The Affordable Care Act: What is Going On?

Since the passage of this act, the actual program itself has been going downhill, fewer benefits, and higher premiums each year. So, every year the deductibles, max out of pocket and monthly premiums have increased. Some years the premiums go 15-20% and other years a reasonable 5% increase happens. The problem is most Americans can’t afford the coverage.

When the deductibles increase to over $7000 and the max out of pocket goes to $8150, the question we need to ask is what are we trying to accomplish?

Protection and reasonable costs associated with providing our families with health insurance is what we should get but with deductibles and maximum out of pocket rising annually is this really insurance or is it just a way to prevent a catastrophic condition from bankrupting us? I suggest the latter. There is nothing wrong with a high deductible plan if you can afford the cost to get to the deductible. Let’s face it, unless you are hospitalized you will never reach the deductible much less the max out of pocket. Also, many Americans can’t afford even that.


The real issue is Congress has their best coverage we Americans can afford to pay for them, but they don’t provide the same coverage for the rest of us. It’s time to change things by demanding that Congress become part of the Affordable Care Act and when they see how bad it’s is, perhaps they’ll make the appropriate changes necessary to fix it? We are only talking about individual coverage as group coverage is a lot better. Why do we allow Congress to have the best coverage and they don’t provide the same for us? They seem to forget they work for us, not the other way around.


We need to start a grassroots movement to get Congress to listen. This blog is a tiny step in that direction. Everyone who reads this should pass it on to their friends and so on. The more people that see this and agree, the more people on our team. We need to get this message to our elected officials and tell them that if they don’t help us, they will not be re-elected.


So, what must we buy for coverage and why? The high deductible type plans are the only ones we can afford unless we want a second mortgage type premium payment. These plans have their place, but most Americans cannot afford anything else. Thus, by default, the high deductible plans are what most Americans can afford and that is the shame called ObamaCare or the Affordable Care Act. A middle-aged couple between 40-50 is paying almost $1200 per month for a decent plan with a lower deductible and lower max out of pocket than described above. The only thing this law has accomplished is eliminating pre-existing conditions. Nothing else.


We used to have better coverage and lower premiums then we have today. We had better doctor networks with nationwide coverage and now the networks are local only with no coverage outside your home location.


If you do go out of network it has to be for an urgent or emergency situation and you could have some balance billing, meaning the cost incurred won’t be picked up in its entirety by your insurance company leaving you with the balance to be paid by yourself. Not what you were promised originally when the law was enacted.


It’s time to act as 2020 is an election year. Will all the hype of the upcoming elections perhaps it makes sense to approach the challenger’s and talk to them about making the Congressional health insurance plan available to all Americans. This would change the dynamics called the affordable care act and fix the problem once and for all. After all, do you think Congress would have a bad health insurance plan as we do? Not in this lifetime, that’s for sure.


Wake up America as we have a chance to fix the problem if we all work together with a common goal of making our health insurance work for us again.

The Barend Agency Inc.

Len Barend, broker




Comments are closed.