NEW YORK — Stacey and Eddie Albert lead pretty healthy lives. She’s a nutritionist. He’s a personal trainer. They rarely go to the doctor, other than their annual physicals.
For years, they were covered by Horizon Blue Cross Blue Shield of New Jersey. In 2013, they paid about $360 a month for a plan that met their needs.
That all changed the following year, when Obamacare took effect. Their premium shot up to around $650 a month for a policy that came with pediatric dental coverage and maternity services — benefits they didn’t use or want since they don’t have kids. They ended up dropping the plan after several months and even went a year without coverage for the first time in the decade they’ve been together, exactly the opposite of what Obamacare was supposed to do.
The Neptune, New Jersey, couple recently re-enrolled in a policy that costs about $700 a month. They feel it’s too much of a gamble to be uninsured, but wish they could go back to their pre-Obamacare plan.
“It took care of what we needed,” said Stacey Albert, 38, who owns Ultimate Fit Zone gym with her husband and earns too much to qualify for Obamacare’s federal subsidies. “We didn’t use it that much. We just don’t want to pay for all that coverage.”
The now-shelved GOP health care bill was geared toward stripping away Obamacare’s requirement that insurers provide only comprehensive coverage, including mental health, maternity, medication and preventative care. Republicans argue that Americans have the right to choose what benefits they want covered — including very few services in so-called catastrophic plans, which have low premiums.
Those skinny plans suited some Americans just fine. Many didn’t even know the limits of the pre-Obamacare plans because they never used enough services to become aware of them.
“They made the Affordable Care Act so ridiculously overbuilt that it’s killing people like me who pay for it,” said Tom Buxton, 59, of Littleton, Colorado. “I don’t need two doctor visits a year unless I want them. That should be my choice. I didn’t go to the doctor for five years.”
A self-employed business consultant, Buxton used to pay $666 a month for a policy for him and his wife, Jennifer. Each had to pay a $3,000 deductible before coverage kicked in. They paid out-of-pocket for the few medical issues they had.
After Obamacare began, their insurer, Golden Rule, offered them a plan for $1,200 a month with a $6,500 deductible each. Unwilling to pay that much, Buxton searched for alternate options. This year, the couple is covered through Medi-Share, offered by Christian Care Ministries, which meets the criteria for coverage under Obamacare.
“I was trying to find [a policy] that didn’t cost me $1,000 more for less coverage,” he said.
The couple pays $560 a month, with a $5,000 deductible between them. The catch is that it doesn’t cover any pre-existing conditions for the past three years, so Buxton has to pay for physical therapy stemming from the hip replacement and shoulder surgeries he had last year. But he’s okay with that.
For Greg Silvestro, the policy he had prior to Obamacare and the one he found on the Florida exchange for 2017 were pretty similar — both have deductibles of about $7,000 and wouldn’t be used much.
But there was one big difference: The Obamacare policy costs $338 a month, more than three times as much as his old plan.
“To me, it’s the same thing: catastrophic coverage,” said Silvestro, 40, a real estate agent and gym owner in Tampa.
He begrudgingly signed up for the Obamacare plan, but the huge price increase forced him and his wife to curtail their spending and standard of living. (A public school teacher, his wife is insured through her job, but it would cost $500 a month to cover him through her policy.)
The high premium also prompted him to look for alternatives. He learned about Medi-Share a few weeks ago and joined it. He now pays $188 a month for a policy with a $5,000 deductible.
“The bottom line is the fact that the coverage of all these plans is basically the same for me,” he said. “However, the cost of Obamacare is substantially higher.”