND the Obama Food Stamps…..its a Rip Off as usual.

  • g

    You are So Right…as soon as you enter all your personal Data into this Non Functioning computer site….Jose and Pepe will have New Id’s……..
    for a few bucks any interested party will find out all your Health information too…just like the Motor Vehicles Dept…..they SELL CDL’s to illegal aliens!
    They will be happy to give away your privare info..for a fee.

  • g

    How Horrible…What a Nightmare….the system doesnt even WORK….and they some anonymous message says to send Your Birth Certificate and photo of SS Card, Driver License………all kinds of fun…..compromising your identity..when identity THFT is the fastest growing crime in America????

  • g

    Totally..we can rest assured of That!
    I would imagine the Sophisticated Doctors will
    find another line of work….ive heard these Socialized programs are like going to a medicine man on an Indian Reservation!!! They will have no SHORTAGE of “doctors” brush up on your Spanish!! Illegal aliens with fake credentials will be tending to YOU!!!

  • g

    Yep Todd..they purposely set it up so we cant browse without Entering Identification data….this raises suspicion right away…Plus the dumb system is Broken Down nationwide nobody can get it to work….I imagine the Smart Doctors are turning in their Licenses and seeking other employment…seemslike a major LOSER.

  • guest

    The ignorant “system” doesnt work to begin the process…imagine trying to get an Appointment to be seen??? This seems like a Nightmare already..and it is for Millions just trying to enter the system!!! What a Hoaky ration of CRAP.

  • guest

    ..So the poor Folks dont pay a penny..but they Do get a Health Plan??? …and the Working Man DOES pay one way or another and also goes out and busts his ass everyday??? So it is actually A health Welfare program financed by the Working People??? Wow! Maybe we can meke the Welfare crowd a bit more Comfortable??? As if WE had a pot to Piss in???? The working class in America seems alot like the Russians…..

  • guest

    Each day this Gov. slams it to the Working Class..but the Poor and the illegal aliens get MORE and MORE and MORE…The Working Class is paying for ALL of this.
    It is painfully obvious in the Trucking Industry…..HitlerCops observing, monitoring, collecting “data”..demanding MONEY……The Wealthy and the Gov take turns kicking the Working Man in the ass! Kind of funny…but true.

  • safetygirl

    Well, what I have learned helping with a business in Canada is that all of their workers come to a new job wondering what kind of supplemental insurance you offer as a benefit. It turns out that socialized medicine is a lot like medicare. It does not pay for much. If you want coverage you have to have additional insurance or risk losing your shorts.

  • safetygirl

    I am guessing that a few years after the ACA is up and fully implemented the private insurance companies will experience resurgence. Obamacare will just be an extension of price fixed medicare paying doctors and hospitals pennies on the dollar. If folks want care they will have to pay for it… or buy a suppemental medical policy. Obamacare is just another social security tax fund that the politicians can borrow from to promise more stuff to more people to get more votes. At this rate the national budget will have to topple. There are not enough working private business people to keep it upright for long.

  • Stormy

    I am by no stretch of the imagination a computer expert but I was able to hack into the electronic medical record site my doctor uses and read my significant other’s (with his permission, of course) information. California had their site left open for a day so anybody could look up anybody’s record.
    If I could find my way in, a professional hacker could get in, sweep all the information, sweep your bank account then disappear in less than 24 hours.
    Am I paranoid… sure am. Did I ever imagine a day would come when the government would be storing my emails, phone calls, contact lists, tracking me by GPS and taking pictures of my mail? Never did but sadly the upcoming generation will think this is the way it should be and always will be.
    We don’t need immigration reform, Obamacare will give Jose and Pepe citizenship.

  • Stormy

    Go out there, Roy, put in your information and get your numbers. Todd can’t give you numbers that live in a computer that won’t even let you put your numbers in.

    Unless you want to post your information on this discussion. You may as well, it is as secure here as it is on the government website

  • Stormy

    If they don’t do something about tort reform a lot of doctors will be losing their license along with everything else they own.

  • guest

    Quit working and you will get the dumb “program” for free. This is a Welfare program. The working class will be Paying for the Welfare Class to have Insurance so they Stop going to the ER and cost hospitals a FORTUNE. It is NOT out of the goodness of Obamas generous heart. Hospitals are going BROKE as ilegal aliens and poor folk get treatment in the ER. Plain and Simple. hospitals are BROKE. This is supposed to make Sure everyone possible carries INSURANCE….why else would Obama give a Damn?? This will insure POOR Americans at th expense of WORKING Americans.

  • g

    Yep and when you go to the “OBAMA DOCTOR” he will install a monitoring CHIP in your body as soon as possible. The government knows best..Dont Resist!!! Comply, Obey, take these “medications”……..

  • g

    Yep Someday…until then…this program is FREE for the POOR and the working class is paying for it…as more poor folks mooch onboard the PREMIUMS for the WORKER will skyrocket.

  • g

    Oh Guaranteed….this will be a nightmare…imagine the “waiting rooms” filled with foreigners and the “doctor” of course will be from India or Pakistan..watch for the American Doctors run for the hills….”socialization”…oh pllllleeeeaze. it will be disgusting you can bet on that..like Cattle at the Trough…with a 3 month waiting list.

  • g

    You can bet no Rich person is going to be at one of these Socialized “community clinics” waiting in a Packed rooms with SICK coughing hacking people spreading who knows what Typhoid fever……suitable for Farm Animals….Opt OUT and be glad you can PAY not to go for treatment by Government Hacks!

  • g

    government employed “doctors” newly arrived from their tents in pakistan…experimenting and installing CHIPS in unsuspecting patients…….it wont be good!

  • g

    Pay the tax or they chase you down the street with a Butterfly Net…….pay and be glad you got off so easy.
    Dont go in one of those Clinics where they will “practice” on you……throw the tax money at them and run……..

  • g

    no rich man is going to walk into one of those Gov run dives and let some Pakistanny start hacking on him……
    THIS is why Congress wants to OPT OUT!!!!!!
    They know it is a NIGHTMARE!!!

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