After much wailing and gnashing of teeth, the Patient Protection and Affordable Health Care Act, aka Obamacare, has taken effect. It’s perfectly understandable to be flummoxed beyond belief right now. But as with voting generally, it’s not OK to let trepidation and irritation keep you totally passive and uninformed. Frankly, a lot of this is win-win, administered by smart, benevolent technocrats whose guiding principle might be “More healthy people equals less paperwork for me!”
But what you want to know is, What does Obamacare mean for you?
To start off, unfortunately we don’t just “get” insurance now. Even San Francisco isn’t Japan, where amiable robots fight diabetes and life expectancy increases in real time. You do have to use your coconut a little bit. Fortunately for 39 million Californians, we live in a progressive state that gives a shit, and has been working faithfully towards the goal of a healthy populace for years now. Unlike Texas or Arizona, we have our own state exchange, Covered California, which screens all available health care plans to make sure people don’t get screwed or misled or directed to the celeb wing at Cedars-Sinai. (Covered California presents your best options sort of the way Flo from Progressive Auto Insurance does, only it’s not annoying and isn’t interested in taking your money for itself.)
Let’s say you’re uninsured. If you’re also under 26, you can stay on your parents’ plan for a while. If you’re 27 or an orphan or you earn less than four times the federal poverty level – which is to say, less than $45,960 for a single person or $62,040 for two – you qualify for at least a partial subsidy to help you pay for all this. Yes, yes, San Francisco’s obscene cost of living distorts the definition of poverty, but before you relocate to Visalia, know that the costs of premiums are coming in lower than initially projected, even as the subsidies stay the same. Tentatively, potentially, Obamacare…seems…to work.
Meanwhile, at the other end of the income spectrum, if you’re a particularly high-earning young freelancer who’s never been sick and therefore never bothered to get insurance, be aware that there is no income cap for coverage – just for the subsidy. Granted, there will now be a tax penalty for continuing to go without insurance – that’s the “mandate” that threw the whole shebang into the Supreme Court last year – but think of it as a nudge in the right direction. You were probably on borrowed time before you shot your eye out, right?
And even if you’re already insured, you should still look into Covered California because it’s quite likely you’ll find better coverage for less money than you’re currently paying. If (like me) you have Healthy San Francisco, nothing has changed immediately. You still need to re-enroll when you’re told to and you still need to slip the EMTs a fifty to drive you over the bridge in the ambulance if you ride that fixie into a plate-glass window in Oakland. But if you also qualify under Covered California, and most everyone does, you will become ineligible for Healthy SF on January 1, 2014.
Finally, you also don’t need to freak out anymore about losing your insurance because you get sick, or being denied because you were sick. That was probably the number one thing about America that made Canadians suspect it was actually run by Voldemort, and nobody can do that to you anymore. Win, again.
When thinking of why we take pains to insure everybody, one’s bleeding heart naturally turns to unfortunate people who got cancer, losing their homes and savings along with their health. In order for that to be a thing of the past, Covered California needs all young and vigorous people to participate. Think of the health insurance market as a form of social responsibility like fair-trade coffee or sustainable seafood. Throwing your healthy young self into the mix and paying for what you don’t yet need but almost certainly will someday helps achieve the very real good of affordable coverage for all.