Now that health care reform has passed, ever wonder how much you’ll have to pay for health insurance if you carry no employer-based insurance in 2014?
I have spent some time entering sample scenarios to a helpful Health Reform Subsidy Calculator from the Henry J. Kaiser Family Foundation. The calculator helps you understand the government subsidy you might acquire for insurance based on your income now vs. 2014, age, employment status, difference between a single person insured vs. a family of four, all adjusted with a regional “cost factor” based on where you live.
Some interesting cut-offs were noted and I have highlighted a few examples using their calculator:
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If a 30 year old man without employer-based insurance enters a government insurance “pool” and makes $15,302, then he will have his insurance paid my Medicaid and pay a “modest” out-of-pocket amount for coverage, depending on his state. If he makes one dollar more ($15,303), his premium will become $3,404 annually, for which the government will provide a tax credit of $2,981 and will require an unsubsidized payment from the patient of $459. This does not include an additional $2,083 of out-of-pocket expenses for health care used, resulting in a possible total cost to the individual of $2,542. (16.6 percent of his income).
If the same person is 49 years old instead and and makes the same $15,303, the premium rises to $6,717, but the government picks up a larger share so the unsubsidized payment for insurance remains $459 and the out-of-pocket expenses remain $2,083.
Now, if the 49 year old has to cover a family of four and makes $31,155 without employer-based insurance, he and his family will be covered by Medicaid. But if this individual makes one dollar more ($31,156), his premium for insurance will be $16,360 with the government crediting the individual for $15,425 for a total unsubsidized annual premium of $935. Out-of-pocket expenses for health care services for this individual and his family rises to $4,167 for a total cost of $5,102 annually (16.4 percent of their total annual income).
Finally, if we take a person making $200,000 annually at age 49 who is has no employer-based insurance, their premium jumps to $16,300 annually with no government subsidy available and an additional $12500 in out of pocket expenses to be paid ($28,800 annually, or 14 percent of their income).
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What is clear is that health care is about to get MUCH more expensive for the majority of Americans, even those from the government’s definition of “middle class.”
Take some time and enter your information to see where you’ll be under the new law when it takes effect. The results are eye-opening.
Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005. He writes regularly at Dr. Wes. DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.
