Unlike Some Politicians, I Don’t Want You Going Naked Come January

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Jonny Goldstein for Action Blitz

People, I’m begging you: If you’re uninsured and don’t have the option of getting health insurance through your employer, please go to healthcare.gov right now to enroll in a health plan. You have until Dec. 15 to enroll—or pick another plan if you’re already enrolled—but getting it done and over with is better than waiting until the last minute. Or just forgetting.

You do not want to forget because you do not want to gamble, with your life and your bank account, by “going naked.” (That’s insurance company lingo for what someone is doing when they decide to stay uninsured.)

A lot of folks assume they’ll have another year of good health, that they won’t come down with some awful disease because they’re young or won’t get hurt because they’re careful. That’s what I mean by gambling. You’re hoping the odds will always be in your favor, but your luck will surely run out one of these days, and it could be sooner than you ever imagined.

Even young people get very sick and need expensive treatment. A lot of them. You might be the next one. Check out the website for Stupid Cancer, a wonderful organization supporting young people who have—or are recovering from—well... stupid cancer. I had the privilege of meeting many young cancer survivors at a Stupid Cancer conference a few years. I don’t recall a single one of them telling me that they ever expected their doctor to say, “Sit down. I’ve got some bad news for you.”

You know that cancer happens to the young and not-so-young alike. What you might not know is how unbelievably expensive cancer is to treat. If you haven’t heard about how drug companies are jacking up the cost of their cancer drugs, check out this 60 Minutes segment. You do not want to be going naked when a doctor tells you to sit down.

And then there are car wrecks. As many of 4.6 million Americans were injured or disabled last year. Another 40,000 died. And we know all too well that people on bikes get hit by cars and trucks. I bet not a one of the injured or killed woke up one morning expecting calamity. You do not want to be going naked in a car, on a bike or even when crossing the street.

Naked people who survive sickness and injuries often wind up in bankruptcy court. By some estimates, more than 600,000 Americans file for bankruptcy annually because of medical debt. And as CNN noted in a recent story, “unlike other causes of debt, medical bills are often unexpected, involuntary, and large.” If there is good news here, it’s that the number of bankruptcies has fallen 50 percent since the Affordable Care Act, a.k.a. Obamacare, was enacted.

You might be thinking, well, I hear you, no one is invincible, but I just can’t afford the premiums.

The good news here is that you probably can. Despite what you might have heard from certain politicians and media types, health insurance is affordable for most of the currently naked. And it’s available to people everywhere in the country, which wasn’t the case before Obamacare, when insurance companies could declare you “uninsurable” because of a preexisting condition or recent diagnosis. When you got that label, you were out of luck, regardless of the size of your bank account.

Video credits: Brian Stillman, Maryclare Demenna and Lindsey Hope Pearlman for Action Blitz

Yes, it’s true that premiums will be higher for most people next year, but it’s not because Obamacare is collapsing (although some politicians are trying to make that happen, just as there are other politicians who are trying to stop them.) The truth is that Obamacare in many regards is more “stable” than ever now that insurers have a better sense of how to set premiums to more than offset the claims they have to pay. And it’s worth noting that a big reason for 2018 premium increases has been the uncertainty of what politicians bent on doing harm to Obamacare would be able to do. Many insurers set premiums based on a worst-case-scenario.

So please know that but also know this: Premiums in the individual market were in many cases going up much more dramatically before the Affordable Care Act was passed. I know that from my own son’s experience. In late 2009, the year before the ACA went into effect, his insurer, Blue Cross, sent him a notice that starting the next January, his premium would go up 65%. And he had been healthy and injury free the whole year. Lord knows what it would have been if he’d had high medical bills in 2009. Blue Cross hit him and many others with that enormous increase because they could (and because they really can’t control rising medical costs, despite what they would like us to believe). There was no law against it back then.

Know this, too; especially this: Eight of 10 people enrolled in an Obamacare exchange plan get financial assistance from the government to cover or help cover their premiums. And for most of those people, financial assistance is also available to help cover their out-of-pocket (OOP) expenses. Even if the Trump administration carries out its plan to end the so-called Cost-Sharing Reduction payments to insurers, insurers are still obligated to help eligible enrollees meet their OOPs. That can’t be changed with an executive order.

You probably haven’t been hearing as much about open enrollment this year as you did last year. That’s why I’m writing this. The current administration is spending only a tiny fraction of what the previous administration spent on advertising and to pay navigators to help guide people through with the health plan selection process. If you need help with that, check out healthinsurance.org or similar website that offers guidance. (Disclosure: I have written for healthinsurance.org’s blog. And I’ll be writing more about it at Tarbell.org, which you’ll want to check out.) And watch this little video about open enrollment created by the fine young volunteers at Action Blitz.

Nakedness has its place. This isn’t one of them.

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