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Douglas Fox is a freelance writer based in Northern California. He has written for Discover, National Geographic, Popular Mechanics, Scientific American, Esquire, New Scientist, The Christian Science Monitor and other publications. His stories have garnered national awards from the American Association for the Advancement of Science (2009) and from the American Society of Journalists and Authors (2011), and have appeared in The Best American Science Writing (2012), The Best Technology Writing (2010) and The Best American Science & Nature Writing (2009).

One response to “Survey Results: A decade of health insurance hell for freelancers”

  1. David Kline

    Thanks for the survey. But as freelancers will soon discover, those presumably lower premiums for ACA plans (in 2014 anyway) could well be offset by changes to coverage that most people don’t know about.

    Most people have heard that the provider networks are much smaller under ObamaCare — the LA Times estimated they were only 1/3 to 1/2 as large as individual insurance networks prior to the launch of ACA-compliant plans.

    But what most people don’t know is that the drug formularies of medicines covered at beneficial rates are also much narrower. In my own case, two brand-name drugs that I’ve been taking for years and paying $40 each month for under pre-ACA insurance plans are no longer considered “preferred.” That means the insurer will will only pay 50% of the retail price — in my case, leaving me to pay $130 of the $260 cost of each drug myself going forward.

    In other words, although my premiums are $100 less per month for my new ACA plan than they were previously, I’m paying a minimum of $180 more per month for my medications.

    And it’s not so easy to switch to other meds. In many cases, people with blood pressure, high cholesterol, diabetes, rheumatoid arthritis, cancer, and other chronic conditions spent many months working with their doctors to find the one drug that worked best for them. You can’t just lightly go switching to a generic drug similar to what you’ve been taking for years. And many of those drugs cost thousands of dollars retail, not $260 like mine do.

    Then there are the new coverage rules for labs, xrays, and other imaging under ACA plans.I have been buying individual insurance since 1973, and in all that time, labs and xrays were always paid by the insurer at the standard 80% (or whatever) rate. But now, under most ObamaCare plans, coverage kicks in for these procedures only AFTER you have fully paid your deductible.

    In other words, people will be paying full retail for all blood work, labs, xrays, and MRIs until the have eaten their deductible — which for most freelancers, I imagine, will be at least $2,500.

    Imagine having to shell out $850 or $1,000 for an MRI now, and you can see how ObamaCare’s “better premiums” don’t mean a helluva lot if you simply can’t afford a basic procedure like an MRI after injuring yourself running or playing tennis.

    Finally, there are the premiums themselves — specifically, how high do they go in 2015 an d beyond given that nowhere near 40% of enrollees in ACA plans are young and healthy, as the administration hoped. In fact, the majority of enrollees to date are 50-64 years old, with very few of those insured in new ACA private plans being 18-34 and healthy.

    So the real cost-benefit of ObamaCare has yet to be determined. True, for the very poor, ObamaCare is a godsend. But a lot more dominoes have to fall before we know how it will all shake out for freelancers in particular, and the middle class in general.

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