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Rick Kraus

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April 14, 2014
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Obamacare turns out to be positive experience

I have been reading a lot of conjecture and rumors lately regarding our nation’s new health-care system. For instance, a recent writer went so far as to say that doctors were refusing to take on new patients with Obamacare.

The true fact is that many doctors are not taking on new patients no matter what kind of insurance they have. There are just not enough primary care doctors, especially outside of major cities. More about doctors and Obamacare later …

In the meantime, I’d like to report our honest story about our experience with the new ACA recently so that people might know what’s really happening out there.

My wife is 59 and I’m 62. We had saved up a nice nest egg and tried to retire a couple of years ago but could not because we could not then get decent health-care coverage on our own. Both of us are fit with no medical issues, but because of our age, we were first told that it would cost us over $3,000 a month for a high-deductible plan, but then the insurance company decided to deny us coverage altogether because of a couple of abnormal pap smears my wife had.

So she went back to her profession as an RN long enough to qualify for Cobra and then retired. Last year, our Cobra was costing us $1,204 per month for a $5,000 deductible on each of us, but we were hopeful the ACA would come to our rescue, and it has.

We are now living off of our nest egg and a few investments, which keep our income well below the $62,040 threshold that qualifies us for a subsidy on our health care. We are now paying $111 per month for the ACAs Silver Plan ($500 deductible each and a max out-of-pocket cost of $2,250 each). Granted, we are qualifying for a $1,214 subsidy but have a much better health plan. If we were making more than $62k per year, we’d gladly pay the full $1,325 per month for the plan we now have.

Those are all real numbers from our past and current insurance bills. We did not get any special deal or exception. We shopped and enrolled for our plan online at Covered California. Anyone who is about our age who signed up in January would have received the same deal, and I cannot understand why anyone could complain about such a deal.

We just moved here from Sacramento, so we needed to find new doctors for our new health plan. I saw my new doctor recently and am very happy with him. With our Anthem Blue Cross plan I was able to find a doctor within the same medical group (Sutter) as I had in Sacramento. So much for not being able to find a doctor to accept our Obamacare insurance. I even asked my doctor about how he decides which insurance to accept, and he said that he has nothing to do with it. His medical group makes all of those decisions for him, and he said he’s perfectly happy with that as it is one less thing for him to worry about.

In our experience, two things stand out: 1) we are able to get affordable health care after being denied it because of our so-called pre-existing conditions. I think that the ACA’s absolute best benefit is for Americans who had also been denied coverage, many of whom ended up crowding ERs (or dying at home of a major disease) for lack of basic health care; 2) my wife was able to retire from her job, which provides someone else with a job who probably needs it much more than she did. This new health plan has given her the freedom to leave a job she did not like or really want to have. So much for the government stealing our freedom.

Americans everywhere now are able to make the leap from jobs that they didn’t like, try something else that suits them better and not have to worry about health-care benefits. Why shouldn’t that be a part of the American Dream?

Rick Kraus lives in Grass Valley.


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The Union Updated Apr 14, 2014 12:34AM Published Apr 14, 2014 12:34AM Copyright 2014 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.