Falling Through the Cracks in Obamacare

Note: This commentary first appeared at PennLive.com.

Mark Ferkler is a Delaware County resident in his mid-thirties. He’s healthy, gainfully employed and now, thanks to Obamacare, is newly uninsured. Yes, you read that right — uninsured.

Despite the president’s promise to lower insurance costs, as Mark found out, the Affordable Care Act often isn’t affordable at all.

Mark is a Democrat and believes health coverage should be accessible to everyone. But he’s faced with a dilemma: “I was dropped from my health insurance that was $150 a month and my boss paid half of it … Now I would have to pay over $340 a month as a single person, and I just can’t afford it!”

Simply keeping up with his current expenses can be a challenge for Mark. Absorbing a more than 400 percent increase in cost for a service he rarely — if ever — uses is just too much for him to swallow.

Mark’s reaction to Obamacare’s personal toll is hardly unique. The latest monthly health care poll by the Kaiser Family Foundation shows the law’s popularity is plummeting. Nationwide, 53 percent now view Obamacare unfavorably — the highest number yet recorded by this poll and worse even than after the disastrous launch of Healthcare.gov.

Why, after the public has finally had a chance to benefit from the president’s signature legislation, are people turning against it?

Solutions from Washington, D.C., notoriously come with strings attached.

While subsidies are available for many, Mark says he doesn’t qualify for help.

“Apparently I make too much money, and yet I can barely pay my bills as it is,” he says. “I would certainly have to change my entire lifestyle to have insurance. It’s just so hard to justify when I haven’t been to a doctor once in the last ten years.”

This dilemma is common among so-called “young invincibles” stuck subsidizing older adults under Obamacare’s community rating scheme. Left with a choice between huge premium bills or no insurance coverage, Mark reluctantly chose the latter.

“It saddens me,” he says. “Not only do I not have insurance, but I’ll have to pay a fine as well!”

A major reason for skyrocketing premiums is Obamacare’s mandated coverage for services many will never use — even if they do get severely ill.

William Cinfici from Berks County was happy with his health insurance but received a cancellation letter this year. New plans offered to him — a single, childless man — required coverage for maternity and pediatric care at a steep jump in price.

William was appalled by the patronizing mandates, saying, “They are taking my freedom away — punishing me for being responsible and saving for care.”

William also notes that higher premiums for irrelevant coverage take discretionary income out of his pocket — with real consequences: “I’ll have to postpone some things, probably deferring maintenance around my house. It’s less I’ll be spending in the local economy. You can call it a negative stimulus.”

While Mark and William were happy with their previous coverage, most would agree that Pennsylvania and the nation needed health care reform before Obamacare was passed.

But reform that’s more expensive and less flexible isn’t the answer.

Thankfully, there are options that can actually bring about Obamacare’s promises of affordability, accessibility and better quality care, but the solution doesn’t lie in more government intrusion.

Mark’s insurance premium could be more affordable if his employer was allowed to contribute tax-free dollars to a selected individual plan. It would be cheaper still if the federal government didn’t dictate coverage mandates — many that William may never use — like coverage for labor and delivery.

Further, state lawmakers can ease waiting times and improve the quality of care by encouraging more physicians to locate in Pennsylvania through House Bill 1760 — which gives doctors liability protection if they volunteer to help the neediest among us at free clinics.

And Senate Bill 1063 would allow nurse practitioners to run their own practices, as they currently can in 17 other states, improving patient accessibility.

Mark Ferkler, William Cinfici and millions more deserve real health care solutions that don’t punish them for working hard and staying healthy. They deserve more than fines and broken promises. Cost-saving solutions are out there for those falling through the cracks, but they won’t be found in the Affordable Care Act.

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Elizabeth Stelle and John R. Bouder are policy analysts at the Commonwealth Foundation (CommonwealthFoundation.org), Pennsylvania’s free-market think tank.