Reader's View, health care: State exchange best for self-employed

Published: February 21, 2013 

If you're self-employed, I'm sure it is easier to get an assault weapon in Idaho than it is to get decent, affordable health insurance. That's why I'm a fan of the new Health Insurance Exchange now under the microscope in the Idaho Legislature.

I don't care if an exchange is part of the Affordable Care Act. No one has ever tried to sell me a Democratic or Republican health insurance plan. You just have to have it, and it makes sense to open up the market to more competition. A state-run exchange would operate closer to the Idahoans who will be served than a federally run exchange, so I can see the benefits of that, too.

I've been self-employed since 1986, so I'm an old hand at the individual health insurance Whac-A-Mole game. I've been insured by four different companies over the years, and I've even been to one company's shareholders meeting to question the way individual policies and pricing are handled.

I currently pay $380 a month for an individual policy with a $3,000 deductible. That isn't $3,000 per year - that's $3,000 "per incident." My insurer has told me that I don't qualify for any of the coverage improvements associated with the Affordable Care Act, because my policy was written before it went into effect. So, I'm in good physical shape and don't have any serious health conditions, but I pay for health insurance and also pay in full "at the time of service" for my annual checkup, mammogram, etc. I joke with my doctor that I'm saving up for a colonoscopy.

In 2012, my monthly premium was raised from $232 to $293. In 2013, it's been raised to $380. In both cases, I received form letters from my insurer citing "high health care costs" as the reason. I had not filed any claims.

Last year, I asked a local insurance broker to show me my options. He came up with only one - for about the same price and a higher deductible - that also included joining a "buyer's club" for discounts on other goods and services. What a racket! And only one policy?

This year, I looked online and applied for new health insurance - a policy with a $5,000 annual deductible, for $338 a month. I was turned down. Why? I had a single visit in 2012 to an orthopedic doctor, to check out some aching and tingling in my arm. I thought it might be carpal tunnel syndrome - but it wasn't, and I'm fine now. The insurance company cited a "recent carpal tunnel condition" as the reason for denying my application. And weren't they thoughtful for sending me information about Idaho's High Risk Reinsurance Pool? The individual HRP rates for a female nonsmoker at my age range from $466 to $1,081 per month, for what amounts to catastrophic coverage - much like what I have now.

Luckily, the orthopedic doc says he'll help me fight the denial. In the meantime, I'm counting on the Idaho Legislature - perhaps a gamble more dangerous than being uninsured - to do the right thing and give me and thousands of other people a shot at better, more affordable health care. Make the insurers work as hard to protect our health and deserve our business as we now have to work to stay insured at all.

Chris Thomas of Boise is a self-employed writer and editor.

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