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ACA health insurance covers the unexpected for retired salesman

March 1, 2017

By BETSY TAYLOR

chw_coverageiscriticalboxJohn Bower tripped on a concrete barrier, lost his balance and conked his head in a Rolla, Mo., parking lot in early 2016.

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John Bower

His wife drove him to the hospital, where he got stitches to close his head gash and received a concussion diagnosis. The medical bills for the visit totaled about $6,000. Much of that was covered by a family health insurance policy that the Bowers purchased through healthcare.gov, the federal marketplace established by the Affordable Care Act.

The retired piano salesman from Creve Coeur, Mo., now 64, says he and his wife pay about $6,400 annually for the subsidized coverage, with a $4,700 individual deductible.

That's slightly less than they paid for the previous high deductible, catastrophic health care coverage they had until their ACA-enabled coverage went into effect in 2014. Bower says the ACA allowed the couple's daughter to be on her parents' insurance while she was in graduate school. She then bought her own health insurance policy through the ACA until she found a job that offered health insurance.

Bower says his pre-ACA policy had deductibles about double those of his current policy.

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Carolyn and John Bower

Although the policy purchased on the ACA marketplace has copay and coinsurance requirements in addition to the deductible, Bower says the coverage makes routine and preventive care affordable.

Bower will drop off the ACA plan when he qualifies for Medicare coverage later this year. He worries about how the proposed repeal of the ACA could impact millions of Americans who stand to lose coverage including his spouse, currently covered through the ACA. Bower says the ACA "gives us many wonderful things" including insurance coverage for those with preexisting medical conditions, subsidies that make insurance affordable and Medicaid expansion that has helped millions of Americans get coverage.

Bower doesn't think the ACA should be repealed, and he certainly doesn't think Americans should tolerate the repeal of the ACA before politicians have a better alternative in place.

Health care, he says, is a human right, and providing access to care for all is an ethical and moral imperative.

If the ACA is repealed without a viable replacement, and the number of uninsured soars again, he fully expects that financial worry will lead people to seek care only when their conditions have deteriorated to the point they can no longer be ignored. "We all pay for that eventually," he says.

 

Copyright © 2017 by the Catholic Health Association of the United States
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