Being a member of the press has plenty of perks, like eating hors d'oeuvres near Alec Baldwin and never having to wear pantyhose. But of all the glamorous fringe benefits of working at Connect, the sexiest by far is the medical coverage.
For the most part, I'm one of those bushy-tailed types who believes that "health insurance" should mean nourishing food and plenty of sleep, along with a sunny attitude and regular exercise. I also follow the sagacity of my Brother the Doctor, a trauma surgeon who advises that the best way to avoid a trip to the emergency room is to stay away from motorcycles, trampolines and guns.
However, accidents happen to even the most cautious of kale eaters. I'm a big fan of my plastic Cigna card because I know how even a small calamity can clean out a family's coffers:
Several years back during a stretch of unemployment, our wannabe gymnast shattered her arm after miscalculating her dismount from the jungle gym. Thanks to the crap policy we could afford back then, with its massive deductible and huge monthly premiums, our out-of-pocket costs for the surgery that required several metal screws and a brief stay in the children's ward was equivalent to a brand new minivan. We hope to have her bionic arm paid off by the time she goes to college.
I'm grateful that I now get a much fairer deal through my employer, should Little Miss Handspring decide to attempt anymore playground Olympic trials. But I know others who aren't so fortunate, many for whom a long illness or preexisting condition have wrecked their financial stability and beaten their spirits. Like that bleeding heart old lady who lived in a shoe, I wish I could claim them all as dependents.
Man, what we need around here is an affordable system that provides decent care and protects patients from suffocating bills, am I right?
In theory, the Affordable Care Act is that system, though so far in practice it seems to be performing about as well as a drunken rhino running the Rock 'n' Roll Marathon. It was disheartening to hear Health and Human Services Secretary Kathleen Sebelius eat crow last week about the ACA website glitches, but it's too early to tell whether this is gonna work. Right now we just need to know the difference between "open enrollment" and a gaping flesh wound.
The congressional chagrin over it all may have shut down the country like a nasty strain of H1N1, but I'm far less interested in politics than pragmatism. Who's eligible and how much does it cost? My current plan already serves my family quite well — do I really get to keep it? If I contract flesh-eating bacteria from swimming in the Savannah River, am I covered?
Human Resources Coordinator Jennifer Delgado has assured me that our company plan is already in compliance with the ACA and that I won't notice any changes in coverage, which is fine by me. But even if I wanted to shop around to see if I could get a better deal in the new insurance marketplace, just the thought of having to navigate healthcare.gov gives me IBS.
Man, what we need around here is someone to help us figure out what this whole Obamacare thing is all about, am I right?
Enter Bill Lucas. He's spent the last three decades selling all kinds of insurance in Chatham County and has a knack for breaking down his area of expertise for lay people. The ACA requires that every American now buys some kind of health care coverage, and to educate folks about available subsidies, plans and tax credits, he's hosting a day of free hourly classes this Sunday, Nov. 10 at the Coastal Georgia Center.
"The fact is, these new laws are going to be good for some people, and not as good for others," explained the affable agent over lattes last week. "Every individual is going to be different."
Many business owners already get an analysis of the costs of providing insurance to their employees. (Under the ACA, some companies will want to send their employees to the exchange while others will try to keep their workers on their group plan versus pay the $2000-$3000 per employee fines.) But Bill understands that no one is deciphering the laws for singles and families.
On Sunday, he and his team will provide a lit torch through the labyrinth of the government website (provided it's working) on laptops lent by Georgia Southern. Drop-ins are welcome, but pre-registration is encouraged, and there will be family-friendly movies showing if you can't find a babysitter. Should it go well, he's planning more classes throughout the ACA's first enrollment period, ending March 31. He promises he's not selling anything; he just sees how confounding it all can be.
"You'd fall asleep reading this stuff," he grins.
For instance, if your employer charges you more than 9 ½ percent of your gross income for your insurance, you want to check out the marketplace. If you're a student, self-employed or otherwise aren't offered a plan through your job, you have to buy insurance or face a fine.
(No, you cannot go to jail for not buying health insurance: Fines of $96 or 1 percent of your income will be automatically deducted from any tax return you might earn, and they'll accrue interest if not paid.)
What if you don't pay taxes and don't buy in? Well, it's not a perfect system by any stretch of rationality.
Bill points out that while the marketplace sounds like consumers get a lot of choices, it's not always the case. In Georgia, only one company is available in certain counties, and many service providers are opting out. Blue Cross Blue Shield is expected to lose 30 percent of its hospitals and 50 percent of its specialists, creating a glut of demand for already over-worked practitioners. Look forward to some seriously long afternoons reading old copies of People.
And while folks with pre-existing conditions can get covered, the flip side of the ACA is that it sure seems like it's subsidizing bad habits. The tax credits only ask about income and tobacco use, which means a 500-lb. soda-guzzling Percocet addict could pay less for insurance than the diabetic who eats his veggies and runs around Daffin Park every day.
Bill is careful not to politicize any of it, though he's happy for some kind of shift in the American way.
"I've been doing this for 28 years, and I can tell you we could not go another ten without a drastic change," he admonishes.
Even my Bro the Doc backs that up. We can't force people to eat right or wear titanium helmets on the monkey bars, but at least we can get everyone covered from catastrophe.
The Affordable Care Act may require future surgeries to bring it up to full functionality, but at least we're limping in the right direction.