aaronstonemd
Jul 10, 2017 · 2 min read

Cobra was insane from the day Bill signed it into law. I remember thinking this is nuts they will just charge so much people will not be able to buy it. I also remember Bill acting surprised that the Cobra premiums were so high. Duuuh. I know people who currently forego Cobra coverage between jobs because they can’t afford it.

So in 2009 before obamacare you paid about as much as I did for health insurance and I have no pre-existing conditions and take no medications. However after obamacare my premiums doubled and each year I would lose my insurance every December and have to scramble to find a new plan. Maybe this will be the first year that I will not lose insurance in December but it is the first year that I have insurance that I would never have agreed to buy before Obamacare. When I had the no deductible no copay health exam on the ACA I calculated that in the old system with me paying directly out of pocket for the service I would have saved money vs. the doubling of the premium over a year or 2. Adding insult to injury the doctors would also have made more money off the service as they would not had to bill an insurance company, appeal denials for payment etc.. There was a period of time when insurance would not cover a pre-existing condition for a year and then would do so in the second year of the policy.

The problem seems to me to be the cost of care and the lack of portability. You and your family pay into the system for years but you move, change jobs, etc. and they act like you never paid into the system. The ACA did nothing to change that and in fact made things worse by adding taxes to prescription drugs, health insurance policies, medical devices etc. at a time when more of the health care costs were being shifted onto patients’ backs. There has to be a way to build up healthcare dollar equity as you age that is transferrable within families and we need to get rid of the Obama and other mandates the needlessly increase the cost of delivering healthcare. This is a ticketing time bomb because the combination of MACRA and ACA is going to be crushing when fully implemented. You know a law is trouble when it has to be implemented over decades because of the likely fallout.

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