Wednesday, January 14, 2015

Not Everybody Wants a Taxpayer Handout - Pride Is Slowing Obamacare Enrollments Among Some in Year Two

This is from Kimberly Leonard writing at U.S. World and News Report:
Grace Brewer says she never thought she would be without health insurance at this stage of her life. "I'm a casualty of Obamacare," says Brewer, 60, a self-employed chiropractor in the Kansas City, Kansas, area.

She wanted to keep the catastrophic health insurance plan she once had, which she says fit her needs. But under the Affordable Care Act, the government's health care reform law, the plan was discontinued because it did not comply with the law's requirements, and her bills doubled to more than $400 a month. "I wanted a minimal plan and I’m not allowed to have it," she says. "That seems like an encroachment on my freedom." 
The Affordable Care Act requires everyone to buy insurance or pay a penalty. Government subsidies can reduce costs for low- and middle-income Americans and without them, many say they could not afford insurance. Americans qualify for subsidies if they are under the age of 65 and have an annual income of up to $46,680 as an individual, or up to $95,400 for a family of four.

Though Brewer could pay less for a plan if she were to accept a subsidy from the federal government, she refuses. "I want to pay my own way," she says. "I will not take a handout." 
Her sentiment is unusual, but brokers say they do hear from clients who are eligible for subsidies – which are based on household income and not assets – but want no part of them. Health officials have been boasting that 6.6 million people have enrolled in health coverage through state or federal marketplaces created under the Affordable Care Act, but in sharp contrast stands a small group of Americans who say they want nothing to do with the plans, even if they would save money. Their reasons vary: Some are protesting Obamacare, while others simply feel it's unethical to accept taxpayer dollars to pay for health insurance. ...

For Brewer, buying a plan on her own would mean she would not have enough to pay for housing, she says, so she chose not to be insured this year and will have to pay a penalty in her 2016 tax filing that is likely to be 2 percent of her income. She has no dependents, is healthy, does not use prescriptions and says she has been careful about her health choices, not overusing medical care.

"I am frustrated. I am angry. And I say 'no' to the exchanges," she says. "Somebody has to stand up and this is the only way I can do it. I will not be signing up under duress. I’m taking care of myself." 
Dave Klemencic, 55, also has chosen to go without health insurance. He could receive a tax subsidy, but says on principle he will not, adding that he does not believe it's in the best interest of the country.

Klemencic, the sole proprietor of Ellenboro Floors in Ritchie County, West Virginia, says he sees the federal subsidy program as welfare, which he does not believe in. He also does not think the government has the constitutional authority to offer the subsidies. 
“I take care of myself fine,” he says. “I’m not going to increase the debt or take money from a taxpayer.” 
Klemencic's total spending on health care last year amounted to $200 for dental checkups, he says, and he plans to continue paying for doctor visits out of pocket. He may have to pay a penalty for that choice, but first he is waiting on a Supreme Court case challenging the government's provision of subsidies in states that did not create their own insurance exchanges. The outcome of the case could exempt him and millions of others from the penalty. ...
Complicating the ethical question is that some people who qualify for subsidies based on their income could afford to pay their own way. “There is no question that we are enrolling people through these programs who would otherwise be considered middle-class or even affluent,” says Ed Haislmaier, a senior research fellow for health policy studies at the right-leaning Heritage Foundation think tank. “We are seeing people with enrollment in these programs that have significant assets, but for whatever reason – usually a temporary reason – fall below the income line.” ...
The fact that the subsidies are causing controversy among the very people they're intended to help is “evidence that the government doesn’t do charity very well,” says Michael Cannon, director of health policy studies at the libertarian Cato Institute think tank.

“Prior to Obamacare, the federal government was subsidizing all sorts of people who did not need health insurance subsidies,” he adds, referring to services like the Children's Health Insurance Program, Medicaid and Medicare, the government's health program for seniors. “With Obamacare, we are subsidizing even more people who don’t need assistance.” ... 
Steve Morgan, a self-employed insurance agent from Faribault, Minnesota, says he and his family pay more for private health insurance because he had a negative experience with the exchange website. 
"I had a strong feeling of distrust and absolutely no faith in this government program," Morgan, 61, tells U.S. News in an email. His family pays $14,000 a year in premiums and $2,600 in deductibles. If he were to take the subsidies, he could save a couple hundred dollars a month. "Yes, maybe I am lucky to afford these premiums, but we have cut donations to worthy causes and certainly do not go out very often."

Ed Anderson, an account manager at the Hawkins Insurance Group in Edina, Missouri, says he has clients who say they don’t want anything to do with Obamacare. “They think it’s inappropriate for the government to be involved in the first place,” he says. ...