Insurance choices: Pay to play or pay the fine?

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Updated Oct 2, 2013
The insurance plan exchanges are run by the states or, in states that opted out of the program, the federal government.The insurance plan exchanges are run by the states or, in states that opted out of the program, the federal government.

For owner-operators in certain situations, Obamacare will solve some health care financing problems. It also creates an unprecedented health care financing problem – fines – for those who want no part of health insurance.

Some of the clients of owner-operator financial services provider ATBS will find the ACA policies to be “something they can actually afford, with the subsidies they could qualify for,” Andy Erwin, ATBS tax manager, told me. A key factor will be that “they can’t be penalized for pre-existing conditions,” he says. “For guys with sleep apnea, high blood pressure, it may have been impossible to buy insurance before.”

Premiums vary widely by plan level, family size, age, income-based tax credits and, to a bizarre degree, where you live. Assume a family of four with household income of $50,000. Using the tax credit, the cheapest (bronze) plan’s premium would be $26 a month in Dallas-Fort Worth, $126 in Orlando and $209 in Pittsburgh, reports the Associated Press.

Most owner-operators will not find anything close to $26 a month.  As Erwin notes, the average age of ATBS clients is 55. Their smoking rate is well above average, and smokers automatically pay a higher premium.

obamacare finesMany owner-operators are unsure about what to do regarding the program. Some who lack health insurance are opting not to participate and pay the fine. The chart here shows the kind of money we’re talking about – and more alarming, how much it escalates by 2016. “It becomes a different decision every year as it goes up,” Erwin says.

Overdrive Senior Editor Todd Dills will report on the program in detail in our November issue. In the meantime, if you don’t have a qualified health plan, it’s worth checking Your answers on simple questions will help you determine your basic options depending on your state of residence, income and other factors.

Another helpful source is the Kaiser Family Foundation site. It has a subsidy calculator and presents lots of information clearly.

Many people would rather endure a dentist’s drill without Novocain than wrangle through insurance plan comparisons or submit to a government that makes you pay for what it thinks is good for you. Whatever your stance, Obamacare doesn’t appear to be going away. If you’re uninsured, learn the ropes and make an informed choice.





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